Is this Statement about operating a piece of equipment or machinery?:

If so, what sort of machinery or equipment?:
(Bulldozer, crane, surveyor's tools, etc.)

Type of Skill or Work Experience:

(Please provide a brief description here, to allow us to categorize your statement.)

Time Period for Statement:

(What date or range of dates would this statement apply to?)

Statement of Experience or Skill:

(Be detailed! Fully describe the work assignment, special skill, or nature of the project so that a non-railroad person can understand what you're describing and why it is important!)

Other Facts or Information:

(Please provide other details you feel are important to share as it describes your skills, training, or experience with the work described.)

Is this Statement related to a claim or grievance you are currently listed on?