Burlington System Division
— BMWED-IBT
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    Upcoming Events
    Lodge 1489 Meeting
    Jun 13, 2023
     Crossroads Bar & Grill 900 County Road 480 Marquette, MI 49855
    Lodge 1488
    Jun 23, 2023
     Heidi's Bar 203 Marsh St Glenwood, MN 56334
    Lodge 1108 Meeting
    Jul 06, 2023
     CLC Building, 723 Flack Ave., Alliance, NE
    Lodge 1320 Meeting
    Jul 13, 2023
     DAV, 3901 N 70th St., Lincoln, NE
    Lodge 800 Meeting
    Jul 19, 2023
     Paul and Jacks Tavern, 1808 Clay St., North Kansas City, MO
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  • Witness Statement Online
    Sample form below. You can edit this form and edit this text. The text will show up at the top of the form page, just as you see it now. You can edit the form using the buttons above.
     
    First name:
    Last Name:
    Email Address:
    Employee Number:
    Position at Time of Statement:
    Is this regarding a Claim? YES                NO
    If YES, what Claim?

    Location of Witnessed or Discovered 

    Work or Violation

    Detailed Description of what you Witnessed

    What was done?

    Who was there?

    When did it happen, and for how long?

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