Burlington System Division
— BMWED-IBT
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    Upcoming Events
    Lodge 1533 Meeting
    Apr 15, 2021
     IAMAW Local 1010 Hall 16542 US-34 West Burlington
    Lodge 509 Meeting
    May 08, 2021
     Leisure Time, Prairie du Chien, WI
    Lodge 1533 Meeting
    Jun 17, 2021
     IAMAW Local 1010 Hall 16542 US-34 West Burlington
    Lodge 509 Meeting & Family Picnic
    Aug 14, 2021
     Stoddard Park, Stoddard, WI
    Lodge 1533 Meeting
    Aug 19, 2021
     IAMAW Local 1010 Hall 16542 US-34 West Burlington
  • 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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