Ds 1663-2026

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The document outlines the procedures and requirements for reporting mishaps resulting in injuries, illnesses, property damage, or environmental contamination within U.S. Government operations. It includes detailed instructions on completing the Report of Mishap (DS-1663), specifying information needed such as nature of injury, location, and corrective actions to prevent future incidents. The report aims to inform safety officials and ensure compliance with occupational safety regulations.

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Click ‘Get Form’ to open the DS-1663 in the editor.
Begin by filling out Section I: Mishap Information. Enter the Agency, Post/City, and Organizational Symbol as applicable.
Provide details about the mishap including Date, Time, Location, and a Detailed Description of what occurred.
In Section II: Personal Information, input the Name, Gender, Date of Birth, and Job Category of the individual involved.
Proceed to Section III: Injury/Illness Information. Check all relevant boxes for Severity and provide specifics on Nature of Injury or Illness.
Complete Section IV: Property Damage Information if applicable. Indicate Estimated Amount of Property Damage and Type of Property.
In Section V: Corrective Action, describe actions taken to prevent future occurrences.
Finally, ensure that Sections VI are signed by the Supervisor and POSHO before submitting your form.

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Versions	Form popularity	Fillable & printable
2018	4.8 Satisfied (94 Votes)

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