Af Form 978 Supervisor S Mishap Report
Af Form 978 Supervisor S Mishap Report – AF Form 978, Inspector’s Accident Report, is a necessary document to help safety professionals identify individuals and obtain the personal information needed to complete accident reports.
The latest version of the leaflet was issued by the US Air Force (AF) on April 9, 2014, all previous versions are obsolete. A printable version of AF Form 978 is available for download below or can be found through the Air Force E-Publications website.
Af Form 978 Supervisor S Mishap Report
Additional information and suggested guidelines can be found in Air Force Instruction (AFI) 91-204, Security Studies and Threat Reports. These guidelines provide general guidance for investigating and reporting United States Air Force security incidents. It applies to commanders, managers, supervisors and security personnel at all levels, those who investigate and report Air Force incidents, and those who prepare such reports. The guidelines also provide information on monitoring and using privileged security reports.
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Accidents are classified by the total direct cost of the accident and the severity of the injury or occupational disease and include:
This form is used to establish the severity of injuries/illnesses and to ensure proper reporting within the Air Force, to determine the causes of illnesses/injuries so that leaders and functional managers can take appropriate action to eliminate or control unsafe and unhealthy conditions. Prepare statistical and historical reports as required by DoD and provide documentation for the total set of treatment reasons.
A supervisor accident report must be completed for any minor or serious injuries, whether they occur on or off duty. The document is then submitted to the security office. The sheet is used by unit commanders and wing safety to document ground casualties. The installation’s ground safety manager reviews the form to determine reporting and ensure appropriate documentation. The form shall be completed by the injured employee’s supervisor and returned to the appropriate safety office within five working days of notification of the accident or accident.
AF Form 978 provides detailed factual and analytical information about accidents. Accident information includes: full name, grade/rank, age, gender, unit/office designation, job title, duty phone, date of accident, time of accident, occurrence of accident, duty status, scheduled days of work , shift hours, hours on duty before the accident occurred, weather conditions, lighting conditions, number of days since last deployment, number of days deployed in the last 365 days, location of the accident, details of the accident, witnesses and their names, condition person, type of injury, body part) injuries, toxicity test and treatment.
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The Property Damage section includes property details, vehicle details, type/date of study, property and vehicle damage details, repair and material costs, seat belt use, speeding, alcohol. The “Chief, Unit Security Representative, Commander, and Security Office Review and Signature” section contains these officers’ names, rank/rank, duty phone numbers, and signatures.
The Safety Office will fill out the following boxes: Reportable – Check the Yes or No box, AF Automatic Safety System Number, Accident Category, Date the accident was reported to Safety, Non-Reportability Certificate, and Signature.
And ensuring proper reporting within the Department of the Air Force; (b) Identify the causes of illnesses/injuries up to supervisors and functional managers
Take appropriate measures to eliminate or control hazardous and unsanitary conditions; (c) Prepare the statistical and historical reports required by Executive Order No. 12196
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22. Description of the accident (who, what, when, where and why; state the cause(s); use more paper if space is needed)
The information contained herein is for Official Use Only (FOUO) and must be protected in accordance with the Privacy Act of 1974, as amended. unauthorized disclosure or
The information herein is for Official Use Only (FOUO) and must be protected in accordance with the Privacy Act of 1974, as amended. unauthorized disclosure or
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Pressing the PRINT button prints only the current page. Download the document to your desktop, tablet or smartphone to print in full. AF Form 707, Officer Performance Report (LT Thru COL) is used to document potential and performance as well as provide information for promotion recommendation. , the act of choosing or justifying; selection duration; forced separation; selective retirement; assignment; enrollment and school selection; and other management decisions. The evaluation system focuses on performance. How well a person does their job and the qualities they bring to the job are important to the Air Force.
The latest version of the leaflet was issued by the US Air Force (AF) on 31 July 2015. A fillable AF Form 707 is available for download below. Additional information and documentation instructions can be found in AFI 36-2406, Officer and Enlisted Rating Systems. The manual provides guidelines and procedures for implementing AF evaluation system policies for the Officer Evaluation System (OES) and the Enlisted Evaluation System (EES).
(Only fill in if the report contains reference comments or does not meet the general criteria of the standard block)
I refer you to this OPR in accordance with AFI 36-2406, paragraph 1.10. It contains the comment(s)/rating(s) that constitute the report as defined in AFI 36-2406, paragraph 1.10.
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Confirm receipt by signing and identifying yourself below. Your signature only confirms that the referral report has been submitted; This does not imply acceptance or agreement
Rate or comment on the report. After signing, you have the right to receive a copy of this memorandum. You can submit disclaimer comments. Send your written comments to:
No later than 3 business days (30 for non-EAD members) from your appointment date. If you need more time, you can request an extension from the people listed above. you can
Submit attachments (limited to 10 pages), but they must be directly related to the reason for citing this report. Relevant appendices not placed elsewhere are attached
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Report to file in your personnel record. Copies of previous reports, etc., submitted as attachments, will be removed from your denial packet prior to submitting these documents.
Already recorded in your record. Your disclaimer comments/attachments may not reflect the character, conduct, integrity or intentions of the evaluator unless you are absolutely unable to do so.
Their approval and documentation. Contact MPS, the Force Management Section, or the AF Contact Center if you need any assistance in preparing your appeal report response.
It is important for you to be aware that receiving a referral report may affect your eligibility for other employee-related actions (such as appointment, promotion, etc.). You can consult
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If you would like more information on this matter, your commanding officer and/or MPS or the Air Force Communications Center. If you believe this report is inaccurate, unfair or unfairly biased against you
The carrier may request a review of the report in accordance with AFI 36-2406, Chapter 10, Correction of Officer and Enlisted Evaluation Reports, when the report becomes a matter of record.
Recommendations should be based on performance and feasibility. Advertising recommendations are prohibited. Do not comment
Developmental education, advanced education, promotion recommendations or anticipated promotion on AF Form 709, completion or enrollment at the OPR support level,
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Family activity, marital status, race, gender, ethnic origin, age, religion or sexual orientation. Evaluators enter only the last four digits of the SSN.
Focus your evaluation in Section IV on what the officer did, how well he did it, and how the officer contributed to the mission. Write briefly
“Bull” format. Your comments in Section IV may include recommendations for the assignment. Submit the report to the rating before compiling the report
Record and provide follow-up feedback to let the rater know how their performance contributed to the final product.
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Review the reviewer’s ratings carefully to ensure they are accurate, fair, and unbiased. If you disagree, you can ask the rater to revise your rating
Assessment. You cannot direct changes in the rating. If you still disagree with the rater, mark “NON-CONCUR” and comment. You can include a recommendation
Carefully review the ratings and comments of the reviewer and supplement. If their assessment is correct, fair and passive, mark and sign “CONCUR”.
Form If you do not agree with the previous raters, you can ask them to revise their rating. You cannot instruct them to change their rating. If you still don’t agree
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Mark the additional evaluator, “NON-CONCUR” and comment in Section VI. Do not use “NON-CONCUR” only to provide comments in the report.
Your signature only confirms receipt of this report. This is not consent. If you do not agree with the content, you can rate
File an appeal through the Evaluation Report Appeals Board IAW AFI 36-2406 Chapter 10 (Correction Officers and Enlisted Evaluation Reports) or through the Air Force Board.
Correction of military records IAW AFI 36-2603 (Air Force Board for Correction of Military Records) and AFPAM 36-2607 (Applicant’s Guide to Air Force Board for Correction)
Af Form 978 Download Fillable Pdf Or Fill Online Supervisor’s Mishap Report
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