Official Oklahoma Traffic Collision Report Form Fill Out This Document Online

Official Oklahoma Traffic Collision Report Form

The Oklahoma Traffic Collision Report form is a comprehensive document used to record details about vehicular collisions within the state of Oklahoma. It is essential for capturing a wide array of data, from the basic information about the vehicles and individuals involved, to specifics about the collision scene, injuries sustained, and any property damage. Understanding how to correctly fill out this form is crucial for anyone involved in a traffic collision in Oklahoma. To ensure accurate and prompt documentation of a traffic collision, click the button below to learn more about filling out the form.

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Outline

When a traffic collision occurs in Oklahoma, the meticulously structured Oklahoma Traffic Collision Report form serves as an essential document, capturing a comprehensive array of details surrounding the incident. Positioned as a cornerstone in post-accident investigations, this form encompasses sections designed to chronicle crucial information such as the investigation status, specifics of the crash site, including the location, date, time, and environmental conditions, alongside data pertaining to the involved parties, vehicles, and the extent of injuries or fatalities. Moreover, it addresses the intricacies of vehicle operations at the incident moment, with fields dedicated to capturing actions preceding the collision, vehicle positions, and the deployment of safety equipment such as airbags. The form further delves into the categorization of the collision, distinguishing events that lead to the mishap, and provides space for supplemental information regarding those affected - ensuring a detailed narrative and a spatial understanding of the crash. Such systematic documentation is crucial not only for law enforcement and insurance assessments but also offers invaluable data for scrutinizing traffic patterns and implementing measures aimed at enhancing road safety. This multifaceted form embodies the thorough approach adopted by Oklahoma to address and analyze traffic collisions, highlighting the state's commitment to road safety and the well-being of its citizens.

Form Sample

 

 

 

 

Y

 

N

Pg

of

 

 

 

Incident Report

 

 

 

 

 

 

 

[

DO NOT WRITE IN THIS SPACE

]

 

 

 

 

 

Y N

 

 

 

Investigation Completed

 

 

Revised

 

 

 

 

OFFICIAL OKLAHOMA TRAFFIC COLLISION REPORT

 

Investigation Made at Scene

 

 

Fatality

 

 

 

 

 

Photographs

 

 

 

Hit and Run

 

 

 

 

 

 

 

 

 

 

 

 

(1) Reporting Agency

Case Number (Agency Use)

 

 

 

 

 

 

 

 

 

 

 

Motor Vehicles Involved

Number Injured

Number Killed

(2) Date of Collision (mm/dd/yyyy)

Time

 

County Number and Name

Nearest City or Town Number and Name

 

 

 

 

 

 

 

 

 

 

 

In

 

 

 

 

 

 

 

 

 

 

 

 

 

Near

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(3)

Distance from Nearest City or Town Limits

 

 

 

 

 

 

 

 

Control # Int ID

 

Location

 

 

 

 

East Grid

 

 

 

 

 

North

Grid

 

 

 

 

Administrative

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mi.

 

 

 

N

 

 

 

 

 

 

 

Mi.

 

 

 

 

E

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

+

 

 

 

 

 

 

 

 

 

+

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ft.

 

 

 

 

S

 

 

 

 

 

 

Ft.

 

 

 

 

W

 

 

 

 

 

 

 

 

 

 

 

 

 

 

.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(4)

 

Street,

Road or

Highway

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Distance from

 

 

 

 

 

 

(Nearest) Intersecting Street, Road or Highway

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

At

 

 

 

 

 

 

 

 

 

 

Mi.

 

 

 

N E

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ft.

 

 

 

S W of

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(5)

Unit

 

Occupants

 

Type

 

Hit &

 

 

 

Last Name

 

 

 

 

 

 

 

 

 

First

 

 

 

 

 

 

 

 

 

 

Middle

 

 

 

 

 

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

 

 

 

Sex

 

 

 

 

 

 

 

 

 

 

 

 

 

Run

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CMV

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(6)

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

 

 

 

 

 

 

 

State

Zip

 

 

 

 

 

 

 

 

Telephone

 

(Use Area

 

Code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(7) Driver License Number

State

Class Endorsement(s)

 

Restriction(s)

 

Inj. Sev. Type of Injury

Drv./Ped. Cond. OP Use

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(8)

 

Ejected Extricated Test

 

(% BAC) Transported by

 

 

 

 

 

To Medical Facility

 

 

 

 

 

 

 

 

License

Plate Number

 

 

 

 

Air

 

 

 

 

 

 

 

 

 

 

 

0.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Bag

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(9) VIN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle Year

 

Color

 

2nd Color

Make

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(10)

 

 

 

 

 

 

 

Insurance Company Name

 

 

 

 

 

 

 

 

 

 

 

 

 

Policy Number

 

 

 

 

 

 

 

 

 

 

 

 

 

Insurance

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Verification

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(11) Vehicle Removed by

 

 

 

 

 

 

 

 

Owner's Last Name

 

 

 

 

 

 

First

 

 

 

 

 

 

State Month Year

Model

Veh. Conf.

Extent of

Damage

Insurance Telephone (Use Area Code)

Middle Initial

Driver

 

 

 

 

(12) Owner's Address

City

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State

Zip

 

Towed Veh. Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Oversized

 

 

 

 

Rolled

 

Phone present

 

 

 

 

 

 

 

 

 

 

 

 

 

Load

 

 

 

 

 

 

Phone in use

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Burned

 

 

 

(13)

Citation

 

 

 

 

 

 

 

 

 

 

 

 

 

Statute/Ordinance

 

Citation

 

 

 

 

 

 

 

 

 

 

Statute/Ordinance

 

 

 

 

 

 

 

 

 

 

Number

 

 

 

 

 

 

 

 

 

 

 

 

 

Number

 

Number

 

 

 

 

 

 

 

 

 

 

Number

 

 

 

 

 

 

 

 

 

(14)

Unit

Occupants

Type

Hit &

 

 

Last Name

 

First

 

Middle

 

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

 

 

 

Sex

 

 

 

 

 

 

 

 

 

 

Run

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CMV

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(15)

Address

 

 

 

 

 

 

 

 

 

 

 

 

City

 

State

Zip

 

 

 

 

 

Telephone (Use Area Code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(16) Driver License Number

State

Class Endorsement(s)

 

Restriction(s)

 

Inj. Sev. Type of Injury

Drv./Ped. Cond. OP Use

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(17)

 

Ejected Extricated Test

 

(% BAC) Transported by

 

 

 

 

 

To Medical Facility

 

 

 

 

 

 

 

 

License

Plate Number

 

 

 

 

Air

 

 

 

 

 

 

 

 

 

 

 

0.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Bag

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(18)

VIN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle Year

 

Color

 

2nd Color

 

 

 

Make

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(19)

 

 

 

 

 

 

 

Insurance Company Name

 

 

 

 

 

 

 

 

 

 

 

 

 

Policy Number

 

 

 

 

 

 

 

 

 

 

 

 

 

Insurance

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Verification

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(20)

Vehicle Removed by

 

 

 

 

 

 

 

 

Owner's Last Name

 

 

 

 

 

 

First

 

 

 

 

 

 

 

 

 

State Month Year

Model

Veh. Conf.

Extent of

Damage

Insurance Telephone (Use Area Code)

Middle Initial

Driver

 

 

 

 

(21) Owner's Address

City

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State

Zip

 

Towed Veh. Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Oversized

 

 

 

 

Rolled

 

Phone present

 

 

 

 

 

 

 

 

 

 

 

 

 

Load

 

 

 

 

 

 

Phone in use

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Burned

 

 

 

(22) Citation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Statute/Ordinance

 

 

 

 

 

 

 

 

 

 

Citation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Statute/Ordinance

 

 

 

 

 

 

 

Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Number

 

 

 

 

 

 

 

 

 

 

 

 

Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Number

 

 

 

 

 

 

 

 

 

 

 

 

(23) Investigating Officer

 

 

 

 

 

 

 

 

 

 

 

Badge Number

 

 

 

 

 

Troop/Div.

 

 

 

Reviewed by (Init.)

 

Reviewer Badge Number

 

Date of Report (mm/dd/yyyy)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unit Type

 

 

 

Injury Severity

 

 

 

 

Type of Injury

 

 

 

 

Driver/Pedestrian Condition

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Occupant Protection (OP) In Use

 

 

 

 

 

D Driver

 

Z Other Cyclist

0

N/A

 

4

Incapacitating

0

N/A

3

Trunk -

00

Not Applicable

 

 

05 Under the

08

Ill (Sick)

 

 

 

00

Not Applicable

 

05

Child Restraint Type Unknown

 

10 Booster Seat

P Pedestrian

 

C Parked Car

1

No Injury

5

Fatal

 

 

1 Head

4

Internal

01

Apparently Normal

 

 

 

 

Influence of

09

Dizzy/Faint

 

 

01 None Used

 

06

Restraint Type Unknown

 

11 Other

X Pedestrian

 

A Animal

2

Possible

6

Unknown

 

 

2 Trunk -

Arms

02

Drinking - Ability Impaired

Medications

10

Emotional

 

 

02

Lap Belt Only

 

07

Helmet

 

 

 

 

 

 

 

 

99 Unknown

 

Conveyance

 

T Train

3

Non -

 

 

 

 

 

 

 

 

External

5

Legs

03

Odor of Alcohol Beverage 06

Very Tired

11

Other

 

 

 

03

Shoulder Belt Only

 

08

Child Restraint - Forward Facing

 

 

 

 

 

B Bicyclist

 

 

 

 

 

incapacitating

 

 

 

 

 

 

 

 

6

Unknown

04

Illegal Drugs

07

Sleepy

99

Unknown

 

 

04

Shoulder and Lap Belt

 

09

Child Restraint - Rear Facing

 

 

 

 

 

 

Air Bag Deployed

 

 

 

 

 

 

Ejected

 

 

 

 

Extricated

 

 

 

 

Chemical Test

 

Extent of Damage

 

Insurance Verification

Oversized Load

 

 

 

 

 

 

Towed Vehicle Type

 

 

 

0

Not Applicable

4

Deployed - Other (knee,

0

Not Applicable 3

Ejected,

 

0 N/A

 

 

0

N/A

 

 

 

4 Test Refused

0 N/A

3

Functional

0

N/A

3

Operator

0 N/A

00

N/A

 

 

 

 

05

Another Vehicle

09

Cattle Trailer

1

Not Deployed

 

air belt, etc.)

 

 

 

1

Not Ejected

Totally

 

1 No

 

 

1

Blood

 

 

 

5 None Given

1 None

4

Disabling

 

1

No

4

Exempt

N Not Permitted

01

Boat Trailer

06

Utility Vehicle

10

No Trailer in Tow

2

Deployed - Front 5

Deployed - Combination

2

Ejected,

9

Unknown

 

2 Yes

 

 

2

Breath

 

 

 

6 Other

2 Minor

9

Unknown

 

2

Owner

 

 

 

 

 

 

 

P Permitted

02

House Trailer

07

Homemade

11

Other

3

Deployed - Side

9

Deployment Unknown

 

Partially

 

 

 

 

 

 

 

 

 

 

3

Blood/Breath

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

03

Farm Trailer

08

Trailer

99

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

04

Horse Trailer

Box Trailer

 

 

 

 

 

WARNING - STATE LAW

 

Use of contents for commercial solicitation is unlawful

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

234

Case Number

 

 

 

 

Pg

 

of

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(24) Unit

Pos in Veh. Last Name

First

Middle Initial

Date of Birth (mm/dd/yyyy)

 

 

Sex

Injured

Witness

(25) Address

Passenger Prop. Owner

 

 

 

City

State

Zip

Telephone (Use Area Code)

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(26)

Injury Severity / Type

 

OP Use Air Bag Ejected

Extricated Transported by

 

 

To

Medical

 

Facility

 

 

 

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(27)

Unit

 

 

Pos in Veh. Last

Name

First

Middle Initial

 

Date of Birth (mm/dd/yyyy)

 

 

 

Sex

Injured

Witness

(28) Address

Passenger Prop. Owner

 

 

 

City

State

Zip

Telephone (Use Area Code)

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(29)

Injury Severity / Type

 

OP Use Air Bag Ejected

Extricated Transported by

 

 

To Medical

 

Facility

 

 

 

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(30)

Unit

 

 

Pos in Veh. Last

Name

First

Middle Initial

 

Date of Birth (mm/dd/yyyy)

 

 

 

Sex

Injured

Witness

(31) Address

Passenger Prop. Owner

 

 

 

City

State

Zip

Telephone (Use Area Code)

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(32)

Injury Severity / Type

 

OP Use Air Bag Ejected

Extricated Transported by

 

 

To Medical

 

Facility

 

 

 

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(33)

Unit

 

 

Pos in Veh. Last

Name

First

Middle Initial

 

Date of Birth (mm/dd/yyyy)

 

 

 

Sex

 

 

Injured

 

Passenger

 

 

 

 

 

 

 

 

 

 

Witness

 

Prop. Owner

 

 

 

 

 

 

 

 

(34) Address

 

 

 

 

 

 

 

City

State

Zip

Same as Driver

Telephone (Use Area Code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(35) Injury Severity / Type

 

OP Use Air Bag Ejected Extricated Transported by

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

To Medical Facility

Property Type

Complete information below if this vehicle is being used for COMMERCE/BUSINESS and has a GVWR/GCWR IN EXCESS OF 10,000 LBS., or has a HAZMAT PLACARD, or is a BUS WITH SEATING FOR NINE OR MORE INCLUDING THE DRIVER

 

(36)

Unit

Carrier Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(37)

City

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State

 

Zip

 

GVWR

 

 

 

0 - 10K lbs.

 

 

 

Axle Qty. Cargo Body

Vehicle Use

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10,001 - 26K lbs.

 

 

 

 

 

 

 

 

 

 

Interstate Commerce

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GCWR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

26K+ lbs.

 

 

 

 

 

 

 

 

 

 

Intrastate Commerce

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(38)

U.S. DOT Number

 

 

 

 

 

Vehicle Inspection Number

 

 

 

 

 

 

 

 

Placard Number

 

Haz. Mat. Class Haz. Mat. Involved

 

Haz.

Mat.

Release

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other Non-Commercial

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OK

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yes

 

 

 

 

 

Yes

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

No

 

 

 

 

 

 

No

 

 

 

Government

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(39)

Unit

 

Carrier Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State

(40)

City

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(41)

U.S. DOT Number

 

 

 

 

 

Vehicle Inspection Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OK

 

 

 

 

 

 

 

 

 

 

 

Zip

 

GVWR

 

 

 

0 - 10K lbs.

 

 

 

Axle Qty. Cargo Body

Vehicle Use

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10,001 - 26K lbs.

 

 

 

 

 

 

 

 

 

 

 

Interstate Commerce

 

 

 

 

 

 

 

 

 

 

 

 

GCWR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

26K+ lbs.

 

 

 

 

 

 

 

 

 

 

 

Intrastate Commerce

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Placard Number

 

Haz. Mat. Class Haz. Mat. Involved

 

Haz.

Mat.

Release

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yes

 

 

 

 

 

Yes

 

 

 

 

Other Non-Commercial

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

No

 

 

 

 

 

No

 

 

 

Government

 

Position in Vehicle

00.Not Applicable

18.Front Row - Other

28.Second Row - Other

38.Thrid Row - Other

48.Fourth Row - Other

Vehicle Configuration

00.

N/A

 

 

 

 

 

 

07. School Bus

13. Bus/Large Van

18.

Farm

 

 

 

9-15 occupants

 

Machinery

01.

Passenger

 

including driver

 

 

 

Veh.-2 Dr

08. Truck/Trailer

 

 

 

02.

Passenger

 

 

 

 

 

 

 

 

Veh.-4 Dr

 

 

 

 

03.

Passenger

 

14. Bus 16+

19.

ATV

 

Veh. Conv.

 

 

 

 

09. Truck-Tractor

occupants

 

 

 

 

including driver

 

 

 

 

(Bobtail)

 

20. SUV

 

 

 

 

04.

Pickup

10. Truck-Tractor/

 

 

 

 

 

15. Motorcycle

 

 

 

 

Semi-Trailer

 

21.

Passenger Van

 

 

 

 

05.

Single Unit

 

 

22.

Truck more

11. Truck-Tractor/

 

 

than 10,000

 

Truck, 2 axles

16. Motor Scooter/

 

 

 

Double

Moped

 

lbs., Cannot

 

 

 

 

Classify

 

 

 

 

 

 

 

 

 

23.

Van 10,000

 

 

 

 

 

lbs. or Less

06.

Single Unit

12. Truck-Tractor/

 

24.

Other

 

Truck, 3+ axles

Triple

17. Motor Home

99.

Unknown

Cargo Body Type

00.

N/A

 

 

 

 

 

 

06.

Intermodal

11.

Hopper (grain/

01.

Bus 9-15 seats

 

 

 

chips/gravel)

 

 

 

 

 

 

07.

Dump Truck/

12.

Pole Trailer

02.

Bus 16+ seats

 

Trailer

 

 

 

 

03.

Van/Enclosed

08.

Concrete Mixer

13.

Log Trailer

 

Box

 

 

 

 

04.

Cargo Tank

09.

Auto Transporter

14.

Vehicle Towing

 

 

 

 

 

Vehicle

 

 

 

 

15.

Other

05.

Flatbed

10.

Garbage/Refuse

99.

Unknown

235

Case Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OFFICIAL OKLAHOMA TRAFFIC COLLISION REPORT

Pg

 

 

of

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Lanes

Legal

 

 

 

 

 

 

 

 

Pedestrian / Pedalcyclist Only

 

 

 

 

 

 

 

 

 

Was the collision in or near a construction, maintenance or utility

Yes

 

 

 

Unit

Actions Prior

Location at Time

Safety

Unit Number of

 

 

 

 

in Roadway

Speed

 

 

 

 

 

 

 

work zone? (If yes, complete this section)

 

 

 

No

This unit will

 

 

 

 

to Collision

of Collision

Equip.

Vehicle Striking

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

correspond

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Type of Work Zone

 

 

 

Location of the Work Zone

to 'Unit 1'

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Collision

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

This unit will

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

Lane Closure

 

 

 

 

 

 

 

 

 

 

1 Before the First Work

 

 

 

 

correspond

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

Lane Shift/Crossover

 

 

 

 

 

 

 

Zone Warning Sign

 

 

 

 

to 'Unit 2'

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3 Work on Shoulder or Median

 

 

 

2

Advance Warning Area

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Light

 

 

 

 

 

 

What

 

Unit 1

 

 

 

 

Unit 2

 

 

Underride/

 

 

Unit 1

Unit 2

 

 

 

 

4 Intermittent or Moving Work

3

Transition Area

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9

Unknown

 

 

 

 

 

 

 

 

 

 

4

Activity Area

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Override

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5

Termination Area

 

 

 

 

1

Daylight

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Was Going

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9

Unknown

 

 

 

 

 

 

 

2

Dark-Not Lighted

 

 

 

 

 

to Do

 

 

 

 

 

 

 

 

 

 

 

 

0

 

Not Applicable

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

Dark-Lighted

 

 

00

Not Applicable

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

 

No Underride or Override

 

 

 

 

 

 

 

 

 

 

 

 

Workers Present Yes

No

 

 

 

Unknown

 

 

 

 

 

 

 

4

Dawn

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

01

Go Ahead

 

 

 

 

 

 

 

 

 

2

 

Underride, Compartment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5

Dusk

 

 

02

Turn Left

 

 

 

 

 

 

 

 

 

 

 

Intrusion

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unit 1

Unit 2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unit 1

 

Unit 2

6

Dark-Unknown

 

 

03

Turn Right

 

 

 

 

 

 

 

 

 

3

 

Underride, No

 

 

 

 

 

 

 

 

Trafficway

 

 

 

 

 

 

 

 

 

 

 

 

Unsafe / Unlawful

 

 

 

 

 

 

 

 

 

 

 

Lighting

 

 

04

Make “U” Turn

 

 

 

 

 

 

 

 

 

 

 

Compartment Intrusion

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Contributing Factors

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7

Other

 

 

05

Stop

 

 

 

 

 

 

 

 

 

 

 

 

4

 

Underride, Compartment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9

Unknown

 

 

06

Slow for Cause

 

 

 

 

 

 

 

 

 

 

 

Intrusion Unknown

 

 

 

 

 

 

0

Not Applicable

 

 

 

 

 

 

 

 

FAILED TO YIELD

 

 

 

49

Tires

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

07

Start from Park/Stop

5

 

Override, Motor Vehicle in

1

Two-Way, Not Divided

 

01

From Stop Sign

 

 

 

50

Suspension

 

 

 

 

 

 

 

 

 

 

 

 

 

08

Change Lanes

 

 

 

 

 

 

 

 

 

 

 

Transport

 

 

 

 

 

 

 

 

 

 

 

 

2

Two-Way, Not Divided

 

02

From Yield Sign

 

 

 

51

Headlights

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Weather

 

 

 

 

09

Overtake

 

 

 

 

 

 

 

 

 

6

 

Override, Other Motor

 

 

 

with a Continuous Left

 

03

Private Drive

 

 

 

52

Tail Lights

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10

Pass

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Turn Lane

 

 

 

 

 

 

 

 

 

 

04

County Road at

 

 

 

53

Stop Lights

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

01

Clear

 

 

11

Back

 

 

 

 

 

 

 

 

 

 

 

 

9

 

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

3

Two-Way, Divided,

 

 

 

 

 

 

Through Highway

 

54

Wheel

 

 

 

 

 

 

 

02

Fog/Smog/Smoke

 

 

12

Remain Stopped

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unprotected (painted > 4

 

05

From Signal Light

 

55

Exhaust System

 

 

 

 

 

 

 

 

 

 

 

 

 

Traffic

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

03

Cloudy

 

 

13

Remain Parked

 

 

 

 

 

 

 

Unit 1

 

Unit 2

 

 

 

feet) Median

 

 

 

 

 

 

 

 

06

From Alley

 

 

 

56

Windshield Wipers

 

 

 

 

04

Rain

 

 

14

Enter/Merge in Traffic

 

 

Control

 

 

 

 

 

 

 

 

 

 

 

 

 

4

Two-Way, Divided,

 

 

 

 

 

07

To Pedestrian

 

 

 

57

Other Mechanical Defects

05

Snow

 

 

15

Negotiate a Curve

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Positive Median Barrier

 

08

To Vehicle on Right

 

LEFT OF CENTER

 

 

 

 

06

Sleet/Hail (Freezing

16

Park

 

 

 

 

 

 

 

 

 

 

 

 

00

No Control

 

 

 

 

 

 

 

 

 

 

 

 

5

Two-Way, Divided, Cable

 

09

To Vehicle in

 

 

 

58

In Meeting

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Intersection

 

 

 

59

No Passing Zone (Unmarked)

 

Rain/Drizzle)

 

 

17

Other

 

 

 

 

 

 

 

 

 

01

Stop Sign

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Barrier

 

 

 

 

 

 

 

 

 

 

 

 

 

 

07

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10

To Emergency

 

 

 

60

Marked Zone

 

 

 

 

Severe Crosswind

 

 

99

Unknown

 

 

 

 

 

 

 

 

 

02

Traffic Signal

 

 

 

 

 

 

6

One-Way

9 Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicles

 

 

 

61

Other

 

 

 

 

 

 

 

08

Blowing Snow

 

 

 

 

 

 

 

 

 

Unit 1

 

 

 

 

Unit

2

 

03

Flashing Traffic Signal

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12

 

 

 

 

 

 

 

 

 

 

09

Blowing Sand, Soil,

 

 

 

What

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unit 1

Unit 2

 

Other

 

 

 

IMPROPER OVERTAKING

 

Dirt

 

 

 

 

Vehicle

 

 

 

 

 

 

 

 

 

 

 

04

School Zone Signs

 

 

 

 

 

 

 

 

 

Vehicle

 

 

 

 

 

 

 

 

 

 

FOLLOWED TOO

 

 

 

62

In Marked Zone

 

 

 

 

10

 

 

 

 

 

Did

 

 

 

 

 

 

 

 

 

 

 

 

05

Yield Sign

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Removal

 

 

 

 

 

 

 

 

 

 

CLOSELY

 

 

 

63

On Hill/Curve

 

 

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

06

Warning Sign

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13

Human Element

 

64

At Intersection

 

 

 

 

99

Unknown

 

 

00

Not Applicable

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

07

Railroad Advance

 

 

 

 

 

 

0

Not Applicable

 

 

 

 

 

 

 

 

14

Traffic Condition

 

65

Without Sufficient Clearance

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

01

Went Ahead

 

 

 

 

 

 

 

 

 

 

 

Warning Sign

 

 

 

 

 

 

1

Towed Due to

 

 

 

 

 

 

 

 

15

Weather Condition

 

66

Other

 

 

 

 

 

 

 

 

Locality

 

 

 

02

Turned Left

 

 

 

 

 

 

 

 

 

08

Railroad Cross Bucks

 

 

 

 

 

 

 

 

Vehicle Damage

 

 

 

 

 

UNSAFE SPEED

 

 

 

IMPROPER PARKING

 

 

 

 

 

 

 

 

 

 

 

 

03

Turned Right

 

 

 

 

 

 

 

 

 

09

Railroad Gates

 

 

 

 

 

 

2

Towed For Reasons

 

16

Driver's Ability (Age)

 

67

On Roadway

 

 

 

 

1

Residential

 

 

04

Entered “U” Turn

 

 

 

 

 

10

Railroad Signal

 

 

 

 

 

 

 

 

 

Other Than Damage

 

17

Inexperienced Driver -

68

Where Prohibited

 

 

 

 

2

Business

 

 

05

Stopped

 

 

 

 

 

 

 

 

 

11

No Passing Zone

 

 

 

 

 

 

3

Remained at Scene

 

 

 

 

 

 

Young

 

 

 

69

Other

 

 

 

 

 

 

 

3

Industrial

 

 

06

Slowed

 

 

 

 

 

 

 

 

 

12

Person (including flagger,

4

Driven from Scene

 

 

 

 

 

18

Exceeding Legal Limit

INATTENTION

 

 

 

 

4

School

 

 

07

Started From Park/Stop

 

 

law enforcement, crossing

9

Unknown

 

 

 

 

 

 

 

 

 

 

19

For Traffic Conditions

70

Distracted by Passenger in

5

Not Built-up

 

 

08

Entered Other Lane

 

 

 

 

 

13

guard, etc.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20

For Type of Roadway

71

Vehicle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unit 1

Unit 2

 

 

 

 

 

 

 

 

6

Mixed Use

 

 

09

Overtaking

 

 

 

 

 

 

 

 

 

Abnormal Control

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Gravel, Dirt, etc.)

 

Other Distraction Inside

7

Other

 

 

10

Passing

 

 

 

 

 

 

 

 

 

14

Posted Speed

 

 

 

 

 

 

 

 

Vehicle

 

 

 

 

 

 

 

 

 

 

 

 

21

For Ice or Snow on

 

72

Vehicle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9

Unknown

 

 

11

Backed

 

 

 

 

 

 

 

 

 

15

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

Condition

 

 

 

 

 

 

 

 

 

 

 

 

Roadway

 

 

 

Distraction From Outside

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12

Remained Stopped

 

 

 

 

 

99

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

22

Rain or Wet Roadway

 

 

Vehicle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Type of

 

 

 

13

Remained Parked

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

00

Not Applicable

 

 

 

 

 

 

 

 

23

Wind

 

 

 

73

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Intersection

 

 

 

14

Entered/Merged

 

 

 

 

 

 

 

Road

 

Unit 1

 

 

Unit

2

 

01

Apparently Normal

 

 

 

 

 

24

Other Weather

 

 

 

WRONG WAY

 

 

 

 

0

Not an Intersection

15

Departed Rdwy-Right

 

Surface

 

 

 

 

 

 

 

 

 

 

 

 

 

02

Brakes

 

 

 

 

 

 

 

 

 

 

 

Conditions

 

 

 

74

On One Way

 

 

 

 

16

Departed Rdwy-Left

 

 

 

 

 

Conditions

 

 

 

 

 

 

 

 

 

 

 

 

 

03

Headlights

 

 

 

 

 

 

 

 

 

 

25

Vehicle Condition

 

75

On Exit Ramp

 

 

 

 

1

Y-Intersection

 

 

17

Swerved Right

 

 

 

 

 

 

 

 

 

01

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

04

Steering

 

 

 

 

 

 

 

 

 

 

26

View Obstruction

 

76

On Entrance Ramp

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Dry

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

T-Intersection

 

 

18

Swerved Left

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

05

Tail Lights

 

 

 

 

 

 

 

 

 

 

27

On Curve/Turn

 

 

 

77

Other

 

 

 

 

 

 

 

3

Four-Way

 

 

19

Parked

 

 

 

 

 

 

 

 

 

02

Wet

 

 

 

 

 

 

 

 

 

 

 

 

06

Brake Lights

 

 

 

 

 

 

 

 

28

Impeding Traffic

 

IMPROPER START FROM

4

Intersection

 

 

20

Other

 

 

 

 

 

 

 

 

 

03

Ice/Frost

 

 

 

 

 

 

 

 

 

 

 

 

07

Tires/Wheels

 

 

 

 

 

 

 

 

29

Other

 

 

 

78

Parked Position

 

 

 

 

 

Five-Point, or More

99

Unknown

 

 

 

 

 

 

 

 

 

04

Snow

 

 

 

 

 

 

 

 

 

 

 

 

08

Suspension

 

 

 

 

 

 

 

 

IMPROPER TURN

 

 

 

79

Other

 

 

 

 

 

 

 

5

Intersection as Part

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

05

Mud, Dirt, Gravel

 

 

 

 

 

 

09

Signal lights

 

 

 

 

 

 

 

 

30

From Wrong Lane

 

80

ALCOHOL-DUI/DWI

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

of Interchange

 

 

 

Visibility Unit 1

 

 

 

 

Unit 2

06

Slush

 

 

 

 

 

 

 

 

 

 

 

 

10

Windows

 

 

 

 

 

 

 

 

 

 

31

From Direct Course

 

81

DRUG-DUI

 

 

 

 

6

Traffic Circle

 

 

 

Obscured

 

 

 

 

 

 

 

 

 

 

 

07

Water (standing, moving)

11

Truck Coupling/Trailer

 

32

Right

 

 

 

OTHER IMPROPER ACT/

7

Roundabout

 

 

 

 

 

by

 

 

 

 

 

 

 

 

 

 

 

 

08

Sand

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hitch/Safety Chains

 

 

 

 

 

33

Left

 

 

 

MOVEMENT

 

 

 

 

 

 

 

9

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

09

Oil

 

 

 

 

 

 

 

 

 

 

 

 

12

Mirrors

15

Other

 

34

Turn About/U-Turn

 

82

Failed to Signal

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

00

Not Applicable

 

 

 

 

 

 

 

 

 

10

Other

 

 

 

 

 

 

 

 

 

 

 

 

13

Wipers

99 Unknown

 

35

To Enter Private Drive

83

Disregarded Warning Signal

Incident Type

 

 

 

 

01

Trees

 

 

 

 

 

 

 

 

 

99

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

14

Power Train

 

 

 

 

 

 

 

 

36

In Front of Oncoming

 

84

Improper Use of Lane

 

 

 

 

02

Embankment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Traffic

 

 

 

85

Improper Backing

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

00

 

 

 

 

 

 

 

03

Building

 

 

 

 

 

 

 

 

 

 

 

 

Road Character

 

 

 

 

 

 

 

Special

 

Unit 1

Unit 2

 

37

Other

 

 

 

86

Apparently Sleepy

 

 

 

 

Not an Incident

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

04

Signs

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Function

 

 

 

 

 

 

 

 

 

 

 

 

38

CHANGED LANES

 

87

Failed to Secure Load

51

Private Property

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

05

Parked Vehicles

 

 

 

 

 

 

 

Grade

 

 

Unit 1

Unit 2

 

of Vehicle

 

 

 

 

 

 

 

 

 

 

 

 

UNSAFELY

 

 

 

88

Other

 

 

 

 

 

 

 

52

Deliberate Intent

 

 

 

 

 

 

 

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

06

High Weeds

 

 

 

 

 

 

 

 

 

 

Level

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

39

STOPPED IN

 

 

 

UNKN./NO IMPROPER ACT

53

Medical Condition

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

00

Not Applicable

 

 

 

 

 

 

 

 

 

 

 

 

 

07

Fences

 

 

 

 

 

 

 

 

 

2

 

Hillcrest

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TRAFFIC LANE

 

89

Deer in Roadway

 

 

 

 

54

Legal Intervention

 

 

08

Shrubbery

 

 

 

 

 

 

 

 

 

3

 

Uphill

 

 

 

 

 

 

 

 

 

 

 

 

01

School Bus

 

 

 

 

 

 

 

 

 

 

FAILED TO STOP

 

 

 

90

Animal in Roadway

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

55

Suicide

 

 

09

Ice, Snow or Frost on

4

 

Downhill

 

 

 

 

 

 

 

 

 

 

 

 

02

Transit Bus

 

 

 

 

 

 

 

 

 

 

40

For Stop Sign

 

 

 

91

Domestic Animal in Rdwy

57

Drowning

 

 

 

 

 

Windows

 

 

 

 

 

 

 

 

 

5

 

Sag (bottom)

 

 

 

 

 

 

03

Intercity Bus

 

 

 

 

 

 

 

 

41

For Traffic Signal

 

92

Avoiding Other Vehicle

58

Other

 

 

10

Smoke

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

04

Charter Bus

 

 

 

 

 

 

 

 

42

For School Bus

 

 

 

93

Avoiding Pedestrian

 

 

 

 

 

 

 

 

11

Fog

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Horizontal

 

 

Unit 1

Unit 2

05

Other Bus

 

 

 

 

 

 

 

 

 

 

43

For Railroad Gates/

 

94

Object/Debris in Roadway

Location of

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12

Dust

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Alignment

 

 

 

 

 

 

 

 

 

 

 

 

06

Military

 

 

 

 

 

 

 

 

 

 

 

Signal

 

 

 

95

Defect in Roadway

 

 

 

 

First Harmful

 

 

 

 

13

Rain

 

 

 

 

 

 

 

 

 

 

 

 

1

 

Straight

 

 

 

 

 

 

 

 

 

 

 

 

07

OHP

 

 

 

 

 

 

 

 

 

 

 

 

44

For Officer/Flagman

 

96

Abnormal Traffic Control

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Event

 

 

14

Sun

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

08

Other Police

 

 

 

 

 

 

 

 

45

At Sidewalk/Stopline

 

97

Improper Bicyclist Action

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

 

Curve - Left

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

01

On Roadway

 

 

15

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

09

Other Law Enforcement

 

46

Other

 

 

 

98

NO IMPROPER ACTION BY

 

 

 

 

 

 

 

 

 

 

 

3

 

Curve - Right

 

 

 

 

 

 

 

 

 

 

02

Shoulder

 

 

99

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10

Ambulance

 

 

 

 

 

 

 

 

 

 

UNSAFE VEHICLE

 

 

 

DRIVER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

03

Median

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11

Fire Truck

 

 

 

 

 

 

 

 

 

 

47

Brakes

 

 

 

99

PEDESTRIAN ACTION

04

Roadside

 

 

 

 

Driver

 

 

Unit 1

Unit 2

 

 

Road

 

 

Unit 1

Unit 2

12

Public Owned Vehicle

 

48

Steering

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

05

Gore

 

 

 

Distracted

 

 

 

 

 

 

 

 

 

 

Surface

 

 

 

 

 

 

 

 

 

 

 

 

13

Highway Equipment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unit

1

 

 

Unit

2

 

 

 

 

 

 

 

 

06

Separator

 

 

 

 

 

by

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Type

 

 

 

 

 

 

 

 

 

 

 

 

14

Special Mobilized Machine

 

Point of First

 

 

 

 

 

 

 

 

 

 

 

07

Parking Lane/Zone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

 

Concrete

 

 

 

 

 

 

 

 

 

 

 

 

15

Other

 

 

99 Unknown

 

Contact on

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

0

Not Applicable/None

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

08

Off Roadway,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

Electronic Communication

2

 

Asphalt

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Emergency

 

Unit 1

Unit 2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Location Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unit 1

 

 

Unit 2

 

 

 

 

 

 

 

09

Outside Right-of

 

 

 

 

 

Devices

 

 

 

 

 

 

 

 

 

3

 

Gravel

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle

 

 

 

 

 

 

 

 

 

 

Most Damaged

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

Other Electronic Device

4

 

Dirt

 

 

 

 

 

 

 

 

 

 

 

 

 

Responding to

 

 

 

 

 

 

 

 

 

Area

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Way

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10

 

 

3

Other Inside Vehicle

 

 

 

 

 

5

 

Brick

 

 

 

 

 

 

 

 

 

 

 

 

 

an Emergency

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

0

N/A

 

 

2

No

 

 

 

 

 

13

Top

15 Non-Collision

 

 

 

 

 

 

 

 

 

4

Other Outside Vehicle

6

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

99

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9

Unknown

 

 

 

 

 

 

 

 

 

9

 

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

1

Yes

 

 

9

Unknown

 

14

Undercarriage

99 Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

236

Case Number

Latitude

.

Longitude

N

.

Railroad Crossing Number

W

Pg of

Direction of Travel Before Collision

Unit

 

 

N E

 

Unit

 

 

N E

Number

 

 

S W

 

Number

 

 

S W

Indicate North

by Arrow

COLLISION EVENTS

Unit

First Event

Second Event

Third Event

Fourth Event

First Harmful Event

First Harmful

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Event for the

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Entire

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Collision

 

Unit

First Event

Second Event

Third Event

Fourth Event

First Harmful Event

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

37

Work Zone/Maintenance

56

Pavement Drop-Off

38

Equipment

57

Ditch

Other Non-Fixed Object

58

Embankment

FIXED OBJECT:

59

Tree (Standing)

40

Barrier (Cable)

60

Dividing Strip

41

Barrier (Concrete)

61

Retaining Wall

42

Barrier (Other)

62

Bridge Abutment

43

Fence Pole

63

Bridge Pier or Support

44

Fence

64

Bridge Rail

10Overturn/Rollover

11Fire/Explosion

12Immersion

13Jackknife

14Cargo/Equipment Loss or Shift

15Equipment Failure (Blown Tire, Brake Failure, etc.)

16Separation of Units

17Departed Road Right

18Departed Road Left

19Cross Median/Centerline

20Downhill Runaway

21Fell/Jumped From Motor Vehicle

22Thrown Or Falling Object

23Other Non-Collision

PERSON, MOTOR VEHICLE, OR NON-

FIXED OBJECT:

30 Pedestrian

31 Pedal Cycle

32 Railway Vehicle (train, engine)

33 Animal

34 Motor Vehicle in Transport

35 Parked Motor Vehicle

36 Struck by Falling, Shifting Cargo or Anything Set in Motion by Motor Vehicle

45

Traffic Signal Support

65

Bridge Post

46

Traffic Sign Support

66

Bridge Curb

47

Utility Pole/Light Support

67

Bridge Super Structure (Beams)

48

Other Post/Pole/Support

68

Bridge Overhead Structure

49

Guardrail/Guardrail Face

69

Delineator

50

Guardrail End

70

Mailbox

51

Culvert

71

Other Fixed Object

52

Curb

72

Other Highway Structure

53

Island

73

Ground

54

Sand Barrels

99

Unknown

55

Impact Attenuator/ Crash

 

 

 

Cushion

 

 

Remarks

237

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OFFICIAL OKLAHOMA TRAFFIC COLLISION REPORT

 

 

 

 

 

 

 

 

 

 

Pg

 

 

 

of

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PERSONS SUPPLEMENTAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(42)

Unit

 

 

 

 

 

 

 

Pos in Veh.

 

Last Name

First

Middle Initial

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

 

 

 

 

Sex

 

 

 

 

 

 

Injured

 

 

Passenger

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Witness

 

 

Prop. Owner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(43)

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

Zip

 

Telephone

 

(Use Area

 

Code)

 

 

 

 

 

 

 

 

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(44)

Injury Severity / Type

 

OP Use

 

Air Bag Ejected Extricated Transported by

 

 

To

Medical

 

Facility

 

 

 

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(45)

Unit

 

 

 

 

 

 

 

Pos in Veh.

 

Last Name

First

Middle Initial

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

 

 

 

 

Sex

 

 

 

 

 

 

Injured

 

 

Passenger

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Witness

 

 

Prop. Owner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(46)

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

Zip

 

Telephone

 

(Use Area

 

Code)

 

 

 

 

 

 

 

 

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(47)

Injury Severity / Type

 

OP Use

 

Air Bag Ejected Extricated Transported by

 

 

To

Medical

 

Facility

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(48)

Unit

 

 

 

 

 

 

 

Pos in Veh.

 

Last Name

First

Middle Initial

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

 

 

 

 

Sex

 

 

 

 

 

 

Injured

 

 

Passenger

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Witness

 

 

Prop. Owner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(49)

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

Zip

 

Telephone

 

(Use Area

 

Code)

 

 

 

 

 

 

 

 

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(50)

Injury Severity / Type

 

OP Use

 

Air Bag Ejected Extricated Transported by

 

 

To

Medical

 

Facility

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(51)

Unit

 

 

 

 

 

 

 

Pos in Veh.

 

Last Name

First

Middle Initial

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

 

 

 

 

Sex

 

 

 

 

 

 

Injured

 

 

Passenger

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Witness

 

 

Prop. Owner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(52)

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

Zip

 

Telephone

 

(Use Area

 

Code)

 

 

 

 

 

 

 

 

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(53)

Injury Severity / Type

 

OP Use

 

Air Bag Ejected Extricated Transported by

 

 

To

Medical

 

Facility

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(54)

Unit

 

 

 

 

 

 

 

Pos in Veh.

 

Last Name

First

Middle Initial

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

 

 

 

 

Sex

 

 

 

 

 

 

Injured

 

 

Passenger

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Witness

 

 

Prop. Owner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(55)

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

Zip

 

Telephone

 

(Use Area

 

Code)

 

 

 

 

 

 

 

 

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(56)

Injury Severity / Type

 

OP Use

 

Air Bag Ejected Extricated Transported by

 

 

To

Medical

 

Facility

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(57)

Unit

 

 

 

 

 

 

 

Pos in Veh.

 

Last Name

First

Middle Initial

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

 

 

 

 

Sex

 

 

 

 

 

 

Injured

 

 

Passenger

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Witness

 

 

Prop. Owner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(58)

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

Zip

 

Telephone

 

(Use Area

 

Code)

 

 

 

 

 

 

 

 

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(59)

Injury Severity / Type

 

OP Use

 

Air Bag Ejected Extricated Transported by

 

 

To

Medical

 

Facility

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(60)

Unit

 

 

 

 

 

 

 

Pos in Veh.

 

Last Name

First

Middle Initial

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

 

 

 

 

Sex

 

 

 

 

 

 

Injured

 

 

Passenger

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Witness

 

 

Prop. Owner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(61)

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

Zip

 

Telephone

 

(Use Area

 

Code)

 

 

 

 

 

 

 

 

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(62)

Injury Severity / Type

 

OP Use

 

Air Bag Ejected Extricated Transported by

 

 

To

Medical

 

Facility

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(63)

Unit

 

 

 

 

 

 

 

Pos in Veh.

 

Last Name

First

Middle Initial

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

 

 

 

 

Sex

 

 

 

 

 

 

Injured

 

 

Passenger

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Witness

 

 

Prop. Owner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(64)

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

Zip

 

Telephone

 

(Use Area

 

Code)

 

 

 

 

 

 

 

 

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(65)

Injury Severity / Type

 

OP Use

 

Air Bag Ejected Extricated Transported by

 

 

To

Medical

 

Facility

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(66)

Unit

 

 

 

 

 

 

 

Pos in Veh.

 

Last Name

First

Middle Initial

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

 

 

 

 

Sex

 

 

 

 

 

 

Injured

 

 

Passenger

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Witness

 

 

Prop. Owner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(67)

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

Zip

 

Telephone

 

(Use Area

 

Code)

 

 

 

 

 

 

 

 

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(68)

Injury Severity / Type

 

OP Use

 

Air Bag Ejected Extricated Transported by

 

 

To

Medical

 

Facility

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

238

OFFICIAL OKLAHOMA TRAFFIC COLLISION REPORT

DIAGRAM SUPPLEMENTAL

Case Number

Pg of

Indicate North

by Arrow

239

 

 

OFFICIAL OKLAHOMA TRAFFIC COLLISION REPORT

Pg

 

of

 

 

 

 

Case Number

 

ADDITIONAL NARRATIVE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

240

Form Breakdown

Fact Detail
Form Title OFFICIAL OKLAHOMA TRAFFIC COLLISION REPORT
Purpose Documenting details of traffic collisions within the state of Oklahoma
Governing Law(s) Oklahoma state traffic laws and regulations under the Department of Public Safety
Key Sections Incident Report, Investigation Details, Motor Vehicles Involved, Occupants Information, Vehicle and Driver Information, Collision Description, Persons Supplemental
Special Considerations Includes sections for documenting if the collision involved a hit and run, commercial motor vehicles, or occurred in a work zone
Signature Required Investigating officer's badge number, Troop/Div., and a section for reviewer's badge number and review date
Use of Form Warning State law warning against the use of report contents for commercial solicitation
Additional Features Fields for detailed collision event sequencing, injury severity, and types of injuries

Detailed Instructions for Using Oklahoma Traffic Collision Report

Filling out the Oklahoma Traffic Collision Report form might seem daunting, but it's important to take it step by step. This report is a vital document for recording the details of a traffic collision and can be crucial for insurance claims, legal matters, and for improving road safety measures. Here's a breakdown of steps to help guide you through the process:

  1. Start with section (1) by checking the appropriate boxes regarding the scene of the accident, such as if it was a hit and run or if there were any fatalities.
  2. In section (2), fill in the details about the collision, including the date, time, county, and nearest city or town.
  3. Write the detailed location in section (3), including the distance from the nearest city or town and the control number if available.
  4. For section (4), provide the exact street, road, or highway where the collision happened and its distance from the nearest intersecting street, road, or highway.
  5. Enter information about the first unit involved in the collision in sections (5) to (12), starting with the type of unit and occupant details, going all the way to the extent of damage to the vehicle.
  6. Repeat the process for the second unit involved by filling in sections (14) to (21) with the same level of detail as the first unit.
  7. For sections (23) to (33), detail the investigation findings, including the investigating officer's badge number, the types of injuries sustained, and vehicle configurations.
  8. If the collision involved a vehicle being used for commerce or business, complete sections (36) to (38) with the relevant carrier and vehicle information.
  9. In section (39) onwards, fill in the details about any non-motorist participants in the collision, such as pedestrians or cyclists, if applicable.
  10. Review the accident's dynamics and contributing factors, including road conditions, type of collision, weather, lighting, and road character in the subsequent sections.
  11. Detail the first harmful event and any subsequent events leading to the accident in the "Collision Events" section.
  12. Conclude the report by filling in information about persons involved who did not fit the earlier classifications, including witnesses or property owners, in sections (42) to (68).

Remember, accuracy is crucial when completing this form. Each piece of information helps to paint a clearer picture of the incident, which is essential for all parties involved. Double-check your entries before submitting the report to ensure that all data is correct and complete.

FAQ

Welcome to our FAQ section on the Oklahoma Traffic Collision Report form. This guide aims to provide clear answers to some commonly asked questions to assist those involved in traffic collisions in Oklahoma.

  1. What is the Oklahoma Traffic Collision Report form?

    The Oklahoma Traffic Collision Report form is an official document used by law enforcement to record details of traffic collisions within the state. It includes information such as the date, time, and location of the collision, details about the vehicles, drivers, and occupants involved, as well as any injuries or fatalities that occurred.

  2. When is the Oklahoma Traffic Collision Report form required?

    This form is required for all traffic collisions in Oklahoma that result in injury, death, or significant property damage. Law enforcement officers attending the scene of the collision will complete and file the report.

  3. How can I obtain a copy of the Oklahoma Traffic Collision Report form?

    Individuals involved in a collision can obtain a copy of the completed report through the reporting agency – typically, this would be the local police department, sheriff’s office, or the Oklahoma Highway Patrol. Requests may involve a fee and require information such as the report number, date of the collision, and names of the parties involved.

  4. What information is required to fill out the form?

    The form requires detailed information including: the date, time, and specific location of the collision; personal and contact information for the drivers, passengers, and witnesses; vehicle details including make, model, and license plate number; insurance information; a description of the collision events and the damage incurred.

  5. What purpose does the Oklahoma Traffic Collision Report serve?

    This report serves multiple purposes, including providing a formal record of the incident for law enforcement, aiding in the investigation of the collision, facilitating insurance claims, and helping to improve road safety through analysis of collision data.

  6. Are there any legal implications if a collision is not reported?

    Yes, failing to report a traffic collision that results in injury, death, or property damage exceeding a specified amount is a legal offense in Oklahoma. Not reporting such incidents may lead to penalties, including fines and potential impact on driving records.

It's important to remember that immediately reporting a traffic collision can be crucial for legal and insurance processes, ensuring that all involved parties have the necessary documentation for their records.

Common mistakes

  1. Not checking whether the airbag deployed: Many people overlook the section about the airbag status (deployed, not deployed, etc.). It's critical to accurately report the airbag's condition at the time of the accident as it can affect injury assessments and insurance claims.

  2. Omitting details about the accident location: Accurately filling out the details under "Street, Road or Highway" and the related proximity to intersecting streets is often neglected. This information is essential for understanding the accident's context and can impact the investigation's outcome.

  3. Forgetting to include witness information: Failing to provide details about witnesses (if any) under the "Persons Supplemental" section is a common mistake. Witness accounts can significantly contribute to the clarity of the accident circumstances.

  4. Incorrect or incomplete insurance information: Many individuals fail to correctly fill out the insurance section, including the insurance company name, policy number, and insurance verification. Accurate insurance information is crucial for processing claims efficiently.

Making sure to address these areas with accurate and complete information can greatly improve the utility of the Oklahoma Traffic Collision Report form for all parties involved.

Documents used along the form

When dealing with traffic collisions, especially in Oklahoma, it’s critical to have the right documents and forms to comprehensively document the event. Aside from the Oklahoma Traffic Collision Report form, there are several other documents commonly used to ensure all aspects of the incident are accurately recorded and legal requirements are met. These documents each serve a unique purpose, ranging from providing detailed witness accounts to verifying insurance coverage.

  • Witness Statement Forms: These forms are used to collect detailed accounts from individuals who witnessed the collision. They help in providing an unbiased perspective on the events leading up to and during the incident.
  • Driver’s Exchange of Information: This document is typically filled out by all drivers involved in the collision. It includes personal information, insurance details, and vehicle descriptions, facilitating the exchange of necessary information between parties.
  • Vehicle Damage Report: To document the extent and specifics of damage to the vehicles involved, this report is used. It serves as an essential record for insurance claims and repair assessments.
  • Insurance Verification Form: This form is used to confirm that the driver or drivers involved in the collision have the legally required minimum insurance coverage.
  • Medical Release Form: In instances where injuries occur, a medical release form may be necessary. This form authorizes the release of medical information to insurance companies for the purpose of processing claims.
  • Tow Truck Receipt: If a vehicle is immobilized due to damage and requires towing, the tow truck receipt provides a record of the service and fees assessed for moving the vehicle from the scene.
  • Diagram Sketch Pad: While not a form per se, having a sketch pad allows officers or involved parties to draw the scene of the collision, including the position of vehicles, traffic signals, and other relevant details. This visual representation can be crucial in understanding how the collision occurred.Police Supplemental Report: If additional information comes to light after the initial report is filed, or if further investigation reveals new details, a supplemental report by the police may be necessary to add to the original collision documentation.

Each of these documents plays a vital role in piecing together the events of a traffic collision comprehensively. They not only ensure that all legal requirements are met but also aid in the resolution of any disputes and the processing of insurance claims. Proper documentation is key to handling the aftermath of a traffic collision efficiently and effectively.

Similar forms

The Oklahoma Traffic Collision Report form shares similarities with the California Traffic Accident Report. Both documents collect comprehensive details regarding the involved vehicles, the accident scene, and personal information of the occupants, such as names, addresses, and injury specifics. They also categorize the events leading to the accident, including weather conditions, road types, and specific actions of the drivers just before the collision. The primary aim is to piece together a factual narrative of the incident to facilitate legal, insurance, and statistical use.

Similarly, the Texas Peace Officer’s Crash Report (CR-3) aligns closely with the Oklahoma Traffic Collision Report in content and purpose. It gathers data on the crash participants, including drivers, passengers, and pedestrians, detailed descriptions of the vehicles involved, and a narrative and diagram section that depicts the events leading up to and during the crash. Both forms include information on whether the accident occurred in a construction zone and the usage of safety equipment by the occupants, aiming to improve traffic safety through detailed analyses of accidents.

The Florida Traffic Crash Report is another document with a structure paralleled to Oklahoma’s. It meticulously documents vehicle information, crash circumstances, and occupant details, alongside environmental and road conditions at the time of the accident. Specific sections dedicated to commercial vehicle data, similar to the Oklahoma form, help in understanding the complexities involved in crashes involving commercial vehicles. These similarities underscore a nationwide effort to standardize the collection of crash data to streamline investigations and improve road safety measures.

Furthermore, the New York Motor Vehicle Crash Report mirrors the Oklahoma form in its detailed collection of data concerning the crash scene, vehicle specifics, and the personal information of those involved. Key features include diagrams to sketch the accident, details on traffic flow, road conditions, and the role of pedestrians or cyclists if applicable. This consistency across state lines indicates a collective approach towards crash documentation, vital for legal, insurance, and policy-making processes aimed at reducing road accidents.

Dos and Don'ts

When filling out the Oklahoma Traffic Collision Report form, there are specific dos and don'ts that can help ensure the accuracy and validity of the report. Adhering to these guidelines can facilitate a smoother processing of the report and contribute to the comprehensive documentation of the incident.

Do:
  1. Include accurate and complete information in every section to ensure that the report provides a full account of the collision.
  2. Review the specifics pertaining to vehicle positions, injury severity, and type of collision events with great care to avoid any discrepancies.
  3. Use the correct date format (mm/dd/yyyy) as specified in the form for the date of the incident and any related dates to prevent confusion.
  4. Confirm that all numbers related to vehicles involved, personal injuries, or fatalities are double-checked for accuracy before submission.
Don’t:
  1. Leave any section blank; if a section does not apply, mark it as ‘N/A’ (Not Applicable) instead of leaving it empty.
  2. Guess or approximate details; if certain information is unknown, it's better to indicate this clearly rather than providing incorrect data.
  3. Alter any pre-printed fields or attempt to modify the structure of the form, as this can invalidate the report or lead to processing delays.
  4. Use informal language or short forms; stick to formal writing and complete sentences where descriptions are required.

Misconceptions

When handling the Oklahoma Traffic Collision Report form, it's easy to encounter misunderstandings. Here are six common misconceptions and the facts to clear them up:

  • Only for Vehicle-Driven Accidents: Some believe this form is exclusively for accidents involving motor vehicle collisions. However, it's also crucial for incidents involving pedestrians, cyclists, or any property damage resulting from a traffic collision.
  • For Immediate Completion Only: There's a misconception that the form must be completed immediately at the scene of the accident. While time-sensitive, accuracy is critical, and some information might require additional investigation or verification.
  • Insurance Details Are Optional: Another misunderstanding is that providing insurance information is optional. In reality, the form requires details of insurance verification for all vehicles involved, highlighting the importance of insurance in liability and coverage assessment.
  • Only for use by Law Enforcement: While law enforcement officials primarily use the form, individuals involved in the collision can also request a copy. This document is crucial for insurance claims and legal matters post-accident.
  • Only Major Accidents Require Reporting: Some think this form is only for severe accidents. However, Oklahoma law requires reporting for any accident resulting in injury, death, or significant property damage. This document plays a vital role in documenting even seemingly minor accidents.
  • Personal Details Are Irrelevant: There is a belief that personal details of those involved are not necessary beyond names. Contrarily, the form asks for comprehensive details, including addresses, driver's license numbers, and more, to ensure all parties involved can be accurately identified and contacted.

Understanding these points ensures the Oklahoma Traffic Collision Report form is accurately and effectively used, providing crucial information for legal, insurance, and safety purposes.

Key takeaways

When dealing with an Oklahoma Traffic Collision Report, there are essential aspects to keep in mind for a smooth process. Here are five key takeaways:

  • Filling out the form meticulously and completely is crucial. Details such as the date of the collision, time, and location (including county and nearest city or town) provide a clear context of the incident. Remember, accuracy is key to ensuring your report is valid and useful.
  • Do not overlook the importance of providing comprehensive information about the driver, vehicle, and insurance. This includes driver license number, state, class, endorsements, restrictions, the vehicle identification number (VIN), vehicle year, color, make, and insurance details such as the company name and policy number. These specifics are vital for insurance claims and legal considerations.
  • Take note of the section detailing the collision itself, including the type of collision, the number of vehicles involved, injuries, fatalities, and whether it was a hit-and-run. This information is fundamental in investigating and resolving the incident.
  • If applicable, mark whether the vehicle involved is used for commerce/business and if it has a gross vehicle weight rating (GVWR) in excess of 10,000 lbs., carries a hazardous material placard, or is a bus with seating for nine or more including the driver. This information can affect the investigation due to different regulations that apply to commercial vehicles.
  • Finally, the Investigating Officer's Badge Number, Troop/Div., and Reviewer Badge Number must be included, if known. This adds an official layer to the report, making it a document that is acknowledged and processed by law enforcement. Including this data ensures that the report will be considered official and can be acted upon by the authorities.

Understanding and carefully completing the Oklahoma Traffic Collision Report can significantly impact the outcome of the incident report. Not only does it serve as a legal document, but it also plays a crucial role in insurance claims and the investigation process. Therefore, ensure every detail is accurate and complete for your report to be considered valid and useful.

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