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The Alaska Motor Vehicle Crash Form 12-209 serves as a crucial document for documenting details related to vehicle collisions in the state. When an accident occurs, this form captures essential information such as the location, time, and conditions of the crash, including the weather and lighting at the time. It allows responders to indicate the number of vehicles involved, the nature of damages, and any injuries sustained by drivers or passengers. The form further includes sections for identifying the drivers, their vehicles, insurance details, and the first sequence of events leading to the collision. Clear options guide users through selecting the circumstances surrounding the crash, while narrative spaces enable detailed descriptions for comprehensive reporting. Proper completion of this form is vital, as it aids law enforcement and insurance companies in processing claims and investigating incidents effectively. All individuals involved in the accident are required to provide their information, helping ensure accountability and accurate record-keeping.

12 209 Alaska Example

ALASKA MOTOR VEHICLE CRASH FORM 12-209

SR #

C R A S H I N F O R M A T I O N

(One choice per field unless otherwise noted. Other* should be explained in narrative)

 

 

 

Total # Vehicles

Crash Date

Time of Crash

am Crash Day

01 MON

03 WED

05 FRI

07 SUN

Crash occurred in (City / Borough)

 

 

 

 

 

pm

 

 

02 TUE

04 THU

06 SAT

 

 

 

 

Name of Street or Highway

 

 

Miles

North of:

South of:

Name of Cross Street, Highway, Bridge, etc.

OFFICIAL USE ONLY

 

 

 

 

 

East of:

West of:

 

 

 

Location Control

Reference Point

 

 

 

 

Feet

 

 

 

 

 

 

 

 

 

At intersection with:

 

 

 

 

 

 

Weather

 

 

 

Lighting

 

 

 

 

Roadway / Junction

 

 

 

 

01 Blowing dirt, snow

07 Sleet, hail (freezing rain)

01 Dark - lighted roadway

07 Not reported

 

01 Crossover

07 Roundabout

13 Other*

02 Clear

 

08 Severe crosswinds

 

02 Dark - not lighted

 

08 Unknown

 

02 Driveway

08 T - intersection

 

 

03 Cloudy

 

09 Snow

 

03 Dark - unknown lighting

 

 

03 Not a junction

09 Y - intersection

 

 

04 Fog/ smoke

 

10 Other*

 

04 Daylight

 

 

 

 

04 On ramp

10 Four way intersection

 

05 Ice fog

 

11 Not reported

 

05 Twilight

 

 

 

 

05 Off ramp

11 Five point or more

 

 

06 Rain

 

12 Unknown

 

06 Other*

 

 

 

 

06 Railway crossing

12 Unknown

 

 

First Sequence of Events (what was the first thing you crashed into, or what was the first event that resulted in the crash. (CHECKONLY ONE FOR EITHER COLLISION OR NON-COLLISION

 

 

 

 

COLLISION

 

 

 

 

 

NON-COLLISION

 

 

 

01 Aircraft

 

09 Ditch

17 Median barrier

 

25 Train

 

 

33 Cargo loss / shift

 

40 Overturn

 

02 Animal

 

10 Embankment

18 Moose

 

26 Tree / shrub

 

34 Crossed median / centerline

41 Ran off road

 

03 Bicyclist

 

11 Fence

19 Parked vehicle

 

27 Utility pole

 

35 Downhill runaway

 

42 Separation of units

04 Bridge / overpass

12 Guard rail face

20 Pedestrian

 

28 Vehicle in transit

 

36 Equipment failure

 

43 Other*

 

 

05 Bridge rail

 

13 Guard rail end

21 Sideswipe

 

29 Vehicle - rear end

 

37 Explosion / fire

 

44 Unknown

 

06 Crash cushion

14 Light support

22 Sign

 

30 Vehicle - head on

 

38 Immersion

 

 

 

 

07 Culvert

 

15 Machinery

23 Snowberm

 

31 Vehicle - angle

 

39 Jackknife

 

 

 

 

08 Curb / wall

 

16 Mail box

24 Traffic signal pole

 

32 Other fixed object

 

 

 

 

 

 

 

Location of First Sequence of Events (where did the crash happen first?)

 

 

 

Road Surface

 

 

 

Did police

 

01 Bike lane

 

04 Outside of trafficway

 

07 Roadway

 

10 Unknown

01 Dry

04 Sand, mud, oil

07 Wet

Yes

 

 

 

investigate

02 Gore

 

05 Parking lot

 

08 Shared use paths

 

 

02 Ice

05 Slush

08 Other*

No

 

 

 

 

this crash?

03 Median

 

06 Roadside

 

09 Shoulder

 

 

 

03 Water

06 Snow

 

 

 

 

 

 

 

 

 

 

 

Y O U R D R I V E R I N F O R M A T I O N

Your Name (Vehicle Driver's Last Name, First Name, Middle Name)

Your Date of Birth

Your Contact Telephone

Your Mailing Address

Your Driver License Number

Your Driver License State

Your Driver License Country

Your City

Your State

Your Zip Code

Your Residence Country

Y O U R V E H I C L E I N F O R M A T I O N

 

Your Vehicle Damage

No. of Occupants

 

 

 

Your Vehicle Owner's Name (Last, First, Middle Initial)

 

 

 

 

Vehicle Owner's Telephone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

01 None / minor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

03 Disabling

05 Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Your Vehicle Owner's Mailing Address

 

 

 

 

 

 

 

 

02 Functional

04 Totaled

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

02

03

 

04

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Your Vehicle Owner's City

 

 

 

Your Vehicle Owner's State

 

Vehicle Owner's Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle Year

Vehicle Make

 

Vehicle Model

 

 

 

License Plate #

 

Vehicle License State

 

01

 

 

05

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Your Vehicle's Direction of Travel

 

 

 

 

 

 

Damage Estimate

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

01 North

02 South

03 East

04 West

 

05 Unknown

 

Over $501

 

 

 

 

 

 

 

 

Your Vehicle Driver's Injury Status (vehicle passengers are listed on page 2)

 

 

 

08

07

 

06

 

 

 

01 Fatal

 

 

03 Non-incapacitating

 

05 None

07 Unknown

 

CHECK ONLY ONE TO SHOW FIRST AREA OF IMPACT

 

 

02 Incapacitating

04 Possible

 

06 Not reported

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Roadway Circumstances (that may have contributed to the crash)

 

 

 

 

Your Vehicle Action

 

 

 

 

 

 

 

 

01 Debris

 

07 Road surface condition

 

 

13 Other*

 

01 Avoiding objects in road

 

08 Out of control

 

15 Straight ahead

 

02 Inoperative traffic device

08 Ruts, holes, bumps

 

 

14 Unknown

 

02 Backing

 

 

09 Passing

 

16 Turning right

 

03 Missing traffic device

 

09 School zone

 

 

 

 

 

03 Changing lanes

 

 

10 Parked

 

17 Turning left

 

04 Obscured traffic device

 

10 Work zone

 

 

 

 

 

04 Entering traffic lane

 

 

11 Skidding

 

18 Other*

 

05 Obstruction in roadway

 

11 Worn, polished road surface

 

 

05 Leaving traffic lane

 

 

12 Slowing

 

19 Unknown

 

06 Shoulder

 

12 None

 

 

 

 

 

 

 

06 Making U-turn

 

 

13 Starting in traffic

 

 

 

 

 

 

 

 

 

 

 

07 Merging

 

 

14 Stopped

 

 

 

Traffic Control

 

 

 

 

 

 

 

 

Vehicle Configuration

 

 

 

 

 

 

 

 

01 Flashing signal

05 School zone signs

09 Officer / Flagman / Guard

 

01 Dog sled

 

 

05 Off highway vehicle

 

09 Other*

 

02 No traffic controls

06 Stop sign

 

 

10 Yield sign

 

 

02 Light truck (4 tires)

 

 

06 Passenger car

 

10 Unknown

 

03 Road construction signs

07 Traffic control signal

11 Other*

 

 

03 Motorhome

 

 

07 Pedalcycle

 

 

 

04 RR crossing device

08 Warning signs

 

 

12 Unknown

 

 

04 Motorcycle

 

 

08 Pedestrian

 

 

 

C R A S H D E S C R I P T I O N

(Write a brief narrative describing the crash)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fairbanks Police Department Rev. 07/05

Crash Form 12-209 - Page 1

ALASKA MOTOR VEHICLE CRASH FORM 12-209

O T H E R D R I V E R ' S I N F O R M A T I O N

Other Driver's Name (Last Name, First Name, Middle Name)

Other Driver's Date of Birth

Other Driver's Contact Telephone

Other Driver's Mailing Address

Other Driver's License #

Other Driver's License State

Other Driver's License Country

Other Driver's Mailing Address City

Other Driver's State

Other Driver's Zip Code

Other Driver's Residence Country

O T H E R D R I V E R V E H I C L E I N F O R M A T I O N

 

Other Vehicle Damage

Other Vehicle No. of Occupants

 

 

 

Other Vehicle Owner's Name (Last, First, Middle Initial)

 

 

 

Other Vehicle Owner's Telephone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

01 None / minor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

03 Disabling

05 Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other Vehicle Owner's Mailing Address

 

 

 

 

 

 

 

 

02 Functional

 

04 Totaled

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

02

 

03

 

04

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other Vehicle Owner's City

 

 

 

Other Vehicle Owner's State

 

Other Vehicle Owner's Zip

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle Year

Vehicle Make

 

Vehicle Model

 

 

License Plate #

 

Vehicle License State

 

01

 

 

 

05

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other Vehicle's Direction of Travel

 

 

 

 

 

 

Damage Estimate

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

01 North

02 South

03 East

04 West

 

05 Unknown

 

Over $501

 

 

 

 

 

 

 

 

 

Other Vehicle Driver's Injury Status (vehicle passengers are listed below)

 

 

 

08

 

07

 

06

 

 

 

01 Fatal

 

 

03 Non-incapacitating

05 None

07 Unknown

 

CHECK ONLY ONE TO SHOW FIRST AREA OF IMPACT

 

 

02 Incapacitating

04 Possible

06 Not reported

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other Driver's Roadway Circumstances (that may have contributed to the crash)

 

Other Driver's Vehicle Action

 

 

 

 

 

 

 

 

01 Debris

 

 

07 Road surface condition

 

 

13 Other*

 

01 Avoiding objects in road

08 Out of control

 

15 Straight ahead

 

02 Inoperative traffic device

08 Ruts, holes, bumps

 

 

14 Unknown

 

02 Backing

 

09 Passing

 

16 Turning right

 

03 Missing traffic device

 

 

09 School zone

 

 

 

 

 

03 Changing lanes

 

10 Parked

 

17 Turning left

 

04 Obscured traffic device

 

10 Work zone

 

 

 

 

 

04 Entering traffic lane

 

11 Skidding

 

18 Other*

 

05 Obstruction in roadway

 

11 Worn, polished road surface

 

 

05 Leaving traffic lane

 

12 Slowing

 

19 Unknown

 

06 Shoulder

 

 

12 None

 

 

 

 

 

 

 

06 Making U-turn

 

13 Starting in traffic

 

 

 

 

 

 

 

 

 

 

 

 

 

 

07 Merging

 

14 Stopped

 

 

 

Other Driver's Traffic Control (traffic control for the other driver may have been different from yours)

Other Driver's Vehicle Configuration

 

 

 

 

 

 

 

01 Flashing signal

 

05 School zone signs

09 Officer / Flagman / Guard

 

01 Dog sled

 

05 Off highway vehicle

 

09 Other*

 

02 No traffic controls

 

06 Stop sign

 

 

10 Yield sign

 

 

02 Light truck (4 tires)

 

06 Passenger car

 

10 Unknown

 

03 Road construction signs

07 Traffic control signal

11 Other*

 

 

03 Motorhome

 

07 Pedalcycle

 

 

 

04 RR crossing device

 

08 Warning signs

 

 

12 Unknown

 

 

04 Motorcycle

 

08 Pedestrian

 

 

 

 

 

 

 

I N J U R Y S E C T I O N

(Fill in the name of injured person, injury status, telephone number, and which vehicle they occupied when the crash occurred)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Injury Status

 

 

 

Telephone

Vehicle License

02 Incapacitating

03 Non-incapacitating

04 Possible

05 None

07 Unknown

 

02 Incapacitating

03 Non-incapacitating

04 Possible

05 None

07 Unknown

 

02 Incapacitating

03 Non-incapacitating

04 Possible

05 None

07 Unknown

 

02 Incapacitating

03 Non-incapacitating

04 Possible

05 None

07 Unknown

 

YOUR INSURANCE INFORMATION

C E R T I F I C A T E O F

I N S U R A N C E

 

Failure to complete the Certificate of Insurance could

 

 

 

result in the suspension of your driver's license)

CRASH

 

Crash Date

 

Crash Location

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Your Name (Driver's Last Name, First Name, Middle Initial)

 

 

Your Date of Birth

 

 

 

Your Driver's License Number

Your Driver's License State

DRIVER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMATION

 

Your Mailing Address

 

 

 

Your City

 

 

 

 

Your State

 

 

 

 

Your Zip Code

Your Contact Telephone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE

 

Vehicle Owner's Name (Last Name, First Name, Middle Initial)

 

 

 

Owner's Date of Birth

 

 

Owner's License Number

Owner' License State

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OWNER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle Owner's Mailing Address

 

 

Owner's City

 

 

 

 

 

Owner's State

 

 

 

 

Owner's Zip Code

Owner's Contact Telephone

INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE

 

Vehicle year

Vehicle make

 

Vehicle model

 

License plate #

 

Vehicle License State

 

Vehicle Identification Number (VIN)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Did you have a current automobile liability policy in effect covering this accident?

YES

NO

 

 

 

 

 

 

Insurance Company or Insurance Carrier Name

 

 

 

 

 

 

 

 

 

 

Insurance Policy Number

 

 

INSURANCE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address and Telephone Number of Insurance Agent

 

 

 

 

 

 

 

 

Insurance Policy

FROM

 

TO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Period:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE

 

YOUR SIGNATURE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INSURANCE VERIFICATION: If the motor vehicle liability insurance policy listed above was not in effect for the motor vehicle listed at the time of the crash indicated above, the insurance company is to complete the following and return this form to the Division of Motor Vehicles at the address listed on the bottom right corner on page 2 of this form. If indicated coverage was in effect at the time of the crash, no action is required.

REASON FOR DENIAL:

Policy expired before crash

Driver is not covered on policy

 

Policy effective after crash

Lapse in policy

 

Policy number given is incorrect

Other:

 

 

Authorized Representative Signature / Date

 

MAIL THIS FORM TO:

DMV MAIN OFFICE

P.O. BOX 110221

JUNEAU, AK 99811-0221

(907) 465-4361

Crash Form 12-209 - Page 2

Form Characteristics

Fact Name Details
Form Purpose The 12-209 form is designed to report motor vehicle crashes in Alaska.
Governing Laws The form complies with Alaska Statutes Section 28.35.080 regarding accident reporting.
Required Information Drivers must provide details about the crash, including date, time, location, and involved vehicles.
Weather and Road Conditions The form asks for information about weather and roadway conditions at the time of the crash.
First Impact Sequence Users must identify what the vehicle first collided with, whether it was a person, animal, or object.
Filing Location The completed form must be sent to the Alaska Department of Motor Vehicles, specifically to their Juneau office.

Guidelines on Utilizing 12 209 Alaska

Completing the Alaska Motor Vehicle Crash Form 12-209 is a crucial step for those involved in a crash. Filling it out accurately helps ensure that all necessary information is documented for future reference and legal compliance. To guide you through the process, here are the steps to follow when filling out the form.

  1. Fill in the crash information section:
    • Enter the total number of vehicles involved.
    • Indicate the crash date and time.
    • Provide city or borough information where the crash occurred.
    • Name the street or highway along with relevant intersections.
    • Describe the weather and lighting conditions at the time of the crash.
  2. Specify the first sequence of events:
    • Select only one option that represents the first thing that was crashed into or the initial event that caused the crash.
    • Identify the location of the first impact and the road surface conditions.
    • State whether the police investigated the crash.
  3. Provide your driver information:
    • Enter your name, date of birth, contact telephone number, and mailing address.
    • Provide your driver license number, state, country, and residency information.
  4. Input your vehicle information:
    • Detail the damage to your vehicle, including the number of occupants.
    • List the vehicle owner's name, telephone number, and mailing address.
    • Specify the vehicle year, make, model, license plate, and direction of travel.
    • Mention any injuries sustained by vehicle occupants.
  5. Document the information for the other driver:
    • Fill out the other driver's name, contact information, and vehicle details.
    • Provide their vehicle's damage assessment and direction of travel.
    • Include any observed injuries and roadway conditions pertaining to the other driver.
  6. Complete the injury section:
    • List names, injury status, and telephone numbers for each injured person.
    • Record which vehicle each individual occupied during the crash.
  7. Fill in your insurance information:
    • Indicate if you had an active automobile policy at the time of the crash.
    • Provide insurance company details and policy numbers.
  8. Sign and date the form in the designated section.
  9. Mail the completed form to the DMV office in Juneau, AK, using the address provided in the instructions.

After following these steps, double-check the form for accuracy and completeness before mailing. Submitting the form promptly can help streamline the process and may assist in resolving any associated legal or insurance matters more efficiently.

What You Should Know About This Form

What is the purpose of the Alaska Motor Vehicle Crash Form 12-209?

The Alaska Motor Vehicle Crash Form 12-209 is used to report information about motor vehicle accidents that occur in the state of Alaska. This form collects details about the crash, such as the date, time, location, vehicles involved, and any injuries sustained. Accurate completion of this form is essential for documentation and can assist in insurance claims and legal matters related to the crash.

Who needs to complete the form?

Both drivers involved in the crash are typically required to complete the form. Each driver provides information about their vehicle, their actions during the incident, and any injuries sustained. If there are multiple vehicles, each driver should file a separate form, ensuring all details are captured correctly.

What information is required on the form?

The form requires several pieces of information, including the names of the drivers, their contact details, license numbers, and vehicle information such as make, model, and damage assessment. The form also asks for specifics about the crash, like the first event leading to the accident, road conditions, weather factors, and any traffic control devices present at the scene.

What if there are injuries involved?

If there are injuries, it is critical to indicate the injury status for each person involved in the crash. There are options for different levels of injury, ranging from fatal to non-incapacitating. Accurate reporting can help ensure appropriate medical attention and assist with any subsequent claims made through insurance or legal channels.

How does the form affect insurance claims?

Completing the 12-209 form accurately is crucial for processing insurance claims. Insurers often require a detailed accident report to determine the circumstances of the crash and to assess liability. Failure to provide correct information may lead to delays or disputes regarding claims, coverage, or fault determinations.

What should I do if I cannot complete the form at the scene?

If you are unable to complete the form at the scene of the accident, it is advisable to do so as soon as possible afterward. Gather all necessary information regarding the accident and all parties involved. If you require assistance, someone familiar with the report may help guide you through the process. It’s important to submit the form to the appropriate authority within the required timeframe.

Is there a deadline for submitting the form?

There is no explicitly stated deadline for submitting the Alaska Motor Vehicle Crash Form 12-209 on the form itself. However, it is generally advisable to complete and submit the form as soon as possible. Timely reporting aids in the resolution of insurance claims and legal obligations that may arise from the crash.

Where do I submit the completed form?

Once the form is completed, it should be mailed to the DMV Main Office at P.O. Box 110221, Juneau, AK 99811-0221. Ensure you keep a copy of the completed form for your records and follow up if you do not receive confirmation of its receipt.

Common mistakes

Completing the Alaska Motor Vehicle Crash Form (12-209) accurately is crucial for ensuring your report is processed without delay. Many individuals, however, fall into common traps that can lead to errors or omissions. Here are seven frequent mistakes to avoid when filling out this form.

One of the primary mistakes is failing to select the correct crash date or time. This information is critical as it helps to document the specific circumstances surrounding the incident. Be careful to note whether the crash occurred in the AM or PM, and choose the appropriate day. Incorrect entries could create confusion and affect the investigation.

Another common error involves inaccurately reporting the location of the crash. It is essential to provide a precise description, including streets, cross streets, and distances from known reference points. Ambiguities in location can make it challenging for authorities to follow up and could hinder any further legal processes.

Many people also neglect to fill out the driver and vehicle information completely. Ensuring that all sections pertaining to your vehicle and personal details are completed accurately, such as your driver's license number and contact information, is vital. Missing or incorrect details can lead to significant delays or issues when processing your claim.

Another mistake is skipping over the 'First Sequence of Events' section. This part allows you to clarify what exactly happened first during the crash. Choosing the correct event helps officers and insurers understand the situation better and can influence the conclusion of fault.

Moreover, individuals often forget to include their insurance information. This part is not only important for reporting the crash but also essential for ensuring that proper liability coverage is considered. Any omission may lead to complications such as fines or penalties regarding your driver's license.

People sometimes also overlook the importance of confirming the accuracy of vehicle damage descriptions. Given the varying levels of severity associated with vehicle damage, it is important to select the correct category. Misclassification could lead to disputes regarding claims or liability.

Finally, disregarding the need for signatures can lead to significant problems. Your signature is necessary to validate that the form is accurate and reflects your account of events. Omitting this can render your report incomplete, potentially delaying response times and resolution of the incident.

By being mindful of these common mistakes, you can ensure that your completion of the Alaska Motor Vehicle Crash Form is thorough and accurate, facilitating a smoother resolution of any associated claims.

Documents used along the form

The Alaska Motor Vehicle Crash Form 12-209 is a critical document in the event of a vehicle collision. To facilitate the proper handling of a crash incident, several other forms and documents may accompany the 12-209. Each of these documents plays a specific role in ensuring that all necessary information is properly recorded and communicated to relevant parties, such as law enforcement, insurance providers, and crash victims.

  • Alaska DMV Crash Report: This document serves as an official statement from the Alaska Department of Motor Vehicles, compiling essential details about the accident, parties involved, and witness statements. It may be required for insurance claims and legal purposes.
  • Insurance Claim Form: When seeking compensation for damages or injuries, an insurance claim form is necessary. This document outlines the specifics of the claim, including details about the crash and the extent of damages or injuries experienced.
  • Witness Statements: If there are individuals who observed the accident, their statements can provide valuable corroboration. Collecting contact information and testimonials from these witnesses may strengthen a case or help clarify conflicting accounts.
  • Driver's Insurance Information: This document confirms the insurance details of each driver involved. It includes policy numbers and the contact information of insurance providers, which can expedite the claims process.
  • Medical Records: If injuries occurred due to the crash, medical records become vital. They document the nature and extent of injuries, providing essential evidence for any insurance claims or potential litigation.
  • Vehicle Damage Estimate: A detailed evaluation of the damages to each vehicle involved helps assess repair costs. This estimate is often necessary to support claims made through insurance.
  • Police Report: If law enforcement responded to the crash, their report would detail the circumstances surrounding the incident. This document can be crucial in determining liability.
  • Accident Reconstruction Report: In complex cases, especially those involving serious injuries or fatalities, an accident reconstruction report may be prepared. This document analyzes the crash's physics and dynamics, offering insights into how the accident occurred.
  • Statement of Loss or Damage: This form lists all losses incurred as a result of the crash. It outlines not just vehicle damage, but also personal property loss, medical expenses, and lost wages if applicable.

By gathering these documents, individuals involved in a vehicle crash in Alaska can ensure that they have a comprehensive record of the incident. This preparation can facilitate communication with legal and insurance professionals, ultimately aiding in the resolution of claims and restoration of normalcy following the accident.

Similar forms

  • Form SR-1 (Accident Report): Similar to the 12-209 form, the SR-1 is designed to capture details about motor vehicle accidents in Alaska. Both forms collect information such as crash location, vehicles involved, and driver information. However, the SR-1 is used more broadly across states, while the 12-209 specifically addresses the nuances of Alaskan regulations.

  • California Highway Patrol 555 Form: This form is used in California for reporting motor vehicle accidents. Like the 12-209, it gathers information about vehicle damage, weather conditions, and personal information of drivers involved. The key difference lies in the geographic and regulatory context in which each form operates.

  • Michigan Traffic Crash Report (UD-10): Michigan's UD-10 report serves a similar purpose, documenting the specifics of traffic crashes. Similarities include sections detailing driver and vehicle information as well as crash circumstances. The reporting format may vary, reflecting the specific requirements of each state's law enforcement.

  • Texas CR-3 Crash Report: Texas utilizes the CR-3 form to record vehicle accidents. This document is comparable to the 12-209 in that it involves capturing information on the crash’s location, contributing factors, and details regarding the involved parties. Texas law and protocols will dictate how the data is processed and utilized.

  • New York State MV-104 Accident Report: In New York, the MV-104 is required for reporting accidents. Similar to the 12-209 form, it collects detailed data on the incident, including the parties involved, vehicles impacted, and crash circumstances. Each state imposes specific time frames and penalties related to these forms, affecting how they are submitted and processed.

Dos and Don'ts

When filling out the Alaska Motor Vehicle Crash Form 12-209, it's essential to keep a clear focus on accuracy and completeness. Here are eight important do's and don'ts to guide you through the process:

  • Do read the instructions carefully before starting to fill out the form.
  • Do provide accurate information regarding the date and location of the crash.
  • Do double-check your contact information and driver’s license details for correctness.
  • Do describe the sequence of events leading to the crash clearly in the designated section.
  • Don't leave any sections blank; incomplete forms can lead to delays.
  • Don't use abbreviations or shorthand; write out full words for clarity.
  • Don't add any unnecessary information; stick to what is relevant to the crash.
  • Don't forget to sign and date the form before submitting it.

Following these guidelines can help ensure a smoother process and reduce the likelihood of errors that can prolong your case review.

Misconceptions

  • Misconception 1: The 12-209 form only applies to major accidents.
  • This form is required for all types of crashes, even minor ones. Regardless of the severity, if there is property damage or injury, this form must be filled out.

  • Misconception 2: Only the police are responsible for completing the form.
  • While law enforcement may assist, it is the duty of the driver or the involved party to ensure the form is accurately completed. This information is crucial for insurance and legal purposes.

  • Misconception 3: The crash report is not needed if the injuries are minor.
  • Misconception 4: The location of the crash is irrelevant in the report.
  • Detailing the location helps authorities assess accident patterns and improve safety measures. Accurately reporting the crash site is important for statistical analysis and potential follow-up actions.

  • Misconception 5: You can submit the form anytime after the crash.
  • There are specific timeframes for submitting the 12-209 form. Delays may lead to complications with insurance claims or legal proceedings, so timely submission is crucial.

  • Misconception 6: Only one driver needs to complete the form.
  • In multi-vehicle crashes, every driver involved should complete the 12-209 form. Each perspective is important for a comprehensive understanding of the accident.

Key takeaways

1. Accurate Information is Crucial: Ensure that all details, including names, addresses, and vehicle information, are filled out accurately. Mistakes can lead to delays or complications during processing.

2. Complete All Sections: Every section of the form must be completed to provide a comprehensive overview of the crash. Missing information can hinder investigation efforts.

3. Narrative Description is Important: Include a brief narrative description of the crash. This helps clarify circumstances and may be essential in resolving disputes or insurance claims.

4. Submit Timely: Submit the completed form promptly to avoid any penalties or issues related to your driver's license. Follow the mailing instructions carefully to ensure it reaches the right department.