Fill Out Your Oklahoma Traffic Collision Report Form
The Oklahoma Traffic Collision Report form serves a critical function in documenting the details of motor vehicle accidents across the state. Every incident, regardless of its severity, is recorded in this standardized format that provides a comprehensive overview of the crash. Key elements of the form include basic incident details, such as the date, time, and location, along with critical information about the vehicles involved, the drivers, and the injuries sustained. Each vehicle has designated spaces for essential information like the driver's license number, insurance details, and vehicle identification numbers. The form also addresses various contributing factors and circumstances relevant to the collision, including whether it occurred near construction zones, the road conditions at the time, and any apparent driver impairment. Additionally, there are meticulous sections to note any citations issued, witness information, and details on any injuries—both to drivers and passengers—ensuring a thorough account of the event. Each part of this extensive document aggregates vital data essential for investigations, insurance claims, and traffic safety analyses, highlighting its importance in legal and insurance contexts.
Oklahoma Traffic Collision Report Example
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Incident Report |
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DO NOT WRITE IN THIS SPACE |
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Investigation Completed |
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Revised |
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OFFICIAL OKLAHOMA TRAFFIC COLLISION REPORT |
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Investigation Made at Scene |
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Fatality |
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Photographs |
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(1) Reporting Agency |
Case Number (Agency Use) |
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Motor Vehicles Involved
Number Injured
Number Killed
(2) Date of Collision (mm/dd/yyyy) |
Time |
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County Number and Name |
Nearest City or Town Number and Name |
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(3) |
Distance from Nearest City or Town Limits |
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Control # Int ID |
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Location |
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East Grid |
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Administrative |
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Mi. |
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Mi. |
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Ft. |
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(4) |
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Street, |
Road or |
Highway |
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Distance from |
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(Nearest) Intersecting Street, Road or Highway |
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At |
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Ft. |
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(5) |
Unit |
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Occupants |
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Type |
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Hit & |
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Last Name |
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Middle |
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Date of Birth (mm/dd/yyyy) |
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Sex |
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Run |
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(6) |
Address |
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City |
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Zip |
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Telephone |
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(Use Area |
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Code) |
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(7) Driver License Number |
State |
Class Endorsement(s) |
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Restriction(s) |
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Inj. Sev. Type of Injury |
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Drv./Ped. Cond. OP Use
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(8) |
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Ejected Extricated Test |
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(% BAC) Transported by |
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To Medical Facility |
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License |
Plate Number |
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Air |
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0. |
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Bag |
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(9) VIN |
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Vehicle Year |
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Color |
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2nd Color |
Make |
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(10) |
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Insurance Company Name |
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Policy Number |
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Insurance |
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Verification |
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(11) Vehicle Removed by |
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Owner's Last Name |
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First |
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State Month Year
Model |
Veh. Conf. |
Extent of
Damage
Insurance Telephone (Use Area Code)
Middle Initial
Driver
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(12) Owner's Address |
City |
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Same as Driver
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State |
Zip |
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Towed Veh. Type |
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Oversized |
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Rolled |
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Phone present |
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Load |
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Phone in use |
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Burned |
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(13) |
Citation |
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Statute/Ordinance |
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Citation |
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Statute/Ordinance |
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Number |
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Number |
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Number |
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Number |
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(14) |
Unit |
Occupants |
Type |
Hit & |
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Last Name |
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First |
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Middle |
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Date of Birth (mm/dd/yyyy) |
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Sex |
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(15) |
Address |
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City |
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State |
Zip |
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Telephone (Use Area Code) |
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(16) Driver License Number |
State |
Class Endorsement(s) |
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Restriction(s) |
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Inj. Sev. Type of Injury |
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Drv./Ped. Cond. OP Use
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(17) |
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Ejected Extricated Test |
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(% BAC) Transported by |
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To Medical Facility |
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License |
Plate Number |
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Air |
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0. |
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Bag |
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(18) |
VIN |
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Vehicle Year |
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Color |
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2nd Color |
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Make |
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(19) |
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Insurance Company Name |
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Policy Number |
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Insurance |
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Verification |
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(20) |
Vehicle Removed by |
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Owner's Last Name |
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First |
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State Month Year
Model |
Veh. Conf. |
Extent of
Damage
Insurance Telephone (Use Area Code)
Middle Initial
Driver
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(21) Owner's Address |
City |
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Same as Driver
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State |
Zip |
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Towed Veh. Type |
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Oversized |
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Rolled |
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Phone present |
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Load |
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Phone in use |
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Burned |
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(22) Citation |
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Statute/Ordinance |
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Citation |
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Statute/Ordinance |
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Number |
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Number |
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Number |
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Number |
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(23) Investigating Officer |
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Badge Number |
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Troop/Div. |
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Reviewed by (Init.) |
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Reviewer Badge Number |
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Date of Report (mm/dd/yyyy) |
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Unit Type |
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Injury Severity |
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Type of Injury |
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Driver/Pedestrian Condition |
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Occupant Protection (OP) In Use |
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D Driver |
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Z Other Cyclist |
0 |
N/A |
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4 |
Incapacitating |
0 |
N/A |
3 |
Trunk - |
00 |
Not Applicable |
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05 Under the |
08 |
Ill (Sick) |
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00 |
Not Applicable |
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05 |
Child Restraint Type Unknown |
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10 Booster Seat |
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P Pedestrian |
|
C Parked Car |
1 |
No Injury |
5 |
Fatal |
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1 Head |
4 |
Internal |
01 |
Apparently Normal |
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Influence of |
09 |
Dizzy/Faint |
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01 None Used |
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06 |
Restraint Type Unknown |
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11 Other |
||||||||||||||||||||||||||||||||||||||||||||||
X Pedestrian |
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A Animal |
2 |
Possible |
6 |
Unknown |
|
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2 Trunk - |
Arms |
02 |
Drinking - Ability Impaired |
Medications |
10 |
Emotional |
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02 |
Lap Belt Only |
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07 |
Helmet |
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99 Unknown |
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Conveyance |
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T Train |
3 |
Non - |
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External |
5 |
Legs |
03 |
Odor of Alcohol Beverage 06 |
Very Tired |
11 |
Other |
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03 |
Shoulder Belt Only |
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08 |
Child Restraint - Forward Facing |
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B Bicyclist |
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incapacitating |
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6 |
Unknown |
04 |
Illegal Drugs |
07 |
Sleepy |
99 |
Unknown |
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04 |
Shoulder and Lap Belt |
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09 |
Child Restraint - Rear Facing |
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Air Bag Deployed |
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Ejected |
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Extricated |
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Chemical Test |
|
Extent of Damage |
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Insurance Verification |
Oversized Load |
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Towed Vehicle Type |
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|||||||||||||||||||||||||||||||||||||||||
0 |
Not Applicable |
4 |
Deployed - Other (knee, |
0 |
Not Applicable 3 |
Ejected, |
|
0 N/A |
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0 |
N/A |
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4 Test Refused |
0 N/A |
3 |
Functional |
0 |
N/A |
3 |
Operator |
0 N/A |
00 |
N/A |
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05 |
Another Vehicle |
09 |
Cattle Trailer |
||||||||||||||||||||||||||||||||||||||||
1 |
Not Deployed |
|
air belt, etc.) |
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1 |
Not Ejected |
Totally |
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1 No |
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1 |
Blood |
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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 |
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2 |
Breath |
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6 Other |
2 Minor |
9 |
Unknown |
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2 |
Owner |
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P Permitted |
02 |
House Trailer |
07 |
Homemade |
11 |
Other |
||||||||||||||||||||||||||||||||||||||
3 |
Deployed - Side |
9 |
Deployment Unknown |
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Partially |
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3 |
Blood/Breath |
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03 |
Farm Trailer |
08 |
Trailer |
99 |
Unknown |
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04 |
Horse Trailer |
Box Trailer |
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||||||||||
WARNING - STATE LAW |
|
Use of contents for commercial solicitation is unlawful |
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234
Case Number |
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Pg |
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of |
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(24) Unit |
Pos in Veh. Last Name |
First |
Middle Initial |
Date of Birth (mm/dd/yyyy) |
|
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Sex |
|
Injured
Witness
(25) Address
Passenger 
Prop. Owner 
|
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City |
State |
Zip |
Telephone (Use Area Code)
|
Same as Driver |
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(26) |
Injury Severity / Type |
|
OP Use Air Bag Ejected |
Extricated Transported by |
|
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To |
Medical |
|
Facility |
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Property Type |
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(27) |
Unit |
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Pos in Veh. Last |
Name |
First |
Middle Initial |
|
Date of Birth (mm/dd/yyyy) |
|
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Sex |
|||||||||||||||||||||||||||||
Injured
Witness
(28) Address
Passenger 
Prop. Owner 
|
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City |
State |
Zip |
Telephone (Use Area Code)
|
Same as Driver |
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(29) |
Injury Severity / Type |
|
OP Use Air Bag Ejected |
Extricated Transported by |
|
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To Medical |
|
Facility |
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Property Type |
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(30) |
Unit |
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Pos in Veh. Last |
Name |
First |
Middle Initial |
|
Date of Birth (mm/dd/yyyy) |
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Sex |
|||||||||||||||||||||||||||||
Injured
Witness
(31) Address
Passenger 
Prop. Owner 
|
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City |
State |
Zip |
Telephone (Use Area Code)
|
Same as Driver |
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(32) |
Injury Severity / Type |
|
OP Use Air Bag Ejected |
Extricated Transported by |
|
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To Medical |
|
Facility |
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Property Type |
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(33) |
Unit |
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Pos in Veh. Last |
Name |
First |
Middle Initial |
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Date of Birth (mm/dd/yyyy) |
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Sex |
|||||||||||||||||||||||||||||
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Injured |
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Passenger |
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Witness |
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Prop. Owner |
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(34) Address |
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City |
State |
Zip |
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Same as Driver
Telephone (Use Area Code)
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(35) Injury Severity / Type |
|
OP Use Air Bag Ejected Extricated Transported by |
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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
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(36) |
Unit |
Carrier Name |
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Address |
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(37) |
City |
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State |
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Zip |
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GVWR |
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0 - 10K lbs. |
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Axle Qty. Cargo Body |
Vehicle Use |
||||||||||||||||||||||||||
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10,001 - 26K lbs. |
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Interstate Commerce |
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GCWR |
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26K+ lbs. |
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Intrastate Commerce |
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(38) |
U.S. DOT Number |
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Vehicle Inspection Number |
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Placard Number |
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Haz. Mat. Class Haz. Mat. Involved |
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Haz. |
Mat. |
Release |
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Other |
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OK |
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Yes |
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Yes |
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No |
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No |
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Government |
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(39) |
Unit |
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Carrier Name |
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Address |
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State |
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(40) |
City |
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(41) |
U.S. DOT Number |
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Vehicle Inspection Number |
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OK |
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Zip |
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GVWR |
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0 - 10K lbs. |
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Axle Qty. Cargo Body |
Vehicle Use |
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10,001 - 26K lbs. |
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Interstate Commerce |
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GCWR |
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26K+ lbs. |
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Intrastate Commerce |
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||||
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Placard Number |
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Haz. Mat. Class Haz. Mat. Involved |
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Haz. |
Mat. |
Release |
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Yes |
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Yes |
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Other |
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No |
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No |
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Government |
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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 |
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07. School Bus |
13. Bus/Large Van |
18. |
Farm |
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Machinery |
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01. |
Passenger |
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including driver |
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08. Truck/Trailer |
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02. |
Passenger |
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03. |
Passenger |
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14. Bus 16+ |
19. |
ATV |
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Veh. Conv. |
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09. |
occupants |
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including driver |
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(Bobtail) |
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20. SUV |
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04. |
Pickup |
10. |
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15. Motorcycle |
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21. |
Passenger Van |
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05. |
Single Unit |
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22. |
Truck more |
11. |
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than 10,000 |
||
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Truck, 2 axles |
16. Motor Scooter/ |
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Double |
Moped |
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lbs., Cannot |
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Classify |
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23. |
Van 10,000 |
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lbs. or Less |
06. |
Single Unit |
12. |
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24. |
Other |
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Truck, 3+ axles |
Triple |
17. Motor Home |
99. |
Unknown |
Cargo Body Type
00. |
N/A |
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06. |
Intermodal |
11. |
Hopper (grain/ |
01. |
Bus |
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chips/gravel) |
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||
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07. |
Dump Truck/ |
12. |
Pole Trailer |
02. |
Bus 16+ seats |
|
Trailer |
||
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||
03. |
Van/Enclosed |
08. |
Concrete Mixer |
13. |
Log Trailer |
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Box |
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04. |
Cargo Tank |
09. |
Auto Transporter |
14. |
Vehicle Towing |
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Vehicle |
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15. |
Other |
05. |
Flatbed |
10. |
Garbage/Refuse |
99. |
Unknown |
235
Case Number |
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|
OFFICIAL OKLAHOMA TRAFFIC COLLISION REPORT |
Pg |
|
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of |
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Total Lanes |
Legal |
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Pedestrian / Pedalcyclist Only |
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Was the collision in or near a construction, maintenance or utility |
Yes |
|||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
|
Unit |
Actions Prior |
Location at Time |
Safety |
Unit Number of |
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||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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in Roadway |
Speed |
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work zone? (If yes, complete this section) |
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No |
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
This unit will |
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to Collision |
of Collision |
Equip. |
Vehicle Striking |
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correspond |
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Type of Work Zone |
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Location of the Work Zone |
||||||||||||||||||||||||||
to 'Unit 1' |
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Collision |
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|||||||
This unit will |
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1 |
Lane Closure |
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1 Before the First Work |
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|||||||||||||||||
correspond |
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2 |
Lane Shift/Crossover |
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Zone Warning Sign |
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||||||||||||||||||||
to 'Unit 2' |
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3 Work on Shoulder or Median |
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2 |
Advance Warning Area |
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||||||||||||||||||||||||||
|
Light |
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What |
|
Unit 1 |
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Unit 2 |
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Underride/ |
|
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Unit 1 |
Unit 2 |
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4 Intermittent or Moving Work |
3 |
Transition Area |
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9 |
Unknown |
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4 |
Activity Area |
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|||||||||||||||||||||||
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Vehicle |
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Override |
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5 |
Termination Area |
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|||||||||||||||||
1 |
Daylight |
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||||||||||||||||||||||||||||
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Was Going |
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9 |
Unknown |
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||||||||||||||||||
2 |
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to Do |
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0 |
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Not Applicable |
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3 |
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00 |
Not Applicable |
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1 |
|
No Underride or Override |
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Workers Present Yes |
No |
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Unknown |
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||||||||||||||||||||||||||||||||||||||||||
4 |
Dawn |
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|||||||||||||||||||||||||||||||||||||||||||||
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01 |
Go Ahead |
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2 |
|
Underride, Compartment |
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||||||||||||||||||||||||||||
5 |
Dusk |
|
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02 |
Turn Left |
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Intrusion |
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Unit 1 |
Unit 2 |
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|
Unit 1 |
|
Unit 2 |
|||||||||||||||||||||||
6 |
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03 |
Turn Right |
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3 |
|
Underride, No |
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Trafficway |
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Unsafe / Unlawful |
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Lighting |
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04 |
Make “U” Turn |
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Compartment Intrusion |
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Contributing Factors |
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7 |
Other |
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05 |
Stop |
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4 |
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Underride, Compartment |
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9 |
Unknown |
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06 |
Slow for Cause |
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Intrusion Unknown |
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0 |
Not Applicable |
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FAILED TO YIELD |
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49 |
Tires |
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07 |
Start from Park/Stop |
5 |
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Override, Motor Vehicle in |
1 |
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01 |
From Stop Sign |
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50 |
Suspension |
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08 |
Change Lanes |
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Transport |
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2 |
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02 |
From Yield Sign |
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51 |
Headlights |
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Weather |
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09 |
Overtake |
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6 |
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Override, Other Motor |
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with a Continuous Left |
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03 |
Private Drive |
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52 |
Tail Lights |
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10 |
Pass |
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Vehicle |
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Turn Lane |
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04 |
County Road at |
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53 |
Stop Lights |
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01 |
Clear |
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11 |
Back |
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9 |
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Unknown |
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3 |
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Through Highway |
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54 |
Wheel |
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02 |
Fog/Smog/Smoke |
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12 |
Remain Stopped |
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Unprotected (painted > 4 |
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05 |
From Signal Light |
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55 |
Exhaust System |
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Traffic |
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03 |
Cloudy |
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13 |
Remain Parked |
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Unit 1 |
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Unit 2 |
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feet) Median |
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06 |
From Alley |
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56 |
Windshield Wipers |
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04 |
Rain |
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14 |
Enter/Merge in Traffic |
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Control |
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4 |
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07 |
To Pedestrian |
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57 |
Other Mechanical Defects |
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05 |
Snow |
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15 |
Negotiate a Curve |
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Positive Median Barrier |
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08 |
To Vehicle on Right |
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LEFT OF CENTER |
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06 |
Sleet/Hail (Freezing |
16 |
Park |
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00 |
No Control |
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5 |
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09 |
To Vehicle in |
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58 |
In Meeting |
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Intersection |
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59 |
No Passing Zone (Unmarked) |
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Rain/Drizzle) |
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17 |
Other |
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01 |
Stop Sign |
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Barrier |
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07 |
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10 |
To Emergency |
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60 |
Marked Zone |
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Severe Crosswind |
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99 |
Unknown |
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02 |
Traffic Signal |
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6 |
9 Unknown |
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Vehicles |
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61 |
Other |
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08 |
Blowing Snow |
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Unit 1 |
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Unit |
2 |
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03 |
Flashing Traffic Signal |
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12 |
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09 |
Blowing Sand, Soil, |
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What |
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Unit 1 |
Unit 2 |
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Other |
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IMPROPER OVERTAKING |
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Dirt |
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Vehicle |
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04 |
School Zone Signs |
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Vehicle |
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FOLLOWED TOO |
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62 |
In Marked Zone |
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10 |
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Did |
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05 |
Yield Sign |
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Removal |
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CLOSELY |
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63 |
On Hill/Curve |
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Other |
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06 |
Warning Sign |
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13 |
Human Element |
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64 |
At Intersection |
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99 |
Unknown |
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00 |
Not Applicable |
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07 |
Railroad Advance |
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0 |
Not Applicable |
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14 |
Traffic Condition |
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65 |
Without Sufficient Clearance |
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01 |
Went Ahead |
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Warning Sign |
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1 |
Towed Due to |
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15 |
Weather Condition |
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66 |
Other |
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|
Locality |
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02 |
Turned Left |
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08 |
Railroad Cross Bucks |
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Vehicle Damage |
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UNSAFE SPEED |
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IMPROPER PARKING |
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03 |
Turned Right |
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09 |
Railroad Gates |
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2 |
Towed For Reasons |
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16 |
Driver's Ability (Age) |
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67 |
On Roadway |
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||||||||||||||||||||||||||||||||||||||||||
1 |
Residential |
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04 |
Entered “U” Turn |
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10 |
Railroad Signal |
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Other Than Damage |
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17 |
Inexperienced Driver - |
68 |
Where Prohibited |
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2 |
Business |
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05 |
Stopped |
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11 |
No Passing Zone |
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3 |
Remained at Scene |
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Young |
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69 |
Other |
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3 |
Industrial |
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06 |
Slowed |
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12 |
Person (including flagger, |
4 |
Driven from Scene |
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18 |
Exceeding Legal Limit |
INATTENTION |
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||||||||||||||||||||||||||||||||||||||||||||||||||
4 |
School |
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07 |
Started From Park/Stop |
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law enforcement, crossing |
9 |
Unknown |
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19 |
For Traffic Conditions |
70 |
Distracted by Passenger in |
||||||||||||||||||||||||||||||||||||||||||||||||||||||||
5 |
Not |
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08 |
Entered Other Lane |
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13 |
guard, etc.) |
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20 |
For Type of Roadway |
71 |
Vehicle |
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Unit 1 |
Unit 2 |
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||||||||||||||||||||||||||||||||||||||||||||||
6 |
Mixed Use |
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09 |
Overtaking |
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|
Abnormal Control |
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(Gravel, Dirt, etc.) |
|
Other Distraction Inside |
||||||||||||||||||||||||||||||||||||||||||||||||
7 |
Other |
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10 |
Passing |
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14 |
Posted Speed |
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Vehicle |
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21 |
For Ice or Snow on |
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72 |
Vehicle |
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9 |
Unknown |
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11 |
Backed |
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15 |
Other |
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Condition |
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Roadway |
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Distraction From Outside |
|||||||||||||||||||||||||||||||||
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12 |
Remained Stopped |
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99 |
Unknown |
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22 |
Rain or Wet Roadway |
|
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Vehicle |
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Type of |
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13 |
Remained Parked |
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00 |
Not Applicable |
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23 |
Wind |
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73 |
Other |
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Intersection |
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14 |
Entered/Merged |
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Road |
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Unit 1 |
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Unit |
2 |
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01 |
Apparently Normal |
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24 |
Other Weather |
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WRONG WAY |
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0 |
Not an Intersection |
15 |
Departed |
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Surface |
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02 |
Brakes |
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Conditions |
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74 |
On One Way |
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16 |
Departed |
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Conditions |
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03 |
Headlights |
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25 |
Vehicle Condition |
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75 |
On Exit Ramp |
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1 |
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17 |
Swerved Right |
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01 |
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04 |
Steering |
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26 |
View Obstruction |
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76 |
On Entrance Ramp |
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Dry |
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2 |
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18 |
Swerved Left |
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05 |
Tail Lights |
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27 |
On Curve/Turn |
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77 |
Other |
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3 |
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19 |
Parked |
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02 |
Wet |
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06 |
Brake Lights |
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28 |
Impeding Traffic |
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IMPROPER START FROM |
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4 |
Intersection |
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20 |
Other |
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03 |
Ice/Frost |
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07 |
Tires/Wheels |
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29 |
Other |
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78 |
Parked Position |
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99 |
Unknown |
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04 |
Snow |
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08 |
Suspension |
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IMPROPER TURN |
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79 |
Other |
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5 |
Intersection as Part |
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05 |
Mud, Dirt, Gravel |
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09 |
Signal lights |
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30 |
From Wrong Lane |
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80 |
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of Interchange |
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Visibility Unit 1 |
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Unit 2 |
06 |
Slush |
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10 |
Windows |
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31 |
From Direct Course |
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81 |
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6 |
Traffic Circle |
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Obscured |
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07 |
Water (standing, moving) |
11 |
Truck Coupling/Trailer |
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32 |
Right |
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OTHER IMPROPER ACT/ |
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7 |
Roundabout |
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by |
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08 |
Sand |
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Hitch/Safety Chains |
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33 |
Left |
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MOVEMENT |
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9 |
Unknown |
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09 |
Oil |
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12 |
Mirrors |
15 |
Other |
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34 |
Turn |
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82 |
Failed to Signal |
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00 |
Not Applicable |
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10 |
Other |
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13 |
Wipers |
99 Unknown |
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35 |
To Enter Private Drive |
83 |
Disregarded Warning Signal |
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Incident Type |
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01 |
Trees |
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99 |
Unknown |
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14 |
Power Train |
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36 |
In Front of Oncoming |
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84 |
Improper Use of Lane |
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02 |
Embankment |
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Traffic |
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85 |
Improper Backing |
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00 |
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03 |
Building |
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Road Character |
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Special |
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Unit 1 |
Unit 2 |
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37 |
Other |
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86 |
Apparently Sleepy |
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Not an Incident |
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04 |
Signs |
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Function |
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38 |
CHANGED LANES |
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87 |
Failed to Secure Load |
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51 |
Private Property |
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05 |
Parked Vehicles |
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Grade |
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Unit 1 |
Unit 2 |
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of Vehicle |
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UNSAFELY |
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88 |
Other |
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52 |
Deliberate Intent |
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1 |
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06 |
High Weeds |
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Level |
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39 |
STOPPED IN |
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UNKN./NO IMPROPER ACT |
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53 |
Medical Condition |
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00 |
Not Applicable |
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07 |
Fences |
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2 |
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Hillcrest |
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TRAFFIC LANE |
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89 |
Deer in Roadway |
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54 |
Legal Intervention |
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08 |
Shrubbery |
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3 |
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Uphill |
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01 |
School Bus |
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FAILED TO STOP |
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90 |
Animal in Roadway |
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55 |
Suicide |
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09 |
Ice, Snow or Frost on |
4 |
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Downhill |
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02 |
Transit Bus |
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40 |
For Stop Sign |
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91 |
Domestic Animal in Rdwy |
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57 |
Drowning |
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Windows |
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5 |
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Sag (bottom) |
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03 |
Intercity Bus |
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41 |
For Traffic Signal |
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92 |
Avoiding Other Vehicle |
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58 |
Other |
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10 |
Smoke |
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04 |
Charter Bus |
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42 |
For School Bus |
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93 |
Avoiding Pedestrian |
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11 |
Fog |
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Horizontal |
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Unit 1 |
Unit 2 |
05 |
Other Bus |
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43 |
For Railroad Gates/ |
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94 |
Object/Debris in Roadway |
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Location of |
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12 |
Dust |
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Alignment |
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06 |
Military |
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Signal |
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95 |
Defect in Roadway |
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First Harmful |
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13 |
Rain |
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1 |
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Straight |
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07 |
OHP |
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44 |
For Officer/Flagman |
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96 |
Abnormal Traffic Control |
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Event |
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14 |
Sun |
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08 |
Other Police |
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45 |
At Sidewalk/Stopline |
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97 |
Improper Bicyclist Action |
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2 |
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Curve - Left |
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01 |
On Roadway |
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15 |
Other |
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09 |
Other Law Enforcement |
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46 |
Other |
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98 |
NO IMPROPER ACTION BY |
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3 |
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Curve - Right |
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02 |
Shoulder |
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99 |
Unknown |
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10 |
Ambulance |
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UNSAFE VEHICLE |
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DRIVER |
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03 |
Median |
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11 |
Fire Truck |
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47 |
Brakes |
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99 |
PEDESTRIAN ACTION |
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04 |
Roadside |
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Driver |
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Unit 1 |
Unit 2 |
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Road |
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Unit 1 |
Unit 2 |
12 |
Public Owned Vehicle |
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48 |
Steering |
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05 |
Gore |
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Distracted |
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Surface |
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13 |
Highway Equipment |
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Unit |
1 |
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Unit |
2 |
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06 |
Separator |
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by |
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Type |
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14 |
Special Mobilized Machine |
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Point of First |
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07 |
Parking Lane/Zone |
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1 |
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Concrete |
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15 |
Other |
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99 Unknown |
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Contact on |
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0 |
Not Applicable/None |
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08 |
Off Roadway, |
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Vehicle |
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1 |
Electronic Communication |
2 |
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Asphalt |
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Emergency |
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Unit 1 |
Unit 2 |
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Location Unknown |
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Unit 1 |
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Unit 2 |
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09 |
Outside |
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Devices |
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3 |
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Gravel |
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Vehicle |
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Most Damaged |
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2 |
Other Electronic Device |
4 |
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Dirt |
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Responding to |
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Area |
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Way |
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10 |
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3 |
Other Inside Vehicle |
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5 |
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Brick |
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an Emergency |
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Other |
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0 |
N/A |
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2 |
No |
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13 |
Top |
15 |
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4 |
Other Outside Vehicle |
6 |
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Other |
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99 |
Unknown |
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9 |
Unknown |
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9 |
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Unknown |
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1 |
Yes |
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9 |
Unknown |
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14 |
Undercarriage |
99 Unknown |
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236
Case Number
Latitude
.
Longitude
N
.
Railroad Crossing Number
W
Pg of
Direction of Travel Before Collision
Unit |
|
|
N E |
|
Unit |
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|
N E |
Number |
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S W |
|
Number |
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|
S W |
Indicate North
by Arrow
COLLISION EVENTS
Unit |
First Event |
Second Event |
Third Event |
Fourth Event |
First Harmful Event |
First Harmful |
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Event for the |
|||
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Entire |
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Collision |
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Unit |
First Event |
Second Event |
Third Event |
Fourth Event |
First Harmful Event |
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37 |
Work Zone/Maintenance |
56 |
Pavement |
38 |
Equipment |
57 |
Ditch |
Other |
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
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 |
|
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Cushion |
|
|
Remarks
237
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|
OFFICIAL OKLAHOMA TRAFFIC COLLISION REPORT |
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Pg |
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of |
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|||||||||||||||||||||||||||||||||||||
Case Number |
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PERSONS SUPPLEMENTAL |
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||||||||||||||||||||||||
(42) |
Unit |
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|
Pos in Veh. |
|
Last Name |
First |
Middle Initial |
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|
Date of Birth (mm/dd/yyyy) |
|
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Sex |
|||||||||||||||||||||||||||||||
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Injured |
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Passenger |
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||||
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Witness |
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Prop. Owner |
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||||
(43) |
Address |
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City |
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State |
Zip |
|
Telephone |
|
(Use Area |
|
Code) |
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|||||||||||||||||||
|
Same as Driver |
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(44) |
Injury Severity / Type |
|
OP Use |
|
Air Bag Ejected Extricated Transported by |
|
|
To |
Medical |
|
Facility |
|
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Property Type |
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(45) |
Unit |
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|
Pos in Veh. |
|
Last Name |
First |
Middle Initial |
|
|
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|
|
Date of Birth (mm/dd/yyyy) |
|
|
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|
|
Sex |
||||||||||||||||||||||||||||||
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Injured |
|
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Passenger |
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Witness |
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Prop. Owner |
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(46) |
Address |
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City |
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State |
Zip |
|
Telephone |
|
(Use Area |
|
Code) |
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|||||||||||||||||||
|
Same as Driver |
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(47) |
Injury Severity / Type |
|
OP Use |
|
Air Bag Ejected Extricated Transported by |
|
|
To |
Medical |
|
Facility |
|
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|
Property Type |
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(48) |
Unit |
|
|
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|
|
Pos in Veh. |
|
Last Name |
First |
Middle Initial |
|
|
|
|
|
|
Date of Birth (mm/dd/yyyy) |
|
|
|
|
|
Sex |
||||||||||||||||||||||||||||||
|
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Injured |
|
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Passenger |
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||||
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Witness |
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Prop. Owner |
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||||
(49) |
Address |
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City |
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State |
Zip |
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Telephone |
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(Use Area |
|
Code) |
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|||||||||||||||||||
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Same as Driver |
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(50) |
Injury Severity / Type |
|
OP Use |
|
Air Bag Ejected Extricated Transported by |
|
|
To |
Medical |
|
Facility |
|
|
|
|
Property Type |
|
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|||||||||||||||||||||||||||||||||||
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(51) |
Unit |
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|
|
Pos in Veh. |
|
Last Name |
First |
Middle Initial |
|
|
|
|
|
|
Date of Birth (mm/dd/yyyy) |
|
|
|
|
|
Sex |
||||||||||||||||||||||||||||||
|
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Injured |
|
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Passenger |
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||||
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Witness |
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Prop. Owner |
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||||
(52) |
Address |
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City |
|
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State |
Zip |
|
Telephone |
|
(Use Area |
|
Code) |
|
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|
|||||||||||||||||||
|
Same as Driver |
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|
(53) |
Injury Severity / Type |
|
OP Use |
|
Air Bag Ejected Extricated Transported by |
|
|
To |
Medical |
|
Facility |
|
|
|
|
Property Type |
|
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|
|||||||||||||||||||||||||||||||||||
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(54) |
Unit |
|
|
|
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|
|
|
Pos in Veh. |
|
Last Name |
First |
Middle Initial |
|
|
|
|
|
|
Date of Birth (mm/dd/yyyy) |
|
|
|
|
|
Sex |
||||||||||||||||||||||||||||||
|
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|
Injured |
|
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Passenger |
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||||
|
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|
Witness |
|
|
Prop. Owner |
|
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||||
(55) |
Address |
|
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|
|
|
|
|
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|
|
City |
|
|
State |
Zip |
|
Telephone |
|
(Use Area |
|
Code) |
|
|
|
|
|
|
|
|
|||||||||||||||||||
|
Same as Driver |
|
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|||||||
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|
(56) |
Injury Severity / Type |
|
OP Use |
|
Air Bag Ejected Extricated Transported by |
|
|
To |
Medical |
|
Facility |
|
|
|
|
Property Type |
|
|
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|
|
|
|||||||||||||||||||||||||||||||||||
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|
(57) |
Unit |
|
|
|
|
|
|
|
Pos in Veh. |
|
Last Name |
First |
Middle Initial |
|
|
|
|
|
|
Date of Birth (mm/dd/yyyy) |
|
|
|
|
|
Sex |
||||||||||||||||||||||||||||||
|
|
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|
|
Injured |
|
|
Passenger |
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||||
|
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|
Witness |
|
|
Prop. Owner |
|
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||||
(58) |
Address |
|
|
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|
|
|
|
|
|
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|
|
City |
|
|
State |
Zip |
|
Telephone |
|
(Use Area |
|
Code) |
|
|
|
|
|
|
|
|
|||||||||||||||||||
|
Same as Driver |
|
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|||||||
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|
|
(59) |
Injury Severity / Type |
|
OP Use |
|
Air Bag Ejected Extricated Transported by |
|
|
To |
Medical |
|
Facility |
|
|
|
|
Property Type |
|
|
|
|
|
|
|||||||||||||||||||||||||||||||||||
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|
(60) |
Unit |
|
|
|
|
|
|
|
Pos in Veh. |
|
Last Name |
First |
Middle Initial |
|
|
|
|
|
|
Date of Birth (mm/dd/yyyy) |
|
|
|
|
|
Sex |
||||||||||||||||||||||||||||||
|
|
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|
|
Injured |
|
|
Passenger |
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||||
|
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|
Witness |
|
|
Prop. Owner |
|
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||||
(61) |
Address |
|
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|
City |
|
|
State |
Zip |
|
Telephone |
|
(Use Area |
|
Code) |
|
|
|
|
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|
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|
|||||||||||||||||||
|
Same as Driver |
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|||||||
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|
(62) |
Injury Severity / Type |
|
OP Use |
|
Air Bag Ejected Extricated Transported by |
|
|
To |
Medical |
|
Facility |
|
|
|
|
Property Type |
|
|
|
|
|
|
|||||||||||||||||||||||||||||||||||
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|
(63) |
Unit |
|
|
|
|
|
|
|
Pos in Veh. |
|
Last Name |
First |
Middle Initial |
|
|
|
|
|
|
Date of Birth (mm/dd/yyyy) |
|
|
|
|
|
Sex |
||||||||||||||||||||||||||||||
|
|
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|
|
Injured |
|
|
Passenger |
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||||
|
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|
Witness |
|
|
Prop. Owner |
|
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||||
(64) |
Address |
|
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|
City |
|
|
State |
Zip |
|
Telephone |
|
(Use Area |
|
Code) |
|
|
|
|
|
|
|
|
|||||||||||||||||||
|
Same as Driver |
|
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|||||||
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|
(65) |
Injury Severity / Type |
|
OP Use |
|
Air Bag Ejected Extricated Transported by |
|
|
To |
Medical |
|
Facility |
|
|
|
|
Property Type |
|
|
|
|
|
|
|||||||||||||||||||||||||||||||||||
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|
(66) |
Unit |
|
|
|
|
|
|
|
Pos in Veh. |
|
Last Name |
First |
Middle Initial |
|
|
|
|
|
|
Date of Birth (mm/dd/yyyy) |
|
|
|
|
|
Sex |
||||||||||||||||||||||||||||||
|
|
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|
|
|
Injured |
|
|
Passenger |
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||||
|
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|
Witness |
|
|
Prop. Owner |
|
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||||
(67) |
Address |
|
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|
City |
|
|
State |
Zip |
|
Telephone |
|
(Use Area |
|
Code) |
|
|
|
|
|
|
|
|
|||||||||||||||||||
|
Same as Driver |
|
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Injury Severity / Type |
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238
OFFICIAL OKLAHOMA TRAFFIC COLLISION REPORT
DIAGRAM SUPPLEMENTAL
Case Number
Pg of
Indicate North
by Arrow
239
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OFFICIAL OKLAHOMA TRAFFIC COLLISION REPORT |
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240
Form Characteristics
| Fact Name | Details |
|---|---|
| Purpose of the Form | The Oklahoma Traffic Collision Report form is designed to document the details and circumstances surrounding traffic collisions, providing crucial information for law enforcement and insurance purposes. |
| Submission Requirement | According to Oklahoma law, the form must be completed and submitted to the appropriate authorities whenever a collision results in injury, death, or damage exceeding $300. |
| Data Collected | The form collects a wide range of information, including the date, time, and location of the incident; details about the vehicles involved; driver and occupant information; and any citations issued. |
| Access to the Form | The form is typically available online through the Oklahoma Department of Public Safety website, or it can be obtained at local law enforcement agencies. |
| Importance for Claim Processing | Insurance companies heavily rely on the data contained within the collision report to process claims effectively, determining liability and estimating damages based on the reported facts. |
Guidelines on Utilizing Oklahoma Traffic Collision Report
The Oklahoma Traffic Collision Report form is an essential document that helps record the details of a traffic incident. Properly filling out this form is vital for ensuring that all relevant information is captured and reported. This not only aids in the investigation but also provides necessary information for all parties involved. Follow the steps below to ensure that you complete the form accurately.
- Begin at the top of the form. Indicate if you are submitting an official Oklahoma Traffic Collision Report by marking “Y” or “N” where indicated. Enter the case number assigned by your reporting agency.
- Input details about the incident: record the date of the collision in mm/dd/yyyy format and the time of the event. Specify the county and the name of the nearest city or town.
- Provide information about the motor vehicles involved. Note the total number of injuries and fatalities that occurred as a result of the collision.
- In the location section, accurately list the street, road, or highway where the incident occurred. Also, note the distance from the nearest intersecting street.
- Carefully fill out the unit occupants’ details. For each driver, list their name, date of birth, address, and driver license number. Mark the driver’s sex and any injuries incurred.
- Document the vehicles’ information. Include the VIN, year, make, and color of the vehicles involved. Record the insurance company details and policy number for each vehicle.
- Remark on the condition and extent of damage for each vehicle. Note whether the vehicles were towed, removed, or sustained damage.
- In the citation section, list any citations issued and their corresponding statute or ordinance numbers.
- Complete the investigating officer's section by entering their badge number and troop or division details. Don’t forget to enter the date of the report.
- Lastly, review the entire form to ensure completeness and clarity. Submit the form to the appropriate reporting agency once finished.
Following these steps will help ensure that all necessary information is included in the report. Properly documenting the details of a traffic collision is not just a legal requirement; it also provides essential clarity for everyone involved. If any questions arise while filling out the form, don't hesitate to seek assistance for guidance.
What You Should Know About This Form
What is the Oklahoma Traffic Collision Report form?
The Oklahoma Traffic Collision Report form is a document that provides detailed information about a traffic collision that occurs within the state. It collects crucial data such as the date, time, location, vehicles involved, injuries sustained, and any contributing factors to the incident. Law enforcement officers typically complete this report at the scene of the crash, and it serves multiple purposes, including aiding investigations and providing documentation for insurance claims.
How can I obtain a copy of the collision report?
You can request a copy of the Oklahoma Traffic Collision Report from the law enforcement agency that investigated the incident. Many agencies allow you to fill out a request form online or in person. There may be a small fee associated with obtaining a copy of the report. It's important to provide details like the date of the accident and case number, if known, to expedite the process.
What should I do if I find inaccuracies in the report?
If you discover inaccuracies in the collision report, you should contact the investigating agency as soon as possible. Provide evidence or documentation that supports your claim of error. The agency may be able to amend the report based on your feedback, ensuring the information remains accurate for all parties involved. Keeping your records and any supporting documents handy will help in this process.
Are there any legal implications associated with the Traffic Collision Report?
Yes, the information contained in the Oklahoma Traffic Collision Report can have significant legal implications. It may be referenced in lawsuits, insurance claims, or police investigations. Consequently, providing truthful and accurate information at the scene is essential. Misrepresentations or omissions could lead to legal issues, including potential criminal charges in serious cases.
What happens if there are injuries or fatalities involved in the collision?
In the event of injuries or fatalities, the Oklahoma Traffic Collision Report becomes even more critical. It documents essential details that authorities need to investigate the situation accurately. Additionally, it can impact insurance claims and legal proceedings. If someone is injured, they may receive medical attention on-site, while fatal incidents trigger a more extensive investigation, potentially involving multiple agencies and a review by a medical examiner.
Common mistakes
Completing the Oklahoma Traffic Collision Report form requires careful attention to detail. One common mistake is providing incomplete or incorrect contact information for the drivers and occupants involved in the collision. This information is essential for follow-up investigations and insurance claims. Missing addresses or phone numbers can cause delays in processing the report.
Another mistake people often make is failing to accurately describe the circumstances of the collision. Information about the time of day, weather conditions, and specific location can impact how the incident is viewed by law enforcement and insurance companies. Incomplete descriptions may lead to confusion or misinterpretation of the events that transpired.
Additionally, some individuals overlook the necessity of documenting injuries accurately. Whether a person suffered minor, serious, or no injuries at all, it's vital to indicate this information clearly on the report. Misrepresenting the severity of injuries can affect liability claims and insurance coverage later.
Finally, a frequent error occurs when the person filling out the form does not fully understand how to categorize vehicle types and damage extent. Whether detailing the make and model of vehicles or specifying the type of damage (e.g., minor, disabling), precision is crucial. Misclassifying this information may lead to complications in the processing of insurance claims and legal matters.
Documents used along the form
The Oklahoma Traffic Collision Report form is a crucial document in documenting traffic incidents. However, it is frequently used alongside several other forms and documents that aid in the investigative process and facilitate legal proceedings. Below is a list of pertinent forms commonly utilized in conjunction with the Oklahoma Traffic Collision Report.
- Declaration of Law Enforcement Officer: This document outlines the findings of the law officer investigating the incident. It provides insight into the circumstances surrounding the accident, including any citations issued or observations made at the scene.
- Driver Accident Statement: A detailed account from the perspective of the involved drivers, this statement outlines their version of the events leading up to the collision. It can be critical in establishing fault.
- Medical Report: In cases where injuries occur, a medical report documents the extent of injuries sustained by victims. It is essential for insurance claims and potential litigation as it provides evidence of damages and treatment received.
- Insurance Claim Form: This form is necessary for filing a claim with the insurance companies of those involved. It helps initiate the claims process and ensures that damages are assessed and compensated.
- Witness Statements: Accounts from witnesses who observed the collision can provide unbiased perspectives. These statements can be vital in corroborating facts and supporting claims made by the involved parties.
- Property Damage Report: This document specifies any property damage that occurred as a result of the collision. It provides detailed descriptions of damage to vehicles and other property, serving as crucial evidence for insurance claims.
Utilizing these accompanying documents with the Oklahoma Traffic Collision Report enhances the overall understanding of the incident and aids in the resolution of claims and legal matters. Each form has its unique importance, contributing to a comprehensive analysis of traffic collisions in the state.
Similar forms
- Accident Report Form - Similar to the Oklahoma Traffic Collision Report, this document collects details about the collision, including information on vehicles, drivers, and injuries. Both forms facilitate the investigation process and contribute to insurance claims.
- Incident Report - This document serves a similar purpose as the collision report in documenting incidents that occur on the road. It includes parties involved, witness information, and a narrative about the event, providing a broader scope of the incident.
- Insurance Claim Form - While detailing specifics about damages and injuries, this form is closely related to the traffic collision report as it often requires the same information to process claims for repairs and medical expenses.
- Police Report - Like the traffic collision report, a police report contains a detailed account of the accident, including witness statements and officer observations. This report is crucial for legal proceedings and insurance processes.
- Vehicle Damage Report - This document outlines the extent of damage done to vehicles involved in a collision. It corresponds with the collision report by providing additional data on damages, which can influence insurance assessments.
- Witness Statement Form - This document gathers information from individuals who observed the accident. Much like the collision report, it is used to clarify events leading up to and during the incident.
- Medical Report - When injuries occur, medical reports are essential for documenting the treatment received. They are similar to the collision report in that they provide detailed accounts of injuries sustained during the incident.
- Driving Record - This document outlines a driver's history, including accidents and violations. Similar to the traffic collision report, it helps assess the driver's credibility and safety record following a traffic incident.
Dos and Don'ts
- Do provide accurate and complete information for each section of the report. Inaccuracies can lead to delays.
- Do include all relevant details about the collision, such as time, date, and location to provide context for the event.
- Do ensure that any fatalities or injuries are reported. This information is crucial for further investigations.
- Do sign and date the report to confirm your information is correct and complete.
- Don't leave sections blank without a valid reason. Missing information may hinder the investigation.
- Don't provide assumptions or guesses. Stick to factual details to maintain the report's credibility.
- Don't alter the report after submission, as this can result in legal consequences.
- Don't forget to keep a copy of the submitted report for your records. This can be useful in future proceedings.
Misconceptions
Here are seven common misconceptions about the Oklahoma Traffic Collision Report form:
- 1. The form is only for serious accidents. Many think it's only necessary after fatal or serious injuries occur. In reality, the form should be completed for any collision involving vehicles, regardless of the severity of injuries.
- 2. The reporting agency provides the form automatically. Some assume that police or other agencies will automatically provide the form. However, individuals often need to request this report themselves, particularly for insurance claims.
- 3. Any filled-out form is sufficient. People believe that they can fill out the form casually. It's important to provide clear and thorough information, as missing or incorrect details can complicate legal and insurance proceedings.
- 4. The driver’s information is the only important detail. Many focus primarily on driver data. Yet, the report also requires details about vehicle occupants and witnesses, which can be crucial for a complete understanding of the incident.
- 5. You can’t collect insurance without the report. It’s a common belief that the report is essential to receive insurance compensation. While it's important, insurance companies may provide assistance based on other evidence, like photographs and witness statements.
- 6. The form must be submitted at the scene. Some individuals think they need to fill out and submit the form on-the-spot. This isn’t true; the report can be completed later, as long as all necessary details are recorded.
- 7. The form cannot be amended later. A misconception exists that once the form is filed, it cannot be changed. In fact, if new information arises, it may be possible to amend the report, provided you follow the proper procedures.
Key takeaways
The Oklahoma Traffic Collision Report form is an essential document for anyone involved in a traffic accident in the state. Proper completion and understanding of this form can streamline the reporting process and aid in insurance and legal matters. Here are some key takeaways regarding the form:
- Accurate Information is Vital: Providing correct details about the date, time, and location of the collision ensures that the incident is logged accurately. This information plays a crucial role in investigations and any potential legal actions.
- Involved Parties Information: It is important to collect comprehensive information about all parties involved, including drivers, passengers, and witnesses. Details such as names, contact information, and insurance details should be recorded clearly.
- Documenting Injuries: The form explicitly asks for information about injuries sustained in the collision. Accurate documentation of injuries can assist in medical evaluations and claims processing.
- Reporting Agency Details: The section dedicated to the reporting agency should be filled out thoroughly, including the case number and badge numbers of the investigating officers. This helps in tracking the report within the respective agency.
- Specific Encounters: Include details about any unique factors present at the scene, such as construction zones or adverse weather conditions. This information can help in determining liability and understanding the accident's context.
In conclusion, understanding and accurately completing the Oklahoma Traffic Collision Report can significantly impact the resolution of traffic-related incidents. Take the time to fill it out thoroughly to ensure all relevant information is captured.
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