Homepage Fill Out Your Oklahoma Traffic Collision Report Form
Article Structure

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

 

 

 

 

Y

 

N

Pg

of

 

 

 

Incident Report

 

 

 

 

 

 

 

[

DO NOT WRITE IN THIS SPACE

]

 

 

 

 

 

Y N

 

 

 

Investigation Completed

 

 

Revised

 

 

 

 

OFFICIAL OKLAHOMA TRAFFIC COLLISION REPORT

 

Investigation Made at Scene

 

 

Fatality

 

 

 

 

 

Photographs

 

 

 

Hit and Run

 

 

 

 

 

 

 

 

 

 

 

 

(1) Reporting Agency

Case Number (Agency Use)

 

 

 

 

 

 

 

 

 

 

 

Motor Vehicles Involved

Number Injured

Number Killed

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

Time

 

County Number and Name

Nearest City or Town Number and Name

 

 

 

 

 

 

 

 

 

 

 

In

 

 

 

 

 

 

 

 

 

 

 

 

 

Near

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(3)

Distance from Nearest City or Town Limits

 

 

 

 

 

 

 

 

Control # Int ID

 

Location

 

 

 

 

East Grid

 

 

 

 

 

North

Grid

 

 

 

 

Administrative

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mi.

 

 

 

N

 

 

 

 

 

 

 

Mi.

 

 

 

 

E

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

+

 

 

 

 

 

 

 

 

 

+

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ft.

 

 

 

 

S

 

 

 

 

 

 

Ft.

 

 

 

 

W

 

 

 

 

 

 

 

 

 

 

 

 

 

 

.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(4)

 

Street,

Road or

Highway

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Distance from

 

 

 

 

 

 

(Nearest) Intersecting Street, Road or Highway

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

At

 

 

 

 

 

 

 

 

 

 

Mi.

 

 

 

N E

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ft.

 

 

 

S W of

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(5)

Unit

 

Occupants

 

Type

 

Hit &

 

 

 

Last Name

 

 

 

 

 

 

 

 

 

First

 

 

 

 

 

 

 

 

 

 

Middle

 

 

 

 

 

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

 

 

 

Sex

 

 

 

 

 

 

 

 

 

 

 

 

 

Run

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CMV

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(6)

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

 

 

 

 

 

 

 

State

Zip

 

 

 

 

 

 

 

 

Telephone

 

(Use Area

 

Code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(7) Driver License Number

State

Class Endorsement(s)

 

Restriction(s)

 

Inj. Sev. Type of Injury

Drv./Ped. Cond. OP Use

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(8)

 

Ejected Extricated Test

 

(% BAC) Transported by

 

 

 

 

 

To Medical Facility

 

 

 

 

 

 

 

 

License

Plate Number

 

 

 

 

Air

 

 

 

 

 

 

 

 

 

 

 

0.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Bag

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(9) VIN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle Year

 

Color

 

2nd Color

Make

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(10)

 

 

 

 

 

 

 

Insurance Company Name

 

 

 

 

 

 

 

 

 

 

 

 

 

Policy Number

 

 

 

 

 

 

 

 

 

 

 

 

 

Insurance

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Verification

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(11) Vehicle Removed by

 

 

 

 

 

 

 

 

Owner's Last Name

 

 

 

 

 

 

First

 

 

 

 

 

 

State Month Year

Model

Veh. Conf.

Extent of

Damage

Insurance Telephone (Use Area Code)

Middle Initial

Driver

 

 

 

 

(12) Owner's Address

City

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State

Zip

 

Towed Veh. Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Oversized

 

 

 

 

Rolled

 

Phone present

 

 

 

 

 

 

 

 

 

 

 

 

 

Load

 

 

 

 

 

 

Phone in use

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Burned

 

 

 

(13)

Citation

 

 

 

 

 

 

 

 

 

 

 

 

 

Statute/Ordinance

 

Citation

 

 

 

 

 

 

 

 

 

 

Statute/Ordinance

 

 

 

 

 

 

 

 

 

 

Number

 

 

 

 

 

 

 

 

 

 

 

 

 

Number

 

Number

 

 

 

 

 

 

 

 

 

 

Number

 

 

 

 

 

 

 

 

 

(14)

Unit

Occupants

Type

Hit &

 

 

Last Name

 

First

 

Middle

 

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

 

 

 

Sex

 

 

 

 

 

 

 

 

 

 

Run

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CMV

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(15)

Address

 

 

 

 

 

 

 

 

 

 

 

 

City

 

State

Zip

 

 

 

 

 

Telephone (Use Area Code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(16) Driver License Number

State

Class Endorsement(s)

 

Restriction(s)

 

Inj. Sev. Type of Injury

Drv./Ped. Cond. OP Use

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(17)

 

Ejected Extricated Test

 

(% BAC) Transported by

 

 

 

 

 

To Medical Facility

 

 

 

 

 

 

 

 

License

Plate Number

 

 

 

 

Air

 

 

 

 

 

 

 

 

 

 

 

0.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Bag

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(18)

VIN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle Year

 

Color

 

2nd Color

 

 

 

Make

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(19)

 

 

 

 

 

 

 

Insurance Company Name

 

 

 

 

 

 

 

 

 

 

 

 

 

Policy Number

 

 

 

 

 

 

 

 

 

 

 

 

 

Insurance

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Verification

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(20)

Vehicle Removed by

 

 

 

 

 

 

 

 

Owner's Last Name

 

 

 

 

 

 

First

 

 

 

 

 

 

 

 

 

State Month Year

Model

Veh. Conf.

Extent of

Damage

Insurance Telephone (Use Area Code)

Middle Initial

Driver

 

 

 

 

(21) Owner's Address

City

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State

Zip

 

Towed Veh. Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Oversized

 

 

 

 

Rolled

 

Phone present

 

 

 

 

 

 

 

 

 

 

 

 

 

Load

 

 

 

 

 

 

Phone in use

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Burned

 

 

 

(22) Citation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Statute/Ordinance

 

 

 

 

 

 

 

 

 

 

Citation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Statute/Ordinance

 

 

 

 

 

 

 

Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Number

 

 

 

 

 

 

 

 

 

 

 

 

Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Number

 

 

 

 

 

 

 

 

 

 

 

 

(23) Investigating Officer

 

 

 

 

 

 

 

 

 

 

 

Badge Number

 

 

 

 

 

Troop/Div.

 

 

 

Reviewed by (Init.)

 

Reviewer Badge Number

 

Date of Report (mm/dd/yyyy)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unit Type

 

 

 

Injury Severity

 

 

 

 

Type of Injury

 

 

 

 

Driver/Pedestrian Condition

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Occupant Protection (OP) In Use

 

 

 

 

 

D Driver

 

Z Other Cyclist

0

N/A

 

4

Incapacitating

0

N/A

3

Trunk -

00

Not Applicable

 

 

05 Under the

08

Ill (Sick)

 

 

 

00

Not Applicable

 

05

Child Restraint Type Unknown

 

10 Booster Seat

P Pedestrian

 

C Parked Car

1

No Injury

5

Fatal

 

 

1 Head

4

Internal

01

Apparently Normal

 

 

 

 

Influence of

09

Dizzy/Faint

 

 

01 None Used

 

06

Restraint Type Unknown

 

11 Other

X Pedestrian

 

A Animal

2

Possible

6

Unknown

 

 

2 Trunk -

Arms

02

Drinking - Ability Impaired

Medications

10

Emotional

 

 

02

Lap Belt Only

 

07

Helmet

 

 

 

 

 

 

 

 

99 Unknown

 

Conveyance

 

T Train

3

Non -

 

 

 

 

 

 

 

 

External

5

Legs

03

Odor of Alcohol Beverage 06

Very Tired

11

Other

 

 

 

03

Shoulder Belt Only

 

08

Child Restraint - Forward Facing

 

 

 

 

 

B Bicyclist

 

 

 

 

 

incapacitating

 

 

 

 

 

 

 

 

6

Unknown

04

Illegal Drugs

07

Sleepy

99

Unknown

 

 

04

Shoulder and Lap Belt

 

09

Child Restraint - Rear Facing

 

 

 

 

 

 

Air Bag Deployed

 

 

 

 

 

 

Ejected

 

 

 

 

Extricated

 

 

 

 

Chemical Test

 

Extent of Damage

 

Insurance Verification

Oversized Load

 

 

 

 

 

 

Towed Vehicle Type

 

 

 

0

Not Applicable

4

Deployed - Other (knee,

0

Not Applicable 3

Ejected,

 

0 N/A

 

 

0

N/A

 

 

 

4 Test Refused

0 N/A

3

Functional

0

N/A

3

Operator

0 N/A

00

N/A

 

 

 

 

05

Another Vehicle

09

Cattle Trailer

1

Not Deployed

 

air belt, etc.)

 

 

 

1

Not Ejected

Totally

 

1 No

 

 

1

Blood

 

 

 

5 None Given

1 None

4

Disabling

 

1

No

4

Exempt

N Not Permitted

01

Boat Trailer

06

Utility Vehicle

10

No Trailer in Tow

2

Deployed - Front 5

Deployed - Combination

2

Ejected,

9

Unknown

 

2 Yes

 

 

2

Breath

 

 

 

6 Other

2 Minor

9

Unknown

 

2

Owner

 

 

 

 

 

 

 

P Permitted

02

House Trailer

07

Homemade

11

Other

3

Deployed - Side

9

Deployment Unknown

 

Partially

 

 

 

 

 

 

 

 

 

 

3

Blood/Breath

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

03

Farm Trailer

08

Trailer

99

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

04

Horse Trailer

Box Trailer

 

 

 

 

 

WARNING - STATE LAW

 

Use of contents for commercial solicitation is unlawful

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

234

Case Number

 

 

 

 

Pg

 

of

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(24) Unit

Pos in Veh. Last Name

First

Middle Initial

Date of Birth (mm/dd/yyyy)

 

 

Sex

Injured

Witness

(25) Address

Passenger Prop. Owner

 

 

 

City

State

Zip

Telephone (Use Area Code)

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(26)

Injury Severity / Type

 

OP Use Air Bag Ejected

Extricated Transported by

 

 

To

Medical

 

Facility

 

 

 

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(27)

Unit

 

 

Pos in Veh. Last

Name

First

Middle Initial

 

Date of Birth (mm/dd/yyyy)

 

 

 

Sex

Injured

Witness

(28) Address

Passenger Prop. Owner

 

 

 

City

State

Zip

Telephone (Use Area Code)

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(29)

Injury Severity / Type

 

OP Use Air Bag Ejected

Extricated Transported by

 

 

To Medical

 

Facility

 

 

 

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(30)

Unit

 

 

Pos in Veh. Last

Name

First

Middle Initial

 

Date of Birth (mm/dd/yyyy)

 

 

 

Sex

Injured

Witness

(31) Address

Passenger Prop. Owner

 

 

 

City

State

Zip

Telephone (Use Area Code)

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(32)

Injury Severity / Type

 

OP Use Air Bag Ejected

Extricated Transported by

 

 

To Medical

 

Facility

 

 

 

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(33)

Unit

 

 

Pos in Veh. Last

Name

First

Middle Initial

 

Date of Birth (mm/dd/yyyy)

 

 

 

Sex

 

 

Injured

 

Passenger

 

 

 

 

 

 

 

 

 

 

Witness

 

Prop. Owner

 

 

 

 

 

 

 

 

(34) Address

 

 

 

 

 

 

 

City

State

Zip

Same as Driver

Telephone (Use Area Code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(35) Injury Severity / Type

 

OP Use Air Bag Ejected Extricated Transported by

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

To Medical Facility

Property Type

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

 

(36)

Unit

Carrier Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(37)

City

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State

 

Zip

 

GVWR

 

 

 

0 - 10K lbs.

 

 

 

Axle Qty. Cargo Body

Vehicle Use

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10,001 - 26K lbs.

 

 

 

 

 

 

 

 

 

 

Interstate Commerce

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GCWR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

26K+ lbs.

 

 

 

 

 

 

 

 

 

 

Intrastate Commerce

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(38)

U.S. DOT Number

 

 

 

 

 

Vehicle Inspection Number

 

 

 

 

 

 

 

 

Placard Number

 

Haz. Mat. Class Haz. Mat. Involved

 

Haz.

Mat.

Release

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other Non-Commercial

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OK

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yes

 

 

 

 

 

Yes

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

No

 

 

 

 

 

 

No

 

 

 

Government

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(39)

Unit

 

Carrier Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State

(40)

City

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(41)

U.S. DOT Number

 

 

 

 

 

Vehicle Inspection Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OK

 

 

 

 

 

 

 

 

 

 

 

Zip

 

GVWR

 

 

 

0 - 10K lbs.

 

 

 

Axle Qty. Cargo Body

Vehicle Use

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10,001 - 26K lbs.

 

 

 

 

 

 

 

 

 

 

 

Interstate Commerce

 

 

 

 

 

 

 

 

 

 

 

 

GCWR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

26K+ lbs.

 

 

 

 

 

 

 

 

 

 

 

Intrastate Commerce

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Placard Number

 

Haz. Mat. Class Haz. Mat. Involved

 

Haz.

Mat.

Release

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yes

 

 

 

 

 

Yes

 

 

 

 

Other Non-Commercial

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

No

 

 

 

 

 

No

 

 

 

Government

 

Position in Vehicle

00.Not Applicable

18.Front Row - Other

28.Second Row - Other

38.Thrid Row - Other

48.Fourth Row - Other

Vehicle Configuration

00.

N/A

 

 

 

 

 

 

07. School Bus

13. Bus/Large Van

18.

Farm

 

 

 

9-15 occupants

 

Machinery

01.

Passenger

 

including driver

 

 

 

Veh.-2 Dr

08. Truck/Trailer

 

 

 

02.

Passenger

 

 

 

 

 

 

 

 

Veh.-4 Dr

 

 

 

 

03.

Passenger

 

14. Bus 16+

19.

ATV

 

Veh. Conv.

 

 

 

 

09. Truck-Tractor

occupants

 

 

 

 

including driver

 

 

 

 

(Bobtail)

 

20. SUV

 

 

 

 

04.

Pickup

10. Truck-Tractor/

 

 

 

 

 

15. Motorcycle

 

 

 

 

Semi-Trailer

 

21.

Passenger Van

 

 

 

 

05.

Single Unit

 

 

22.

Truck more

11. Truck-Tractor/

 

 

than 10,000

 

Truck, 2 axles

16. Motor Scooter/

 

 

 

Double

Moped

 

lbs., Cannot

 

 

 

 

Classify

 

 

 

 

 

 

 

 

 

23.

Van 10,000

 

 

 

 

 

lbs. or Less

06.

Single Unit

12. Truck-Tractor/

 

24.

Other

 

Truck, 3+ axles

Triple

17. Motor Home

99.

Unknown

Cargo Body Type

00.

N/A

 

 

 

 

 

 

06.

Intermodal

11.

Hopper (grain/

01.

Bus 9-15 seats

 

 

 

chips/gravel)

 

 

 

 

 

 

07.

Dump Truck/

12.

Pole Trailer

02.

Bus 16+ seats

 

Trailer

 

 

 

 

03.

Van/Enclosed

08.

Concrete Mixer

13.

Log Trailer

 

Box

 

 

 

 

04.

Cargo Tank

09.

Auto Transporter

14.

Vehicle Towing

 

 

 

 

 

Vehicle

 

 

 

 

15.

Other

05.

Flatbed

10.

Garbage/Refuse

99.

Unknown

235

Case Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OFFICIAL OKLAHOMA TRAFFIC COLLISION REPORT

Pg

 

 

of

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Lanes

Legal

 

 

 

 

 

 

 

 

Pedestrian / Pedalcyclist Only

 

 

 

 

 

 

 

 

 

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

Yes

 

 

 

Unit

Actions Prior

Location at Time

Safety

Unit Number of

 

 

 

 

in Roadway

Speed

 

 

 

 

 

 

 

work zone? (If yes, complete this section)

 

 

 

No

This unit will

 

 

 

 

to Collision

of Collision

Equip.

Vehicle Striking

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

correspond

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Type of Work Zone

 

 

 

Location of the Work Zone

to 'Unit 1'

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Collision

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

This unit will

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

Lane Closure

 

 

 

 

 

 

 

 

 

 

1 Before the First Work

 

 

 

 

correspond

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

Lane Shift/Crossover

 

 

 

 

 

 

 

Zone Warning Sign

 

 

 

 

to 'Unit 2'

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3 Work on Shoulder or Median

 

 

 

2

Advance Warning Area

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Light

 

 

 

 

 

 

What

 

Unit 1

 

 

 

 

Unit 2

 

 

Underride/

 

 

Unit 1

Unit 2

 

 

 

 

4 Intermittent or Moving Work

3

Transition Area

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9

Unknown

 

 

 

 

 

 

 

 

 

 

4

Activity Area

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Override

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5

Termination Area

 

 

 

 

1

Daylight

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Was Going

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9

Unknown

 

 

 

 

 

 

 

2

Dark-Not Lighted

 

 

 

 

 

to Do

 

 

 

 

 

 

 

 

 

 

 

 

0

 

Not Applicable

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

Dark-Lighted

 

 

00

Not Applicable

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

 

No Underride or Override

 

 

 

 

 

 

 

 

 

 

 

 

Workers Present Yes

No

 

 

 

Unknown

 

 

 

 

 

 

 

4

Dawn

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

01

Go Ahead

 

 

 

 

 

 

 

 

 

2

 

Underride, Compartment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5

Dusk

 

 

02

Turn Left

 

 

 

 

 

 

 

 

 

 

 

Intrusion

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unit 1

Unit 2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unit 1

 

Unit 2

6

Dark-Unknown

 

 

03

Turn Right

 

 

 

 

 

 

 

 

 

3

 

Underride, No

 

 

 

 

 

 

 

 

Trafficway

 

 

 

 

 

 

 

 

 

 

 

 

Unsafe / Unlawful

 

 

 

 

 

 

 

 

 

 

 

Lighting

 

 

04

Make “U” Turn

 

 

 

 

 

 

 

 

 

 

 

Compartment Intrusion

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Contributing Factors

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7

Other

 

 

05

Stop

 

 

 

 

 

 

 

 

 

 

 

 

4

 

Underride, Compartment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9

Unknown

 

 

06

Slow for Cause

 

 

 

 

 

 

 

 

 

 

 

Intrusion Unknown

 

 

 

 

 

 

0

Not Applicable

 

 

 

 

 

 

 

 

FAILED TO YIELD

 

 

 

49

Tires

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

07

Start from Park/Stop

5

 

Override, Motor Vehicle in

1

Two-Way, Not Divided

 

01

From Stop Sign

 

 

 

50

Suspension

 

 

 

 

 

 

 

 

 

 

 

 

 

08

Change Lanes

 

 

 

 

 

 

 

 

 

 

 

Transport

 

 

 

 

 

 

 

 

 

 

 

 

2

Two-Way, Not Divided

 

02

From Yield Sign

 

 

 

51

Headlights

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Weather

 

 

 

 

09

Overtake

 

 

 

 

 

 

 

 

 

6

 

Override, Other Motor

 

 

 

with a Continuous Left

 

03

Private Drive

 

 

 

52

Tail Lights

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10

Pass

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Turn Lane

 

 

 

 

 

 

 

 

 

 

04

County Road at

 

 

 

53

Stop Lights

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

01

Clear

 

 

11

Back

 

 

 

 

 

 

 

 

 

 

 

 

9

 

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

3

Two-Way, Divided,

 

 

 

 

 

 

Through Highway

 

54

Wheel

 

 

 

 

 

 

 

02

Fog/Smog/Smoke

 

 

12

Remain Stopped

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unprotected (painted > 4

 

05

From Signal Light

 

55

Exhaust System

 

 

 

 

 

 

 

 

 

 

 

 

 

Traffic

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

03

Cloudy

 

 

13

Remain Parked

 

 

 

 

 

 

 

Unit 1

 

Unit 2

 

 

 

feet) Median

 

 

 

 

 

 

 

 

06

From Alley

 

 

 

56

Windshield Wipers

 

 

 

 

04

Rain

 

 

14

Enter/Merge in Traffic

 

 

Control

 

 

 

 

 

 

 

 

 

 

 

 

 

4

Two-Way, Divided,

 

 

 

 

 

07

To Pedestrian

 

 

 

57

Other Mechanical Defects

05

Snow

 

 

15

Negotiate a Curve

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Positive Median Barrier

 

08

To Vehicle on Right

 

LEFT OF CENTER

 

 

 

 

06

Sleet/Hail (Freezing

16

Park

 

 

 

 

 

 

 

 

 

 

 

 

00

No Control

 

 

 

 

 

 

 

 

 

 

 

 

5

Two-Way, Divided, Cable

 

09

To Vehicle in

 

 

 

58

In Meeting

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Intersection

 

 

 

59

No Passing Zone (Unmarked)

 

Rain/Drizzle)

 

 

17

Other

 

 

 

 

 

 

 

 

 

01

Stop Sign

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Barrier

 

 

 

 

 

 

 

 

 

 

 

 

 

 

07

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10

To Emergency

 

 

 

60

Marked Zone

 

 

 

 

Severe Crosswind

 

 

99

Unknown

 

 

 

 

 

 

 

 

 

02

Traffic Signal

 

 

 

 

 

 

6

One-Way

9 Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicles

 

 

 

61

Other

 

 

 

 

 

 

 

08

Blowing Snow

 

 

 

 

 

 

 

 

 

Unit 1

 

 

 

 

Unit

2

 

03

Flashing Traffic Signal

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12

 

 

 

 

 

 

 

 

 

 

09

Blowing Sand, Soil,

 

 

 

What

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unit 1

Unit 2

 

Other

 

 

 

IMPROPER OVERTAKING

 

Dirt

 

 

 

 

Vehicle

 

 

 

 

 

 

 

 

 

 

 

04

School Zone Signs

 

 

 

 

 

 

 

 

 

Vehicle

 

 

 

 

 

 

 

 

 

 

FOLLOWED TOO

 

 

 

62

In Marked Zone

 

 

 

 

10

 

 

 

 

 

Did

 

 

 

 

 

 

 

 

 

 

 

 

05

Yield Sign

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Removal

 

 

 

 

 

 

 

 

 

 

CLOSELY

 

 

 

63

On Hill/Curve

 

 

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

06

Warning Sign

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13

Human Element

 

64

At Intersection

 

 

 

 

99

Unknown

 

 

00

Not Applicable

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

07

Railroad Advance

 

 

 

 

 

 

0

Not Applicable

 

 

 

 

 

 

 

 

14

Traffic Condition

 

65

Without Sufficient Clearance

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

01

Went Ahead

 

 

 

 

 

 

 

 

 

 

 

Warning Sign

 

 

 

 

 

 

1

Towed Due to

 

 

 

 

 

 

 

 

15

Weather Condition

 

66

Other

 

 

 

 

 

 

 

 

Locality

 

 

 

02

Turned Left

 

 

 

 

 

 

 

 

 

08

Railroad Cross Bucks

 

 

 

 

 

 

 

 

Vehicle Damage

 

 

 

 

 

UNSAFE SPEED

 

 

 

IMPROPER PARKING

 

 

 

 

 

 

 

 

 

 

 

 

03

Turned Right

 

 

 

 

 

 

 

 

 

09

Railroad Gates

 

 

 

 

 

 

2

Towed For Reasons

 

16

Driver's Ability (Age)

 

67

On Roadway

 

 

 

 

1

Residential

 

 

04

Entered “U” Turn

 

 

 

 

 

10

Railroad Signal

 

 

 

 

 

 

 

 

 

Other Than Damage

 

17

Inexperienced Driver -

68

Where Prohibited

 

 

 

 

2

Business

 

 

05

Stopped

 

 

 

 

 

 

 

 

 

11

No Passing Zone

 

 

 

 

 

 

3

Remained at Scene

 

 

 

 

 

 

Young

 

 

 

69

Other

 

 

 

 

 

 

 

3

Industrial

 

 

06

Slowed

 

 

 

 

 

 

 

 

 

12

Person (including flagger,

4

Driven from Scene

 

 

 

 

 

18

Exceeding Legal Limit

INATTENTION

 

 

 

 

4

School

 

 

07

Started From Park/Stop

 

 

law enforcement, crossing

9

Unknown

 

 

 

 

 

 

 

 

 

 

19

For Traffic Conditions

70

Distracted by Passenger in

5

Not Built-up

 

 

08

Entered Other Lane

 

 

 

 

 

13

guard, etc.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20

For Type of Roadway

71

Vehicle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unit 1

Unit 2

 

 

 

 

 

 

 

 

6

Mixed Use

 

 

09

Overtaking

 

 

 

 

 

 

 

 

 

Abnormal Control

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Gravel, Dirt, etc.)

 

Other Distraction Inside

7

Other

 

 

10

Passing

 

 

 

 

 

 

 

 

 

14

Posted Speed

 

 

 

 

 

 

 

 

Vehicle

 

 

 

 

 

 

 

 

 

 

 

 

21

For Ice or Snow on

 

72

Vehicle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9

Unknown

 

 

11

Backed

 

 

 

 

 

 

 

 

 

15

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

Condition

 

 

 

 

 

 

 

 

 

 

 

 

Roadway

 

 

 

Distraction From Outside

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12

Remained Stopped

 

 

 

 

 

99

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

22

Rain or Wet Roadway

 

 

Vehicle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Type of

 

 

 

13

Remained Parked

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

00

Not Applicable

 

 

 

 

 

 

 

 

23

Wind

 

 

 

73

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Intersection

 

 

 

14

Entered/Merged

 

 

 

 

 

 

 

Road

 

Unit 1

 

 

Unit

2

 

01

Apparently Normal

 

 

 

 

 

24

Other Weather

 

 

 

WRONG WAY

 

 

 

 

0

Not an Intersection

15

Departed Rdwy-Right

 

Surface

 

 

 

 

 

 

 

 

 

 

 

 

 

02

Brakes

 

 

 

 

 

 

 

 

 

 

 

Conditions

 

 

 

74

On One Way

 

 

 

 

16

Departed Rdwy-Left

 

 

 

 

 

Conditions

 

 

 

 

 

 

 

 

 

 

 

 

 

03

Headlights

 

 

 

 

 

 

 

 

 

 

25

Vehicle Condition

 

75

On Exit Ramp

 

 

 

 

1

Y-Intersection

 

 

17

Swerved Right

 

 

 

 

 

 

 

 

 

01

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

04

Steering

 

 

 

 

 

 

 

 

 

 

26

View Obstruction

 

76

On Entrance Ramp

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Dry

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

T-Intersection

 

 

18

Swerved Left

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

05

Tail Lights

 

 

 

 

 

 

 

 

 

 

27

On Curve/Turn

 

 

 

77

Other

 

 

 

 

 

 

 

3

Four-Way

 

 

19

Parked

 

 

 

 

 

 

 

 

 

02

Wet

 

 

 

 

 

 

 

 

 

 

 

 

06

Brake Lights

 

 

 

 

 

 

 

 

28

Impeding Traffic

 

IMPROPER START FROM

4

Intersection

 

 

20

Other

 

 

 

 

 

 

 

 

 

03

Ice/Frost

 

 

 

 

 

 

 

 

 

 

 

 

07

Tires/Wheels

 

 

 

 

 

 

 

 

29

Other

 

 

 

78

Parked Position

 

 

 

 

 

Five-Point, or More

99

Unknown

 

 

 

 

 

 

 

 

 

04

Snow

 

 

 

 

 

 

 

 

 

 

 

 

08

Suspension

 

 

 

 

 

 

 

 

IMPROPER TURN

 

 

 

79

Other

 

 

 

 

 

 

 

5

Intersection as Part

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

05

Mud, Dirt, Gravel

 

 

 

 

 

 

09

Signal lights

 

 

 

 

 

 

 

 

30

From Wrong Lane

 

80

ALCOHOL-DUI/DWI

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

of Interchange

 

 

 

Visibility Unit 1

 

 

 

 

Unit 2

06

Slush

 

 

 

 

 

 

 

 

 

 

 

 

10

Windows

 

 

 

 

 

 

 

 

 

 

31

From Direct Course

 

81

DRUG-DUI

 

 

 

 

6

Traffic Circle

 

 

 

Obscured

 

 

 

 

 

 

 

 

 

 

 

07

Water (standing, moving)

11

Truck Coupling/Trailer

 

32

Right

 

 

 

OTHER IMPROPER ACT/

7

Roundabout

 

 

 

 

 

by

 

 

 

 

 

 

 

 

 

 

 

 

08

Sand

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hitch/Safety Chains

 

 

 

 

 

33

Left

 

 

 

MOVEMENT

 

 

 

 

 

 

 

9

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

09

Oil

 

 

 

 

 

 

 

 

 

 

 

 

12

Mirrors

15

Other

 

34

Turn About/U-Turn

 

82

Failed to Signal

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

00

Not Applicable

 

 

 

 

 

 

 

 

 

10

Other

 

 

 

 

 

 

 

 

 

 

 

 

13

Wipers

99 Unknown

 

35

To Enter Private Drive

83

Disregarded Warning Signal

Incident Type

 

 

 

 

01

Trees

 

 

 

 

 

 

 

 

 

99

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

14

Power Train

 

 

 

 

 

 

 

 

36

In Front of Oncoming

 

84

Improper Use of Lane

 

 

 

 

02

Embankment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Traffic

 

 

 

85

Improper Backing

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

00

 

 

 

 

 

 

 

03

Building

 

 

 

 

 

 

 

 

 

 

 

 

Road Character

 

 

 

 

 

 

 

Special

 

Unit 1

Unit 2

 

37

Other

 

 

 

86

Apparently Sleepy

 

 

 

 

Not an Incident

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

04

Signs

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Function

 

 

 

 

 

 

 

 

 

 

 

 

38

CHANGED LANES

 

87

Failed to Secure Load

51

Private Property

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

05

Parked Vehicles

 

 

 

 

 

 

 

Grade

 

 

Unit 1

Unit 2

 

of Vehicle

 

 

 

 

 

 

 

 

 

 

 

 

UNSAFELY

 

 

 

88

Other

 

 

 

 

 

 

 

52

Deliberate Intent

 

 

 

 

 

 

 

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

06

High Weeds

 

 

 

 

 

 

 

 

 

 

Level

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

39

STOPPED IN

 

 

 

UNKN./NO IMPROPER ACT

53

Medical Condition

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

00

Not Applicable

 

 

 

 

 

 

 

 

 

 

 

 

 

07

Fences

 

 

 

 

 

 

 

 

 

2

 

Hillcrest

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TRAFFIC LANE

 

89

Deer in Roadway

 

 

 

 

54

Legal Intervention

 

 

08

Shrubbery

 

 

 

 

 

 

 

 

 

3

 

Uphill

 

 

 

 

 

 

 

 

 

 

 

 

01

School Bus

 

 

 

 

 

 

 

 

 

 

FAILED TO STOP

 

 

 

90

Animal in Roadway

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

55

Suicide

 

 

09

Ice, Snow or Frost on

4

 

Downhill

 

 

 

 

 

 

 

 

 

 

 

 

02

Transit Bus

 

 

 

 

 

 

 

 

 

 

40

For Stop Sign

 

 

 

91

Domestic Animal in Rdwy

57

Drowning

 

 

 

 

 

Windows

 

 

 

 

 

 

 

 

 

5

 

Sag (bottom)

 

 

 

 

 

 

03

Intercity Bus

 

 

 

 

 

 

 

 

41

For Traffic Signal

 

92

Avoiding Other Vehicle

58

Other

 

 

10

Smoke

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

04

Charter Bus

 

 

 

 

 

 

 

 

42

For School Bus

 

 

 

93

Avoiding Pedestrian

 

 

 

 

 

 

 

 

11

Fog

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Horizontal

 

 

Unit 1

Unit 2

05

Other Bus

 

 

 

 

 

 

 

 

 

 

43

For Railroad Gates/

 

94

Object/Debris in Roadway

Location of

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12

Dust

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Alignment

 

 

 

 

 

 

 

 

 

 

 

 

06

Military

 

 

 

 

 

 

 

 

 

 

 

Signal

 

 

 

95

Defect in Roadway

 

 

 

 

First Harmful

 

 

 

 

13

Rain

 

 

 

 

 

 

 

 

 

 

 

 

1

 

Straight

 

 

 

 

 

 

 

 

 

 

 

 

07

OHP

 

 

 

 

 

 

 

 

 

 

 

 

44

For Officer/Flagman

 

96

Abnormal Traffic Control

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Event

 

 

14

Sun

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

08

Other Police

 

 

 

 

 

 

 

 

45

At Sidewalk/Stopline

 

97

Improper Bicyclist Action

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

 

Curve - Left

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

01

On Roadway

 

 

15

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

09

Other Law Enforcement

 

46

Other

 

 

 

98

NO IMPROPER ACTION BY

 

 

 

 

 

 

 

 

 

 

 

3

 

Curve - Right

 

 

 

 

 

 

 

 

 

 

02

Shoulder

 

 

99

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10

Ambulance

 

 

 

 

 

 

 

 

 

 

UNSAFE VEHICLE

 

 

 

DRIVER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

03

Median

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11

Fire Truck

 

 

 

 

 

 

 

 

 

 

47

Brakes

 

 

 

99

PEDESTRIAN ACTION

04

Roadside

 

 

 

 

Driver

 

 

Unit 1

Unit 2

 

 

Road

 

 

Unit 1

Unit 2

12

Public Owned Vehicle

 

48

Steering

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

05

Gore

 

 

 

Distracted

 

 

 

 

 

 

 

 

 

 

Surface

 

 

 

 

 

 

 

 

 

 

 

 

13

Highway Equipment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unit

1

 

 

Unit

2

 

 

 

 

 

 

 

 

06

Separator

 

 

 

 

 

by

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Type

 

 

 

 

 

 

 

 

 

 

 

 

14

Special Mobilized Machine

 

Point of First

 

 

 

 

 

 

 

 

 

 

 

07

Parking Lane/Zone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

 

Concrete

 

 

 

 

 

 

 

 

 

 

 

 

15

Other

 

 

99 Unknown

 

Contact on

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

0

Not Applicable/None

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

08

Off Roadway,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

Electronic Communication

2

 

Asphalt

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Emergency

 

Unit 1

Unit 2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Location Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unit 1

 

 

Unit 2

 

 

 

 

 

 

 

09

Outside Right-of

 

 

 

 

 

Devices

 

 

 

 

 

 

 

 

 

3

 

Gravel

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle

 

 

 

 

 

 

 

 

 

 

Most Damaged

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

Other Electronic Device

4

 

Dirt

 

 

 

 

 

 

 

 

 

 

 

 

 

Responding to

 

 

 

 

 

 

 

 

 

Area

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Way

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10

 

 

3

Other Inside Vehicle

 

 

 

 

 

5

 

Brick

 

 

 

 

 

 

 

 

 

 

 

 

 

an Emergency

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

0

N/A

 

 

2

No

 

 

 

 

 

13

Top

15 Non-Collision

 

 

 

 

 

 

 

 

 

4

Other Outside Vehicle

6

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

99

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9

Unknown

 

 

 

 

 

 

 

 

 

9

 

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

1

Yes

 

 

9

Unknown

 

14

Undercarriage

99 Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

236

Case Number

Latitude

.

Longitude

N

.

Railroad Crossing Number

W

Pg of

Direction of Travel Before Collision

Unit

 

 

N E

 

Unit

 

 

N E

Number

 

 

S W

 

Number

 

 

S W

Indicate North

by Arrow

COLLISION EVENTS

Unit

First Event

Second Event

Third Event

Fourth Event

First Harmful Event

First Harmful

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Event for the

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Entire

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Collision

 

Unit

First Event

Second Event

Third Event

Fourth Event

First Harmful Event

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

37

Work Zone/Maintenance

56

Pavement Drop-Off

38

Equipment

57

Ditch

Other Non-Fixed Object

58

Embankment

FIXED OBJECT:

59

Tree (Standing)

40

Barrier (Cable)

60

Dividing Strip

41

Barrier (Concrete)

61

Retaining Wall

42

Barrier (Other)

62

Bridge Abutment

43

Fence Pole

63

Bridge Pier or Support

44

Fence

64

Bridge Rail

10Overturn/Rollover

11Fire/Explosion

12Immersion

13Jackknife

14Cargo/Equipment Loss or Shift

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

16Separation of Units

17Departed Road Right

18Departed Road Left

19Cross Median/Centerline

20Downhill Runaway

21Fell/Jumped From Motor Vehicle

22Thrown Or Falling Object

23Other Non-Collision

PERSON, MOTOR VEHICLE, OR NON-

FIXED OBJECT:

30 Pedestrian

31 Pedal Cycle

32 Railway Vehicle (train, engine)

33 Animal

34 Motor Vehicle in Transport

35 Parked Motor Vehicle

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

45

Traffic Signal Support

65

Bridge Post

46

Traffic Sign Support

66

Bridge Curb

47

Utility Pole/Light Support

67

Bridge Super Structure (Beams)

48

Other Post/Pole/Support

68

Bridge Overhead Structure

49

Guardrail/Guardrail Face

69

Delineator

50

Guardrail End

70

Mailbox

51

Culvert

71

Other Fixed Object

52

Curb

72

Other Highway Structure

53

Island

73

Ground

54

Sand Barrels

99

Unknown

55

Impact Attenuator/ Crash

 

 

 

Cushion

 

 

Remarks

237

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OFFICIAL OKLAHOMA TRAFFIC COLLISION REPORT

 

 

 

 

 

 

 

 

 

 

Pg

 

 

 

of

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PERSONS SUPPLEMENTAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(42)

Unit

 

 

 

 

 

 

 

Pos in Veh.

 

Last Name

First

Middle Initial

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

 

 

 

 

Sex

 

 

 

 

 

 

Injured

 

 

Passenger

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Witness

 

 

Prop. Owner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(43)

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

Zip

 

Telephone

 

(Use Area

 

Code)

 

 

 

 

 

 

 

 

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(44)

Injury Severity / Type

 

OP Use

 

Air Bag Ejected Extricated Transported by

 

 

To

Medical

 

Facility

 

 

 

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(45)

Unit

 

 

 

 

 

 

 

Pos in Veh.

 

Last Name

First

Middle Initial

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

 

 

 

 

Sex

 

 

 

 

 

 

Injured

 

 

Passenger

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Witness

 

 

Prop. Owner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(46)

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

Zip

 

Telephone

 

(Use Area

 

Code)

 

 

 

 

 

 

 

 

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(47)

Injury Severity / Type

 

OP Use

 

Air Bag Ejected Extricated Transported by

 

 

To

Medical

 

Facility

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(48)

Unit

 

 

 

 

 

 

 

Pos in Veh.

 

Last Name

First

Middle Initial

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

 

 

 

 

Sex

 

 

 

 

 

 

Injured

 

 

Passenger

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Witness

 

 

Prop. Owner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(49)

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

Zip

 

Telephone

 

(Use Area

 

Code)

 

 

 

 

 

 

 

 

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(50)

Injury Severity / Type

 

OP Use

 

Air Bag Ejected Extricated Transported by

 

 

To

Medical

 

Facility

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(51)

Unit

 

 

 

 

 

 

 

Pos in Veh.

 

Last Name

First

Middle Initial

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

 

 

 

 

Sex

 

 

 

 

 

 

Injured

 

 

Passenger

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Witness

 

 

Prop. Owner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(52)

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

Zip

 

Telephone

 

(Use Area

 

Code)

 

 

 

 

 

 

 

 

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(53)

Injury Severity / Type

 

OP Use

 

Air Bag Ejected Extricated Transported by

 

 

To

Medical

 

Facility

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(54)

Unit

 

 

 

 

 

 

 

Pos in Veh.

 

Last Name

First

Middle Initial

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

 

 

 

 

Sex

 

 

 

 

 

 

Injured

 

 

Passenger

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Witness

 

 

Prop. Owner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(55)

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

Zip

 

Telephone

 

(Use Area

 

Code)

 

 

 

 

 

 

 

 

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(56)

Injury Severity / Type

 

OP Use

 

Air Bag Ejected Extricated Transported by

 

 

To

Medical

 

Facility

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(57)

Unit

 

 

 

 

 

 

 

Pos in Veh.

 

Last Name

First

Middle Initial

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

 

 

 

 

Sex

 

 

 

 

 

 

Injured

 

 

Passenger

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Witness

 

 

Prop. Owner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(58)

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

Zip

 

Telephone

 

(Use Area

 

Code)

 

 

 

 

 

 

 

 

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(59)

Injury Severity / Type

 

OP Use

 

Air Bag Ejected Extricated Transported by

 

 

To

Medical

 

Facility

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(60)

Unit

 

 

 

 

 

 

 

Pos in Veh.

 

Last Name

First

Middle Initial

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

 

 

 

 

Sex

 

 

 

 

 

 

Injured

 

 

Passenger

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Witness

 

 

Prop. Owner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(61)

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

Zip

 

Telephone

 

(Use Area

 

Code)

 

 

 

 

 

 

 

 

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(62)

Injury Severity / Type

 

OP Use

 

Air Bag Ejected Extricated Transported by

 

 

To

Medical

 

Facility

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(63)

Unit

 

 

 

 

 

 

 

Pos in Veh.

 

Last Name

First

Middle Initial

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

 

 

 

 

Sex

 

 

 

 

 

 

Injured

 

 

Passenger

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Witness

 

 

Prop. Owner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(64)

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

Zip

 

Telephone

 

(Use Area

 

Code)

 

 

 

 

 

 

 

 

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(65)

Injury Severity / Type

 

OP Use

 

Air Bag Ejected Extricated Transported by

 

 

To

Medical

 

Facility

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(66)

Unit

 

 

 

 

 

 

 

Pos in Veh.

 

Last Name

First

Middle Initial

 

 

 

 

 

 

Date of Birth (mm/dd/yyyy)

 

 

 

 

 

Sex

 

 

 

 

 

 

Injured

 

 

Passenger

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Witness

 

 

Prop. Owner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(67)

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

Zip

 

Telephone

 

(Use Area

 

Code)

 

 

 

 

 

 

 

 

 

Same as Driver

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(68)

Injury Severity / Type

 

OP Use

 

Air Bag Ejected Extricated Transported by

 

 

To

Medical

 

Facility

 

 

 

 

Property Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

238

OFFICIAL OKLAHOMA TRAFFIC COLLISION REPORT

DIAGRAM SUPPLEMENTAL

Case Number

Pg of

Indicate North

by Arrow

239

 

 

OFFICIAL OKLAHOMA TRAFFIC COLLISION REPORT

Pg

 

of

 

 

 

 

Case Number

 

ADDITIONAL NARRATIVE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

240

Form 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.

  1. 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.
  2. 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.
  3. Provide information about the motor vehicles involved. Note the total number of injuries and fatalities that occurred as a result of the collision.
  4. In the location section, accurately list the street, road, or highway where the incident occurred. Also, note the distance from the nearest intersecting street.
  5. 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.
  6. 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.
  7. Remark on the condition and extent of damage for each vehicle. Note whether the vehicles were towed, removed, or sustained damage.
  8. In the citation section, list any citations issued and their corresponding statute or ordinance numbers.
  9. 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.
  10. 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.