The Oklahoma Traffic Collision Report form is a standardized document used by law enforcement to record details about traffic incidents within the state. This form captures essential information, including the parties involved, the circumstances of the collision, and any injuries or fatalities that may have occurred. Understanding how to properly complete this report is crucial for accurate record-keeping and legal processes following a traffic accident.
The Oklahoma Traffic Collision Report form is a crucial document used to capture essential details following a traffic accident. This form serves multiple purposes, including documenting the circumstances surrounding the incident, identifying the parties involved, and recording any injuries or fatalities. It consists of various sections that require information such as the date and time of the collision, the location, and the vehicles involved. Additionally, it collects data on the drivers, their licenses, and insurance details. The form also addresses the severity of injuries sustained by occupants and pedestrians, as well as any citations issued. Investigating officers complete this report, ensuring that all relevant facts are accurately recorded for future reference. Understanding how to fill out this form correctly can significantly impact insurance claims, legal proceedings, and overall accountability in the aftermath of a traffic collision.
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.
E
+
Ft.
S
W
.
(4)
Street,
Road or
Highway
Distance from
(Nearest) Intersecting Street, Road or Highway
At
N E
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
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
State Month Year
Model
Veh. Conf.
Extent of
Damage
Insurance Telephone (Use Area Code)
Middle Initial
Driver
(12) Owner's Address
Same as Driver
Towed Veh. Type
Oversized
Rolled
Phone present
Load
Phone in use
Burned
(13)
Citation
Statute/Ordinance
Number
(14)
(15)
Telephone (Use Area Code)
(16) Driver License Number
(17)
(18)
VIN
(19)
(20)
Vehicle Removed by
(21) Owner's Address
(22) Citation
(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
3
Trunk -
00
Not Applicable
05 Under the
08
Ill (Sick)
05
Child Restraint Type Unknown
10 Booster Seat
P Pedestrian
C Parked Car
1
No Injury
5
Fatal
1 Head
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
Lap Belt Only
07
Helmet
99 Unknown
Conveyance
T Train
Non -
External
Legs
03
Odor of Alcohol Beverage 06
Very Tired
11
Other
Shoulder Belt Only
Child Restraint - Forward Facing
B Bicyclist
incapacitating
04
Illegal Drugs
Sleepy
99
Shoulder and Lap Belt
Child Restraint - Rear Facing
Air Bag Deployed
Ejected
Extricated
Chemical Test
Extent of Damage
Insurance Verification
Oversized Load
Towed Vehicle Type
Deployed - Other (knee,
Not Applicable 3
Ejected,
0 N/A
4 Test Refused
Functional
Operator
Another Vehicle
Cattle Trailer
Not Deployed
air belt, etc.)
Not Ejected
Totally
1 No
Blood
5 None Given
1 None
Disabling
No
Exempt
N Not Permitted
Boat Trailer
Utility Vehicle
No Trailer in Tow
Deployed - Front 5
Deployed - Combination
9
2 Yes
Breath
6 Other
2 Minor
Owner
P Permitted
House Trailer
Homemade
Deployed - Side
Deployment Unknown
Partially
Blood/Breath
Farm Trailer
Trailer
Horse Trailer
Box Trailer
WARNING - STATE LAW
Use of contents for commercial solicitation is unlawful
234
Case Number
(24) Unit
Pos in Veh. Last Name
Injured
Witness
(25) Address
Passenger Prop. Owner
(26)
Injury Severity / Type
OP Use Air Bag Ejected
Extricated Transported by
To
Medical
Facility
Property Type
(27)
Pos in Veh. Last
Name
(28) Address
(29)
To Medical
(30)
(31) Address
(32)
(33)
Passenger
Prop. Owner
(34) Address
(35) Injury Severity / Type
OP Use Air Bag Ejected Extricated Transported by
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)
Carrier Name
(37)
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
Government
(39)
(40)
(41)
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.
07. School Bus
13. Bus/Large Van
18.
Farm
9-15 occupants
Machinery
01.
including driver
Veh.-2 Dr
08. Truck/Trailer
02.
Veh.-4 Dr
03.
14. Bus 16+
19.
ATV
Veh. Conv.
09. Truck-Tractor
occupants
(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.
12. Truck-Tractor/
24.
Truck, 3+ axles
Triple
17. Motor Home
99.
Cargo Body Type
Intermodal
11.
Hopper (grain/
Bus 9-15 seats
chips/gravel)
07.
Dump Truck/
12.
Pole Trailer
Bus 16+ seats
Van/Enclosed
08.
Concrete Mixer
13.
Log Trailer
Box
Cargo Tank
09.
Auto Transporter
14.
Vehicle Towing
Vehicle
15.
Flatbed
10.
Garbage/Refuse
235
Total Lanes
Legal
Pedestrian / Pedalcyclist Only
Was the collision in or near a construction, maintenance or utility
Actions Prior
Location at Time
Safety
Unit Number of
in Roadway
Speed
work zone? (If yes, complete this section)
This unit will
to Collision
of Collision
Equip.
Vehicle Striking
correspond
Type of Work Zone
Location of the Work Zone
to 'Unit 1'
Collision
Lane Closure
1 Before the First Work
Lane Shift/Crossover
Zone Warning Sign
to 'Unit 2'
3 Work on Shoulder or Median
Advance Warning Area
Light
What
Unit 1
Unit 2
Underride/
4 Intermittent or Moving Work
Transition Area
Activity Area
Override
Termination Area
Daylight
Was Going
Dark-Not Lighted
to Do
Dark-Lighted
No Underride or Override
Workers Present Yes
Dawn
Go Ahead
Underride, Compartment
Dusk
Turn Left
Intrusion
Dark-Unknown
Turn Right
Underride, No
Trafficway
Unsafe / Unlawful
Lighting
Make “U” Turn
Compartment Intrusion
Contributing Factors
7
Stop
Slow for Cause
Intrusion Unknown
FAILED TO YIELD
49
Tires
Start from Park/Stop
Override, Motor Vehicle in
Two-Way, Not Divided
From Stop Sign
50
Suspension
Change Lanes
Transport
From Yield Sign
51
Headlights
Weather
Overtake
Override, Other Motor
with a Continuous Left
Private Drive
52
Tail Lights
Pass
Turn Lane
County Road at
53
Stop Lights
Clear
Back
Two-Way, Divided,
Through Highway
54
Wheel
Fog/Smog/Smoke
12
Remain Stopped
Unprotected (painted > 4
From Signal Light
55
Exhaust System
Traffic
Cloudy
13
Remain Parked
feet) Median
From Alley
56
Windshield Wipers
Rain
14
Enter/Merge in Traffic
Control
To Pedestrian
57
Other Mechanical Defects
Snow
15
Negotiate a Curve
Positive Median Barrier
To Vehicle on Right
LEFT OF CENTER
Sleet/Hail (Freezing
16
Park
No Control
Two-Way, Divided, Cable
To Vehicle in
58
In Meeting
Intersection
59
No Passing Zone (Unmarked)
Rain/Drizzle)
17
Stop Sign
Barrier
To Emergency
60
Marked Zone
Severe Crosswind
Traffic Signal
One-Way
9 Unknown
Vehicles
61
Blowing Snow
Flashing Traffic Signal
Blowing Sand, Soil,
IMPROPER OVERTAKING
Dirt
School Zone Signs
FOLLOWED TOO
62
In Marked Zone
Did
Yield Sign
Removal
CLOSELY
63
On Hill/Curve
Warning Sign
Human Element
64
At Intersection
Railroad Advance
Traffic Condition
65
Without Sufficient Clearance
Went Ahead
Towed Due to
Weather Condition
66
Locality
Turned Left
Railroad Cross Bucks
Vehicle Damage
UNSAFE SPEED
IMPROPER PARKING
Turned Right
Railroad Gates
Towed For Reasons
Driver's Ability (Age)
67
On Roadway
Residential
Entered “U” Turn
Railroad Signal
Other Than Damage
Inexperienced Driver -
68
Where Prohibited
Business
Stopped
No Passing Zone
Remained at Scene
Young
69
Industrial
Slowed
Person (including flagger,
Driven from Scene
18
Exceeding Legal Limit
INATTENTION
School
Started From Park/Stop
law enforcement, crossing
19
For Traffic Conditions
70
Distracted by Passenger in
Not Built-up
Entered Other Lane
guard, etc.)
20
For Type of Roadway
71
Mixed Use
Overtaking
Abnormal Control
(Gravel, Dirt, etc.)
Other Distraction Inside
Passing
Posted Speed
21
For Ice or Snow on
72
Backed
Condition
Roadway
Distraction From Outside
Remained Stopped
22
Rain or Wet Roadway
Type of
Remained Parked
23
Wind
73
Entered/Merged
Road
24
Other Weather
WRONG WAY
Not an Intersection
Departed Rdwy-Right
Surface
Brakes
Conditions
74
On One Way
Departed Rdwy-Left
25
Vehicle Condition
75
On Exit Ramp
Y-Intersection
Swerved Right
Steering
26
View Obstruction
76
On Entrance Ramp
Dry
T-Intersection
Swerved Left
27
On Curve/Turn
77
Four-Way
Parked
Wet
Brake Lights
28
Impeding Traffic
IMPROPER START FROM
Ice/Frost
Tires/Wheels
29
78
Parked Position
Five-Point, or More
IMPROPER TURN
79
Intersection as Part
Mud, Dirt, Gravel
Signal lights
30
From Wrong Lane
80
ALCOHOL-DUI/DWI
of Interchange
Visibility Unit 1
Slush
Windows
31
From Direct Course
81
DRUG-DUI
Traffic Circle
Obscured
Water (standing, moving)
Truck Coupling/Trailer
32
Right
OTHER IMPROPER ACT/
Roundabout
by
Sand
Hitch/Safety Chains
33
Left
MOVEMENT
Oil
Mirrors
34
Turn About/U-Turn
82
Failed to Signal
Wipers
35
To Enter Private Drive
83
Disregarded Warning Signal
Incident Type
Trees
Power Train
36
In Front of Oncoming
84
Improper Use of Lane
Embankment
85
Improper Backing
Building
Road Character
Special
37
86
Apparently Sleepy
Not an Incident
Signs
Function
38
CHANGED LANES
87
Failed to Secure Load
Private Property
Parked Vehicles
Grade
of Vehicle
UNSAFELY
88
Deliberate Intent
High Weeds
Level
39
STOPPED IN
UNKN./NO IMPROPER ACT
Medical Condition
Fences
Hillcrest
TRAFFIC LANE
89
Deer in Roadway
Legal Intervention
Shrubbery
Uphill
School Bus
FAILED TO STOP
90
Animal in Roadway
Suicide
Ice, Snow or Frost on
Downhill
Transit Bus
40
For Stop Sign
91
Domestic Animal in Rdwy
Drowning
Sag (bottom)
Intercity Bus
41
For Traffic Signal
92
Avoiding Other Vehicle
Smoke
Charter Bus
42
For School Bus
93
Avoiding Pedestrian
Fog
Horizontal
Other Bus
43
For Railroad Gates/
94
Object/Debris in Roadway
Location of
Dust
Alignment
Military
Signal
95
Defect in Roadway
First Harmful
Straight
OHP
44
For Officer/Flagman
96
Abnormal Traffic Control
Event
Sun
Other Police
45
At Sidewalk/Stopline
97
Improper Bicyclist Action
Curve - Left
Other Law Enforcement
46
98
NO IMPROPER ACTION BY
Curve - Right
Shoulder
Ambulance
UNSAFE VEHICLE
DRIVER
Median
Fire Truck
47
PEDESTRIAN ACTION
Roadside
Public Owned Vehicle
48
Gore
Distracted
Highway Equipment
Separator
Special Mobilized Machine
Point of First
Parking Lane/Zone
Concrete
Contact on
Not Applicable/None
Off Roadway,
Electronic Communication
Asphalt
Emergency
Location Unknown
Outside Right-of
Devices
Gravel
Most Damaged
Other Electronic Device
Responding to
Area
Way
Other Inside Vehicle
Brick
an Emergency
Top
15 Non-Collision
Other Outside Vehicle
Undercarriage
236
Latitude
Longitude
Railroad Crossing Number
Pg of
Direction of Travel Before Collision
S W
Indicate North
by Arrow
COLLISION EVENTS
First Event
Second Event
Third Event
Fourth Event
First Harmful Event
Event for the
Entire
Work Zone/Maintenance
Pavement Drop-Off
Equipment
Ditch
Other Non-Fixed Object
FIXED OBJECT:
Tree (Standing)
Barrier (Cable)
Dividing Strip
Barrier (Concrete)
Retaining Wall
Barrier (Other)
Bridge Abutment
Fence Pole
Bridge Pier or Support
Fence
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-
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
Traffic Signal Support
Bridge Post
Traffic Sign Support
Bridge Curb
Utility Pole/Light Support
Bridge Super Structure (Beams)
Other Post/Pole/Support
Bridge Overhead Structure
Guardrail/Guardrail Face
Delineator
Guardrail End
Mailbox
Culvert
Other Fixed Object
Curb
Other Highway Structure
Island
Ground
Sand Barrels
Impact Attenuator/ Crash
Cushion
Remarks
237
PERSONS SUPPLEMENTAL
(42)
Pos in Veh.
(43)
(44)
OP Use
Air Bag Ejected Extricated Transported by
(45)
(46)
(47)
(48)
(49)
(50)
(51)
(52)
(53)
(54)
(55)
(56)
(57)
(58)
(59)
(60)
(61)
(62)
(63)
(64)
(65)
(66)
(67)
(68)
238
DIAGRAM SUPPLEMENTAL
239
ADDITIONAL NARRATIVE
240
Sales Tax Exemption Oklahoma - To be valid, the Oklahoma 13-79 form requires detailed information about the vendor, including name, FEIN, and address.
Oklahoma Real Estate Contract - Clarifies the transfer and proration of leases, security deposits, and other tenant-related finances at the time of closing.
Filing the New York Articles of Incorporation form is crucial for anyone looking to create a corporation in New York, and resources such as UsaLawDocs.com can provide valuable guidance throughout this process, ensuring that all necessary information about the corporation's name, purpose, and structure is correctly documented.
Oklahoma Form 512 Instructions - Corporations can detail reasons for the amended return and provide necessary schedules or reports for clarification.