Civilian Traffic Report Form – Fill Out and Use This PDF

The Civilian Traffic Collision Report form is a critical document for anyone involved in a traffic accident in Kentucky that was not investigated by police officers, especially when the incident results in property damage exceeding $500. By accurately completing this form and mailing it to the Kentucky State Police, as outlined, individuals can officially document the collision. Making sure this documentation is handled correctly is crucial for insurance claims and any legal matters that may arise.

If you've found yourself in such a predicament, take the first step towards safeguarding your rights and interests by filling out the form. Click the button below to get started. Failure to report can have serious consequences, so don't delay.

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Civilian Traffic Report Form PDF Details

At the core of ensuring accountability and systematic documentation for traffic incidents that do not involve law enforcement at the scene, the Commonwealth of Kentucky has instituted the Civilian Traffic Collision Report. This document, provided by the Kentucky State Police, is a critical tool designed for citizens to report traffic collisions. Its necessity becomes apparent in accidents resulting in property damage exceeding five hundred dollars, as stated under KRS 189.635(4), where official police reports are absent. The form requires detailed information about the collision including the date, time, location, and specifics of the vehicles and individuals involved, such as driver's license numbers, vehicle registration, and insurance details. Additionally, it mandates a narrative and diagrammatic representation of the incident, ensuring that the event is thoroughly documented. To aid in the precision of the report, directions on entering information about pedestrians, non-motor vehicles, or additional vehicles involved are clearly stipulated. Moreover, pre-collision actions and environmental conditions contributing to the accident are to be noted, providing a comprehensive account of the circumstances leading to and following the event. This procedure not only facilitates the prompt reporting of incidents to the Kentucky State Police but also serves as a pivotal record that can be essential for insurance claims and legal matters. Meticulous completion and prompt submission of this form, thereby, play a significant role in the post-accident resolution process.

Question	Answer
Form Name	Civilian Traffic Report Form
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	ksp civilian report, ky form collision, commonwealth of kentucky civilian traffic collision report, ky accident report

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COMMONWEALTH OF KENTUCKY

CIVILIAN TRAFFIC COLLISION REPORT

MAIL TO: Kentucky State Police, Criminal ID\Records Br., 1266 Louisville Road, Frankfort, KY 40601

Please print legibly or type all information. Use black or dark blue ink. Make copies before mailing. Do not complete this report if the traffic collision was investigated by a police officer.

Date of Collision

Time

This Collision Occurred In Limits of (City or Town)

PM County

Miles

N S E

On Roadway Number or Roadway Name

WOf (City or Town)

Intersection Roadway Name / #

Or Between Streets (Roadway Name / #)

YOUR INFORMATION (Vehicle 1)

OTHER VEHICLE / PEDESTRIAN (Vehicle 2)

Driver

First

Middle

Last

First

Middle

Last

Address

Driver’s License (Number & State)

Date of Birth (Month/Day/Year)

Phone

Owner of Vehicle

First

Middle

Last

First

Middle

Last

Address

Vehicle Make &

Year

Model

Year

Model

Registration Plate Number & State

Insurance Company

Address

Damage to Vehicle

Estimated Cost of Repairs

Damage to Property Other than Vehicle

Owner’s Name

Estimated Cost of Repairs

Owner’s Address

DIAGRAM WHAT HAPPENED IN THIS COLLISION

DESCRIBE WHAT HAPPENED

(Number Vehicles, Your Vehicle is Vehicle 1)

Indicate North by Arrow N

Name of Person Completing Report
Sign Here (Owner or Driver) Making Report	Date of Report

KRS 189.635(4) provides that:

Any person operating a vehicle on the highways of this state who is involved in an accident resulting in any property dama ge exceeding five hundred dollars ($500) in which an investigation is not conducted by a law enforcement officer shall file a written report of the accident with the Department o f Kentucky State Police within ten (10) days of occurrence of the accident upon forms provided by the department.

DO NOT COMPLETE THIS REPORT IF THE TRAFFIC COLLISION WAS INVESTIGATED BY A POLICE OFFICER

Instructions

(1)If you were involved in a collision with a pedestrian, enter the pedestrian information in the OTHER VEHICLE/PEDESTRIAN space provided for OTHER

VEHICLE/PEDESTRIAN and print the word “PEDESTRIAN” in the OWNER block.

(2)If you were involved in a collision with a vehicle other than a motor vehicle, (for example, snowmobile, minibike, bicycle, all-terrain vehicle, trail bike, or other non- motor vehicle) enter the driver, owner, and vehicle information as you normally would for OTHER VEHICLE/PEDESTRIAN.

(3)If a vehicle is unoccupied at the time of the collision, enter all available information pertaining to that vehicle. Be sure to correctly enter the vehicle’s license number and vehicle’s description in the appropriate VEHICLE block.

(4)Driver information must be entered exactly as it appears on each driver’s license.

(5)Owner information must be entered exactly as it appears on the registration receipt of each vehicle involved in the collision.

(6)If you were involved in a collision in which there were more than two vehicles, additional report forms must be filled out. On the form, place the information for the third vehicle in then space marked “YOUR INFORMATION” and identify it as Vehicle 3. Use the space marked “OTHER VEHICLE/PEDESTRIAN” for the fourth vehicle and identify it as Vehicle 4, and so on.

Please complete the following information by marking the appropriate values (X).

PRE-COLLISION DIRECTION OF TRAVEL	1ST EVENT COLLISION WITH	WEATHER	ROADWAY TYPE
PRE-COLLISION DIRECTION OF TRAVEL	(continuation)	WEATHER	ROADWAY TYPE
	(continuation)
VEHICLE 1 VEHICLE 2	Fixed Object	Blowing Sand, Soil, Dirt, Snow	County Road
North	Bridge Parapet End	Clear	Federal
South	Bridge, Pier, Abutment	Cloudy	Frontage Road
East	Bridge Rail	Fog/Smog/Smoke	Interstate
West	Building/Wall	Fog with Rain	Local Street
	Crash Cushion/Impact Attenuator	Raining	Parkway
Pre-Collision Vehicle Action	Culvert/Head Wall	Severe Crosswinds	State
VEHICLE 1 VEHICLE 2	Curbing	Sleet/Hail	None of the Above
Avoiding Object in Roadway	Earth Embankment/Rock Cut/Ditch	Snowing
Backing	Fence	Other	TRAFFIC CONTROL
Changing Lanes	Fire Hydrant		Advisory Speed Sign
Entering Parked Position	Guardrail End	ROADWAY CONDITION	Center Line
Going Straight Ahead	Guardrail Face	Dry	Flashing Light
Leaving Traffic Lane	Light/Luminaire Support	Ice	Median
Making Left Turn	Mailbox	Sand, Mud, Dirt, Oil, Gravel	No Passing Zone
Making U Turn	Median Barrier	Snow/Slush	Officer or Flagman
Merging	Other Post, Pole or Support	Wet	RR Gates
Overtaking	Overhead Sign Support	Other	RR Signs or Signals
Parked	Sign Post		School Zone Signs
Slowing or Stopped	Snow Embankment	ROADWAY SURFACE	Stop & Go Signal
Starting from Parking	Toll Booth	Asphalt	Stop Sign
Starting in Traffic	Traffic Signal Support	Concrete	Warning Signs
Stopped in Traffic	Tree	Gravel	Yield Signal
Wrong Way	Utility Pole	Other	Other
Other	Other Fixed Object		None
Unknown	Non-Collision	ROADWAY CHARACTER
	Fell from Vehicle	Curve & Grade
1ST EVENT COLLISION WITH	Fire/Explosion	Curve & Hillcrest
Non-Fixed Object	Jackknife	Curve & Level
Animal	Overturned	Straight & Grade
Bicycle	Ran off Roadway (Only)	Straight & Hillcrest
Deer	Submersion	Straight & Level
Motor Vehicle in Transport,	Other Non-Collision
Other Roadway

Other Motor Vehicle

Pedestrian

Railroad Train

Other Object/Not Fixed

KSP 232

Revision Date 05-06-2011

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This document will require specific info to be filled out, thus you must take your time to provide what is requested:

1. For starters, once completing the ksp civilian report, beging with the area that contains the subsequent blank fields:

2. When this section is done, you're ready to add the needed particulars in Insurance Company, Address, Damage to Vehicle, Insurance Company, Address, Damage to Vehicle, Estimated Cost of Repairs, Estimated Cost of Repairs, Estimated Cost of Repairs, DESCRIBE WHAT HAPPENED, and Damage to Property Other than in order to move on to the third part.

3. Through this part, examine Damage to Property Other than, Name of Person Completing Report, Sign Here Owner or Driver Making, and Date of Report. Each one of these must be filled out with highest accuracy.

Damage to Property Other than, Name of Person Completing Report, and Date of Report of ksp 232 form

4. The next section will require your attention in the following parts: PRECOLLISION DIRECTION OF TRAVEL, Vehicle Vehicle, North, South, East, West, ST EVENT COLLISION WITH, Bridge Parapet End, Bridge Pier Abutment, Bridge Rail, BuildingWall, WEATHER, ROADWAY TYPE, Blowing Sand Soil Dirt Snow, and County Road. Be sure to enter all requested info to go further.

Learn how to fill in ksp 232 form part 4

5. This last notch to finalize this form is integral. Make sure to fill out the appropriate form fields, consisting of Other, Wrong Way, Other, Unknown, ST EVENT COLLISION WITH, NonFixed Object, Animal, Bicycle, Deer, Utility Pole, Other Fixed Object, NonCollision, Fell from Vehicle, FireExplosion, and Jackknife, prior to finalizing. If you don't, it can end up in an incomplete and possibly nonvalid form!

Animal, Other, and Jackknife in ksp 232 form

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Civilian Traffic Report Form – Fill Out and Use This PDF

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