When an off-highway vehicle incident occurs, it's essential to report the details accurately for legal and safety purposes. The OHV Incident Operator Report (Form 4100-174) is designed for this, helping operators document crucial details about accidents involving vehicles like snowmobiles, ATVs, UTVs, or OHMs. Below is a step-by-step guide on how to fill out this form properly.
1. Provide Incident Details
Begin by entering the date, time, and day of the week of the incident. Specify the location, choosing from options such as private land, public land, public road, etc., and indicate the city, township, county, and state where the incident occurred.
2. Describe the Incident
Note the number of vehicles involved in the crash. Check the appropriate boxes to indicate if the incident resulted in injuries requiring medical treatment, a fatality, or the disappearance of a person that suggests injury or death.
3. Write Vehicle and Operator Information
Fill in the type of vehicle involved (snowmobile, ATV, UTV, OHM) and provide detailed information about the operator, including name, address, phone number, date of birth, and experience level. Indicate whether safety training specific to OHVs was completed.
4. Detail Safety Equipment and Injuries
Mark whether safety equipment such as helmets or eye protection was used and note if seat belts were applicable and used. Describe the nature of any injuries sustained, categorizing them as minor or major, and provide a detailed description of the injuries.
5. Additional Passenger and Vehicle Information
If other passengers were involved, enter their names, contact information, and any injuries they sustained. For the vehicle, provide details such as the make, model, year, vehicle ID number, engine size, and whether studs/chains were used. Note the estimated speed at the time of the incident and how many vehicles are designed to seat.
6. Information on Other Parties and Witnesses
If other parties were involved in the incident, provide their details and describe their involvement. List any witnesses, including their names, addresses, and contact information.
7. Describe the Environment and Circumstances
Specify the environmental conditions during the incident, such as weather, trail conditions, visibility, and road conditions. Select the type of incident from the provided options, such as collision with another vehicle, ejection from the vehicle, etc. Share your opinion on what contributed to the incident, like vehicle speed, inexperience, or equipment failure.
8. Provide a Narrative Description
In a separate section, describe what happened in a narrative format, detailing the events leading up to the incident. This part should provide a clear and comprehensive account of the incident's circumstances.
9. Review and Sign the Report
Double-check the report for accuracy, then print your name, sign, and date the form. Indicate to which law enforcement agency or warden the incident was reported.