Every state has different requirements for filing an accident report. In Oklahoma, motorists involved in a traffic collision must complete and submit an Oklahoma Traffic Collision Report Form (OIC-350) to the Department of Public Safety. This document outlines the specifics of the incident, including information on the drivers involved, vehicles involved, and damages sustained. Failing to submit a traffic collision report can lead to fines and penalties, so it's important to know what is required in order to avoid any issues. For more information on Oklahoma's traffic collision reporting requirements, visit the DPS website.
You will find information regarding the type of form you would like to complete in the table. It can show you how long it will require to fill out oklahoma traffic collision report, exactly what parts you need to fill in and some additional specific facts.
| Question | Answer |
|---|---|
| Form Name | Oklahoma Traffic Collision Report |
| Form Length | 7 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 1 min 45 sec |
| Other names | oklahoma collision, ok collision report, oklahoma highway patrol accident reports, ok highway patrol accident reports |
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Y |
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Pg |
of |
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Incident Report |
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DO NOT WRITE IN THIS SPACE |
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Y N |
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Investigation Completed |
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Revised |
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OFFICIAL OKLAHOMA TRAFFIC COLLISION REPORT |
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Investigation Made at Scene |
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Fatality |
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Photographs |
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Hit and Run |
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(1) Reporting Agency |
Case Number (Agency Use) |
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Motor Vehicles Involved
Number Injured
Number Killed
(2) Date of Collision (mm/dd/yyyy) |
Time |
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County Number and Name |
Nearest City or Town Number and Name |
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(3) |
Distance from Nearest City or Town Limits |
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Control # Int ID |
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Location |
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East Grid |
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Mi. |
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Mi. |
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Ft. |
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S |
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(4) |
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Street, |
Road or |
Highway |
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Distance from |
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(Nearest) Intersecting Street, Road or Highway |
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At |
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Mi. |
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N E |
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Ft. |
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S W of |
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(5) |
Unit |
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Occupants |
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Type |
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Hit & |
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Last Name |
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Middle |
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Date of Birth (mm/dd/yyyy) |
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Sex |
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(6) |
Address |
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Zip |
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(Use Area |
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Code) |
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(7) Driver License Number |
State |
Class Endorsement(s) |
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Restriction(s) |
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Inj. Sev. Type of Injury |
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Drv./Ped. Cond. OP Use
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(8) |
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Ejected Extricated Test |
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(% BAC) Transported by |
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To Medical Facility |
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License |
Plate Number |
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Air |
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0. |
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Bag |
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(9) VIN |
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Vehicle Year |
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Color |
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2nd Color |
Make |
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(10) |
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Insurance Company Name |
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Policy Number |
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Insurance |
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Verification |
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(11) Vehicle Removed by |
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Owner's Last Name |
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First |
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State Month Year
Model |
Veh. Conf. |
Extent of
Damage
Insurance Telephone (Use Area Code)
Middle Initial
Driver
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(12) Owner's Address |
City |
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Same as Driver
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State |
Zip |
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Towed Veh. Type |
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Oversized |
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Rolled |
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Phone present |
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Load |
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Phone in use |
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Burned |
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(13) |
Citation |
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Statute/Ordinance |
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Citation |
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Statute/Ordinance |
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Number |
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Number |
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Number |
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Number |
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(14) |
Unit |
Occupants |
Type |
Hit & |
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Last Name |
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First |
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Middle |
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Date of Birth (mm/dd/yyyy) |
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Sex |
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Run |
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CMV |
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(15) |
Address |
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City |
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State |
Zip |
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Telephone (Use Area Code) |
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(16) Driver License Number |
State |
Class Endorsement(s) |
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Restriction(s) |
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Inj. Sev. Type of Injury |
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Drv./Ped. Cond. OP Use
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(17) |
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Ejected Extricated Test |
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(% BAC) Transported by |
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To Medical Facility |
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License |
Plate Number |
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Air |
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0. |
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Bag |
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(18) |
VIN |
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Vehicle Year |
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Color |
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2nd Color |
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Make |
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(19) |
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Insurance Company Name |
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Policy Number |
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Insurance |
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Verification |
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(20) |
Vehicle Removed by |
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Owner's Last Name |
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First |
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State Month Year
Model |
Veh. Conf. |
Extent of
Damage
Insurance Telephone (Use Area Code)
Middle Initial
Driver
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(21) Owner's Address |
City |
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Same as Driver
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State |
Zip |
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Towed Veh. Type |
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Oversized |
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Rolled |
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Phone present |
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Load |
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Phone in use |
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Burned |
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(22) Citation |
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Statute/Ordinance |
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Citation |
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Statute/Ordinance |
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Number |
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Number |
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Number |
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Number |
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(23) Investigating Officer |
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Badge Number |
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Troop/Div. |
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Reviewed by (Init.) |
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Reviewer Badge Number |
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Date of Report (mm/dd/yyyy) |
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Unit Type |
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Injury Severity |
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Type of Injury |
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Driver/Pedestrian Condition |
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Occupant Protection (OP) In Use |
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D Driver |
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Z Other Cyclist |
0 |
N/A |
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4 |
Incapacitating |
0 |
N/A |
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3 |
Trunk - |
00 |
Not Applicable |
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05 Under the |
08 |
Ill (Sick) |
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00 |
Not Applicable |
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05 |
Child Restraint Type Unknown |
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10 Booster Seat |
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P Pedestrian |
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C Parked Car |
1 |
No Injury |
5 |
Fatal |
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1 |
Head |
4 |
Internal |
01 |
Apparently Normal |
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Influence of |
09 |
Dizzy/Faint |
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01 |
None Used |
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06 |
Restraint Type Unknown |
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11 Other |
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X Pedestrian |
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A Animal |
2 |
Possible |
6 |
Unknown |
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2 |
Trunk - |
Arms |
02 |
Drinking - Ability Impaired |
Medications |
10 |
Emotional |
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02 |
Lap Belt Only |
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07 |
Helmet |
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99 Unknown |
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Conveyance |
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T Train |
3 |
Non - |
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External |
5 |
Legs |
03 |
Odor of Alcohol Beverage 06 |
Very Tired |
11 |
Other |
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03 |
Shoulder Belt Only |
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08 |
Child Restraint - Forward Facing |
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B Bicyclist |
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incapacitating |
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6 |
Unknown |
04 |
Illegal Drugs |
07 |
Sleepy |
99 |
Unknown |
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04 |
Shoulder and Lap Belt |
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09 |
Child Restraint - Rear Facing |
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Air Bag Deployed |
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Ejected |
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Extricated |
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Chemical Test |
|
Extent of Damage |
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Insurance Verification |
Oversized Load |
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Towed Vehicle Type |
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|||||||||||||||||||||||||||||||||||||||||||
0 |
Not Applicable |
4 |
Deployed - Other (knee, |
0 |
Not Applicable 3 |
Ejected, |
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0 |
N/A |
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0 |
N/A |
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4 |
Test Refused |
0 N/A |
3 |
Functional |
0 |
N/A |
3 |
Operator |
0 N/A |
00 |
N/A |
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05 |
Another Vehicle |
09 |
Cattle Trailer |
||||||||||||||||||||||||||||||||||||||||||
1 |
Not Deployed |
5 |
air belt, etc.) |
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1 |
Not Ejected |
Totally |
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1 |
No |
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1 |
Blood |
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5 |
None Given |
1 None |
4 |
Disabling |
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1 |
No |
4 |
Exempt |
N Not Permitted |
01 |
Boat Trailer |
06 |
Utility Vehicle |
10 |
No Trailer in Tow |
||||||||||||||||||||||||||||||||||||||||||
2 |
Deployed - Front |
Deployed - Combination |
2 |
Ejected, |
9 |
Unknown |
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2 |
Yes |
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2 |
Breath |
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6 |
Other |
2 Minor |
9 |
Unknown |
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2 |
Owner |
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P Permitted |
02 |
House Trailer |
07 |
Homemade |
11 |
Other |
||||||||||||||||||||||||||||||||||||||||
3 |
Deployed - Side |
9 |
Deployment Unknown |
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Partially |
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3 |
Blood/Breath |
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03 |
Farm Trailer |
08 |
Trailer |
99 |
Unknown |
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04 |
Horse Trailer |
Box Trailer |
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||||||||||
WARNING - STATE LAW |
|
Use of contents for commercial solicitation is unlawful |
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234
Case Number |
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Pg |
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of |
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(24) Unit |
Pos in Veh. Last Name |
First |
Middle Initial |
Date of Birth (mm/dd/yyyy) |
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Sex |
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Injured
Witness
(25) Address
Passenger Prop. Owner
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City |
State |
Zip |
Telephone (Use Area Code)
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Same as Driver |
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(26) |
Injury Severity / Type |
|
OP Use Air Bag Ejected |
Extricated Transported by |
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To |
Medical |
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Facility |
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Property Type |
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(27) |
Unit |
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Pos in Veh. Last |
Name |
First |
Middle Initial |
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Date of Birth (mm/dd/yyyy) |
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Sex |
|||||||||||||||||||||||||||||
Injured
Witness
(28) Address
Passenger Prop. Owner
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City |
State |
Zip |
Telephone (Use Area Code)
|
Same as Driver |
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(29) |
Injury Severity / Type |
|
OP Use Air Bag Ejected |
Extricated Transported by |
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To Medical |
|
Facility |
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Property Type |
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(30) |
Unit |
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Pos in Veh. Last |
Name |
First |
Middle Initial |
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Date of Birth (mm/dd/yyyy) |
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Sex |
|||||||||||||||||||||||||||||
Injured
Witness
(31) Address
Passenger Prop. Owner
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City |
State |
Zip |
Telephone (Use Area Code)
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Same as Driver |
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(32) |
Injury Severity / Type |
|
OP Use Air Bag Ejected |
Extricated Transported by |
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To Medical |
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Facility |
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Property Type |
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(33) |
Unit |
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Pos in Veh. Last |
Name |
First |
Middle Initial |
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Date of Birth (mm/dd/yyyy) |
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Sex |
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Injured |
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Passenger |
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Witness |
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Prop. Owner |
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(34) Address |
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City |
State |
Zip |
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Same as Driver
Telephone (Use Area Code)
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(35) Injury Severity / Type |
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OP Use Air Bag Ejected Extricated Transported by |
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To Medical Facility
Property Type
Complete information below if this vehicle is being used for COMMERCE/BUSINESS and has a GVWR/GCWR IN EXCESS OF 10,000 LBS., or has a HAZMAT PLACARD, or is a BUS WITH SEATING FOR NINE OR MORE INCLUDING THE DRIVER
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(36) |
Unit |
Carrier Name |
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Address |
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(37) |
City |
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State |
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Zip |
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GVWR |
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0 - 10K lbs. |
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Axle Qty. Cargo Body |
Vehicle Use |
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10,001 - 26K lbs. |
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Interstate Commerce |
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GCWR |
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26K+ lbs. |
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Intrastate Commerce |
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(38) |
U.S. DOT Number |
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Vehicle Inspection Number |
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Placard Number |
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Haz. Mat. Class Haz. Mat. Involved |
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Haz. |
Mat. |
Release |
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Other |
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OK |
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Yes |
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Yes |
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No |
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No |
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Government |
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(39) |
Unit |
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Carrier Name |
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Address |
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State |
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(40) |
City |
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(41) |
U.S. DOT Number |
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Vehicle Inspection Number |
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OK |
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Zip |
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GVWR |
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0 - 10K lbs. |
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Axle Qty. Cargo Body |
Vehicle Use |
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10,001 - 26K lbs. |
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Interstate Commerce |
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GCWR |
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26K+ lbs. |
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Intrastate Commerce |
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||||
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Placard Number |
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Haz. Mat. Class Haz. Mat. Involved |
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Haz. |
Mat. |
Release |
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Yes |
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Yes |
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Other |
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No |
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No |
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Government |
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Position in Vehicle
00.Not Applicable
18.Front Row - Other
28.Second Row - Other
38.Thrid Row - Other
48.Fourth Row - Other
Vehicle Configuration
00. |
N/A |
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07. School Bus |
13. Bus/Large Van |
18. |
Farm |
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Machinery |
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01. |
Passenger |
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including driver |
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08. Truck/Trailer |
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02. |
Passenger |
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03. |
Passenger |
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14. Bus 16+ |
19. |
ATV |
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Veh. Conv. |
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09. |
occupants |
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including driver |
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(Bobtail) |
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20. SUV |
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04. |
Pickup |
10. |
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15. Motorcycle |
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21. |
Passenger Van |
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05. |
Single Unit |
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22. |
Truck more |
11. |
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than 10,000 |
||
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Truck, 2 axles |
16. Motor Scooter/ |
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Double |
Moped |
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lbs., Cannot |
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Classify |
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23. |
Van 10,000 |
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lbs. or Less |
06. |
Single Unit |
12. |
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24. |
Other |
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Truck, 3+ axles |
Triple |
17. Motor Home |
99. |
Unknown |
Cargo Body Type
00. |
N/A |
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06. |
Intermodal |
11. |
Hopper (grain/ |
01. |
Bus |
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chips/gravel) |
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||
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07. |
Dump Truck/ |
12. |
Pole Trailer |
02. |
Bus 16+ seats |
|
Trailer |
||
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||
03. |
Van/Enclosed |
08. |
Concrete Mixer |
13. |
Log Trailer |
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Box |
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04. |
Cargo Tank |
09. |
Auto Transporter |
14. |
Vehicle Towing |
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Vehicle |
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15. |
Other |
05. |
Flatbed |
10. |
Garbage/Refuse |
99. |
Unknown |
235
Case Number |
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|
OFFICIAL OKLAHOMA TRAFFIC COLLISION REPORT |
Pg |
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of |
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Total Lanes |
Legal |
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Pedestrian / Pedalcyclist Only |
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Was the collision in or near a construction, maintenance or utility |
Yes |
|||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
|
Unit |
Actions Prior |
Location at Time |
Safety |
Unit Number of |
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||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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in Roadway |
Speed |
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work zone? (If yes, complete this section) |
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No |
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
This unit will |
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to Collision |
of Collision |
Equip. |
Vehicle Striking |
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correspond |
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Type of Work Zone |
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Location of the Work Zone |
||||||||||||||||||||||||||
to 'Unit 1' |
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Collision |
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|||||||
This unit will |
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1 |
Lane Closure |
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1 Before the First Work |
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|||||||||||||||||
correspond |
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2 |
Lane Shift/Crossover |
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Zone Warning Sign |
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||||||||||||||||||||
to 'Unit 2' |
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3 Work on Shoulder or Median |
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2 |
Advance Warning Area |
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||||||||||||||||||||||||||
|
Light |
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What |
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Unit 1 |
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Unit 2 |
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Underride/ |
|
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Unit 1 |
Unit 2 |
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4 Intermittent or Moving Work |
3 |
Transition Area |
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9 |
Unknown |
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4 |
Activity Area |
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|||||||||||||||||||||||
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Vehicle |
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Override |
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5 |
Termination Area |
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|||||||||||||||||
1 |
Daylight |
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||||||||||||||||||||||||||||
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Was Going |
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9 |
Unknown |
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||||||||||||||||||
2 |
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to Do |
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0 |
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Not Applicable |
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3 |
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00 |
Not Applicable |
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1 |
|
No Underride or Override |
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Workers Present Yes |
No |
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Unknown |
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||||||||||||||||||||||||||||||||||||||||||
4 |
Dawn |
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|||||||||||||||||||||||||||||||||||||||||||||
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01 |
Go Ahead |
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2 |
|
Underride, Compartment |
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||||||||||||||||||||||||||||
5 |
Dusk |
|
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02 |
Turn Left |
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Intrusion |
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Unit 1 |
Unit 2 |
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|
Unit 1 |
|
Unit 2 |
|||||||||||||||||||||||
6 |
|
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03 |
Turn Right |
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3 |
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Underride, No |
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Trafficway |
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Unsafe / Unlawful |
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Lighting |
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04 |
Make “U” Turn |
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Compartment Intrusion |
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Contributing Factors |
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7 |
Other |
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05 |
Stop |
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4 |
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Underride, Compartment |
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9 |
Unknown |
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06 |
Slow for Cause |
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Intrusion Unknown |
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0 |
Not Applicable |
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FAILED TO YIELD |
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49 |
Tires |
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07 |
Start from Park/Stop |
5 |
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Override, Motor Vehicle in |
1 |
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01 |
From Stop Sign |
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50 |
Suspension |
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08 |
Change Lanes |
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Transport |
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2 |
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02 |
From Yield Sign |
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51 |
Headlights |
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Weather |
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09 |
Overtake |
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6 |
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Override, Other Motor |
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with a Continuous Left |
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03 |
Private Drive |
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52 |
Tail Lights |
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10 |
Pass |
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Vehicle |
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Turn Lane |
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04 |
County Road at |
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53 |
Stop Lights |
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01 |
Clear |
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11 |
Back |
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9 |
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Unknown |
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3 |
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Through Highway |
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54 |
Wheel |
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02 |
Fog/Smog/Smoke |
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12 |
Remain Stopped |
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Unprotected (painted > 4 |
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05 |
From Signal Light |
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55 |
Exhaust System |
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Traffic |
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03 |
Cloudy |
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13 |
Remain Parked |
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Unit 1 |
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Unit 2 |
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feet) Median |
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06 |
From Alley |
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56 |
Windshield Wipers |
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04 |
Rain |
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14 |
Enter/Merge in Traffic |
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Control |
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4 |
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07 |
To Pedestrian |
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57 |
Other Mechanical Defects |
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05 |
Snow |
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15 |
Negotiate a Curve |
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Positive Median Barrier |
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08 |
To Vehicle on Right |
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LEFT OF CENTER |
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06 |
Sleet/Hail (Freezing |
16 |
Park |
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00 |
No Control |
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5 |
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09 |
To Vehicle in |
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58 |
In Meeting |
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Intersection |
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59 |
No Passing Zone (Unmarked) |
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Rain/Drizzle) |
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17 |
Other |
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01 |
Stop Sign |
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Barrier |
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07 |
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10 |
To Emergency |
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60 |
Marked Zone |
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Severe Crosswind |
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99 |
Unknown |
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02 |
Traffic Signal |
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6 |
9 Unknown |
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Vehicles |
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61 |
Other |
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08 |
Blowing Snow |
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Unit 1 |
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Unit |
2 |
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03 |
Flashing Traffic Signal |
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12 |
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09 |
Blowing Sand, Soil, |
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What |
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Unit 1 |
Unit 2 |
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Other |
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IMPROPER OVERTAKING |
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Dirt |
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Vehicle |
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04 |
School Zone Signs |
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Vehicle |
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FOLLOWED TOO |
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62 |
In Marked Zone |
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10 |
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Did |
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05 |
Yield Sign |
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Removal |
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CLOSELY |
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63 |
On Hill/Curve |
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Other |
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06 |
Warning Sign |
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13 |
Human Element |
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64 |
At Intersection |
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99 |
Unknown |
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00 |
Not Applicable |
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07 |
Railroad Advance |
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0 |
Not Applicable |
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14 |
Traffic Condition |
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65 |
Without Sufficient Clearance |
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01 |
Went Ahead |
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Warning Sign |
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1 |
Towed Due to |
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15 |
Weather Condition |
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66 |
Other |
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Locality |
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02 |
Turned Left |
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08 |
Railroad Cross Bucks |
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Vehicle Damage |
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UNSAFE SPEED |
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IMPROPER PARKING |
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03 |
Turned Right |
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09 |
Railroad Gates |
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2 |
Towed For Reasons |
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16 |
Driver's Ability (Age) |
|
67 |
On Roadway |
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||||||||||||||||||||||||||||||||||||||||||
1 |
Residential |
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04 |
Entered “U” Turn |
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10 |
Railroad Signal |
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Other Than Damage |
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17 |
Inexperienced Driver - |
68 |
Where Prohibited |
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2 |
Business |
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05 |
Stopped |
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11 |
No Passing Zone |
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3 |
Remained at Scene |
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Young |
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69 |
Other |
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3 |
Industrial |
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06 |
Slowed |
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12 |
Person (including flagger, |
4 |
Driven from Scene |
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18 |
Exceeding Legal Limit |
INATTENTION |
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||||||||||||||||||||||||||||||||||||||||||||||||||
4 |
School |
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07 |
Started From Park/Stop |
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law enforcement, crossing |
9 |
Unknown |
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19 |
For Traffic Conditions |
70 |
Distracted by Passenger in |
||||||||||||||||||||||||||||||||||||||||||||||||||||||||
5 |
Not |
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08 |
Entered Other Lane |
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13 |
guard, etc.) |
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20 |
For Type of Roadway |
71 |
Vehicle |
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Unit 1 |
Unit 2 |
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||||||||||||||||||||||||||||||||||||||||||||||
6 |
Mixed Use |
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09 |
Overtaking |
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|
Abnormal Control |
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|
(Gravel, Dirt, etc.) |
|
Other Distraction Inside |
||||||||||||||||||||||||||||||||||||||||||||||||
7 |
Other |
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10 |
Passing |
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14 |
Posted Speed |
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Vehicle |
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21 |
For Ice or Snow on |
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72 |
Vehicle |
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9 |
Unknown |
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11 |
Backed |
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15 |
Other |
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Condition |
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Roadway |
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Distraction From Outside |
|||||||||||||||||||||||||||||||||
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12 |
Remained Stopped |
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99 |
Unknown |
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22 |
Rain or Wet Roadway |
|
|
Vehicle |
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Type of |
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13 |
Remained Parked |
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00 |
Not Applicable |
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23 |
Wind |
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73 |
Other |
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Intersection |
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14 |
Entered/Merged |
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Road |
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Unit 1 |
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Unit |
2 |
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01 |
Apparently Normal |
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24 |
Other Weather |
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WRONG WAY |
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0 |
Not an Intersection |
15 |
Departed |
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Surface |
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02 |
Brakes |
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Conditions |
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74 |
On One Way |
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16 |
Departed |
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Conditions |
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03 |
Headlights |
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25 |
Vehicle Condition |
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75 |
On Exit Ramp |
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1 |
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17 |
Swerved Right |
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01 |
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04 |
Steering |
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26 |
View Obstruction |
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76 |
On Entrance Ramp |
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Dry |
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2 |
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18 |
Swerved Left |
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05 |
Tail Lights |
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27 |
On Curve/Turn |
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77 |
Other |
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3 |
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19 |
Parked |
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02 |
Wet |
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06 |
Brake Lights |
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28 |
Impeding Traffic |
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IMPROPER START FROM |
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4 |
Intersection |
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20 |
Other |
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03 |
Ice/Frost |
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07 |
Tires/Wheels |
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29 |
Other |
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78 |
Parked Position |
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99 |
Unknown |
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04 |
Snow |
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08 |
Suspension |
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IMPROPER TURN |
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79 |
Other |
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5 |
Intersection as Part |
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05 |
Mud, Dirt, Gravel |
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09 |
Signal lights |
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30 |
From Wrong Lane |
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80 |
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of Interchange |
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Visibility Unit 1 |
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Unit 2 |
06 |
Slush |
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10 |
Windows |
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31 |
From Direct Course |
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81 |
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6 |
Traffic Circle |
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Obscured |
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07 |
Water (standing, moving) |
11 |
Truck Coupling/Trailer |
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32 |
Right |
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OTHER IMPROPER ACT/ |
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7 |
Roundabout |
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by |
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08 |
Sand |
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Hitch/Safety Chains |
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33 |
Left |
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MOVEMENT |
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9 |
Unknown |
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09 |
Oil |
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12 |
Mirrors |
15 |
Other |
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34 |
Turn |
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82 |
Failed to Signal |
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00 |
Not Applicable |
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10 |
Other |
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13 |
Wipers |
99 Unknown |
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35 |
To Enter Private Drive |
83 |
Disregarded Warning Signal |
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Incident Type |
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01 |
Trees |
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99 |
Unknown |
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14 |
Power Train |
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36 |
In Front of Oncoming |
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84 |
Improper Use of Lane |
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02 |
Embankment |
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Traffic |
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85 |
Improper Backing |
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00 |
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03 |
Building |
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Road Character |
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Special |
|
Unit 1 |
Unit 2 |
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37 |
Other |
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86 |
Apparently Sleepy |
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Not an Incident |
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04 |
Signs |
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Function |
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38 |
CHANGED LANES |
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87 |
Failed to Secure Load |
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51 |
Private Property |
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05 |
Parked Vehicles |
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Grade |
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Unit 1 |
Unit 2 |
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of Vehicle |
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UNSAFELY |
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88 |
Other |
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52 |
Deliberate Intent |
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1 |
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06 |
High Weeds |
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Level |
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39 |
STOPPED IN |
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UNKN./NO IMPROPER ACT |
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53 |
Medical Condition |
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00 |
Not Applicable |
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07 |
Fences |
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2 |
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Hillcrest |
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TRAFFIC LANE |
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89 |
Deer in Roadway |
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54 |
Legal Intervention |
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08 |
Shrubbery |
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3 |
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Uphill |
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01 |
School Bus |
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FAILED TO STOP |
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90 |
Animal in Roadway |
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55 |
Suicide |
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09 |
Ice, Snow or Frost on |
4 |
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Downhill |
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02 |
Transit Bus |
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40 |
For Stop Sign |
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91 |
Domestic Animal in Rdwy |
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57 |
Drowning |
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Windows |
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5 |
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Sag (bottom) |
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03 |
Intercity Bus |
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41 |
For Traffic Signal |
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92 |
Avoiding Other Vehicle |
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58 |
Other |
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10 |
Smoke |
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04 |
Charter Bus |
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42 |
For School Bus |
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93 |
Avoiding Pedestrian |
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11 |
Fog |
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Horizontal |
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Unit 1 |
Unit 2 |
05 |
Other Bus |
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43 |
For Railroad Gates/ |
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94 |
Object/Debris in Roadway |
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Location of |
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12 |
Dust |
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Alignment |
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06 |
Military |
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Signal |
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95 |
Defect in Roadway |
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|||||||||||||||||||||||||
First Harmful |
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13 |
Rain |
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1 |
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Straight |
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07 |
OHP |
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44 |
For Officer/Flagman |
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96 |
Abnormal Traffic Control |
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|
Event |
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14 |
Sun |
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08 |
Other Police |
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45 |
At Sidewalk/Stopline |
|
97 |
Improper Bicyclist Action |
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2 |
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Curve - Left |
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01 |
On Roadway |
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15 |
Other |
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09 |
Other Law Enforcement |
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46 |
Other |
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98 |
NO IMPROPER ACTION BY |
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3 |
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Curve - Right |
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02 |
Shoulder |
|
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99 |
Unknown |
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10 |
Ambulance |
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UNSAFE VEHICLE |
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DRIVER |
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03 |
Median |
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11 |
Fire Truck |
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47 |
Brakes |
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99 |
PEDESTRIAN ACTION |
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04 |
Roadside |
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Driver |
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Unit 1 |
Unit 2 |
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Road |
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Unit 1 |
Unit 2 |
12 |
Public Owned Vehicle |
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48 |
Steering |
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05 |
Gore |
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Distracted |
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Surface |
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13 |
Highway Equipment |
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Unit |
1 |
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Unit |
2 |
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06 |
Separator |
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by |
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Type |
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14 |
Special Mobilized Machine |
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Point of First |
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07 |
Parking Lane/Zone |
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1 |
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Concrete |
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15 |
Other |
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99 Unknown |
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Contact on |
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0 |
Not Applicable/None |
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08 |
Off Roadway, |
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Vehicle |
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1 |
Electronic Communication |
2 |
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Asphalt |
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Emergency |
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Unit 1 |
Unit 2 |
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Location Unknown |
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Unit 1 |
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Unit 2 |
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09 |
Outside |
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Devices |
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3 |
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Gravel |
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Vehicle |
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Most Damaged |
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2 |
Other Electronic Device |
4 |
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Dirt |
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Responding to |
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Area |
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Way |
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10 |
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3 |
Other Inside Vehicle |
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5 |
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Brick |
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an Emergency |
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Other |
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0 |
N/A |
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2 |
No |
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13 |
Top |
15 |
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4 |
Other Outside Vehicle |
6 |
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Other |
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99 |
Unknown |
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9 |
Unknown |
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9 |
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Unknown |
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1 |
Yes |
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9 |
Unknown |
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14 |
Undercarriage |
99 Unknown |
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236
Case Number
Latitude
.
Longitude
N
.
Railroad Crossing Number
W
Pg of
Direction of Travel Before Collision
Unit |
|
|
N E |
|
Unit |
|
|
N E |
Number |
|
|
S W |
|
Number |
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|
S W |
Indicate North
by Arrow
COLLISION EVENTS
Unit |
First Event |
Second Event |
Third Event |
Fourth Event |
First Harmful Event |
First Harmful |
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Event for the |
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Entire |
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Collision |
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Unit |
First Event |
Second Event |
Third Event |
Fourth Event |
First Harmful Event |
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37 |
Work Zone/Maintenance |
56 |
Pavement |
38 |
Equipment |
57 |
Ditch |
Other |
58 |
Embankment |
|
FIXED OBJECT: |
59 |
Tree (Standing) |
|
40 |
Barrier (Cable) |
60 |
Dividing Strip |
41 |
Barrier (Concrete) |
61 |
Retaining Wall |
42 |
Barrier (Other) |
62 |
Bridge Abutment |
43 |
Fence Pole |
63 |
Bridge Pier or Support |
44 |
Fence |
64 |
Bridge Rail |
10Overturn/Rollover
11Fire/Explosion
12Immersion
13Jackknife
14Cargo/Equipment Loss or Shift
15Equipment Failure (Blown Tire, Brake Failure, etc.)
16Separation of Units
17Departed Road Right
18Departed Road Left
19Cross Median/Centerline
20Downhill Runaway
21Fell/Jumped From Motor Vehicle
22Thrown Or Falling Object
23Other
PERSON, MOTOR VEHICLE, OR NON-
FIXED OBJECT:
30 Pedestrian
31 Pedal Cycle
32 Railway Vehicle (train, engine)
33 Animal
34 Motor Vehicle in Transport
35 Parked Motor Vehicle
36 Struck by Falling, Shifting Cargo or Anything Set in Motion by Motor Vehicle
45 |
Traffic Signal Support |
65 |
Bridge Post |
46 |
Traffic Sign Support |
66 |
Bridge Curb |
47 |
Utility Pole/Light Support |
67 |
Bridge Super Structure (Beams) |
48 |
Other Post/Pole/Support |
68 |
Bridge Overhead Structure |
49 |
Guardrail/Guardrail Face |
69 |
Delineator |
50 |
Guardrail End |
70 |
Mailbox |
51 |
Culvert |
71 |
Other Fixed Object |
52 |
Curb |
72 |
Other Highway Structure |
53 |
Island |
73 |
Ground |
54 |
Sand Barrels |
99 |
Unknown |
55 |
Impact Attenuator/ Crash |
|
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Cushion |
|
|
Remarks
237
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|
OFFICIAL OKLAHOMA TRAFFIC COLLISION REPORT |
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Pg |
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of |
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|||||||||||||||||||||||||||||||||||||
Case Number |
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PERSONS SUPPLEMENTAL |
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||||||||||||||||||||||||
(42) |
Unit |
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|
Pos in Veh. |
|
Last Name |
First |
Middle Initial |
|
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|
Date of Birth (mm/dd/yyyy) |
|
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|
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Sex |
|||||||||||||||||||||||||||||||
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Injured |
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Passenger |
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||||
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Witness |
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Prop. Owner |
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||||
(43) |
Address |
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City |
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State |
Zip |
|
Telephone |
|
(Use Area |
|
Code) |
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|||||||||||||||||||
|
Same as Driver |
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(44) |
Injury Severity / Type |
|
OP Use |
|
Air Bag Ejected Extricated Transported by |
|
|
To |
Medical |
|
Facility |
|
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Property Type |
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(45) |
Unit |
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|
|
Pos in Veh. |
|
Last Name |
First |
Middle Initial |
|
|
|
|
|
|
Date of Birth (mm/dd/yyyy) |
|
|
|
|
|
Sex |
||||||||||||||||||||||||||||||
|
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Injured |
|
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Passenger |
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Witness |
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Prop. Owner |
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(46) |
Address |
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City |
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State |
Zip |
|
Telephone |
|
(Use Area |
|
Code) |
|
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|||||||||||||||||||
|
Same as Driver |
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(47) |
Injury Severity / Type |
|
OP Use |
|
Air Bag Ejected Extricated Transported by |
|
|
To |
Medical |
|
Facility |
|
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|
|
Property Type |
|
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(48) |
Unit |
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|
Pos in Veh. |
|
Last Name |
First |
Middle Initial |
|
|
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|
|
Date of Birth (mm/dd/yyyy) |
|
|
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|
|
Sex |
||||||||||||||||||||||||||||||
|
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Injured |
|
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Passenger |
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||||
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Witness |
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Prop. Owner |
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||||
(49) |
Address |
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City |
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State |
Zip |
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Telephone |
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(Use Area |
|
Code) |
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Same as Driver |
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(50) |
Injury Severity / Type |
|
OP Use |
|
Air Bag Ejected Extricated Transported by |
|
|
To |
Medical |
|
Facility |
|
|
|
|
Property Type |
|
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|||||||||||||||||||||||||||||||||||
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(51) |
Unit |
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|
Pos in Veh. |
|
Last Name |
First |
Middle Initial |
|
|
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|
|
|
Date of Birth (mm/dd/yyyy) |
|
|
|
|
|
Sex |
||||||||||||||||||||||||||||||
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Injured |
|
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Passenger |
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||||
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Witness |
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Prop. Owner |
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||||
(52) |
Address |
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City |
|
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State |
Zip |
|
Telephone |
|
(Use Area |
|
Code) |
|
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|
|||||||||||||||||||
|
Same as Driver |
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(53) |
Injury Severity / Type |
|
OP Use |
|
Air Bag Ejected Extricated Transported by |
|
|
To |
Medical |
|
Facility |
|
|
|
|
Property Type |
|
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|
|||||||||||||||||||||||||||||||||||
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(54) |
Unit |
|
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|
|
Pos in Veh. |
|
Last Name |
First |
Middle Initial |
|
|
|
|
|
|
Date of Birth (mm/dd/yyyy) |
|
|
|
|
|
Sex |
||||||||||||||||||||||||||||||
|
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Injured |
|
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Passenger |
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||||
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Witness |
|
|
Prop. Owner |
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||||
(55) |
Address |
|
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City |
|
|
State |
Zip |
|
Telephone |
|
(Use Area |
|
Code) |
|
|
|
|
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|
|
|||||||||||||||||||
|
Same as Driver |
|
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|||||||
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|
(56) |
Injury Severity / Type |
|
OP Use |
|
Air Bag Ejected Extricated Transported by |
|
|
To |
Medical |
|
Facility |
|
|
|
|
Property Type |
|
|
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|
|||||||||||||||||||||||||||||||||||
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(57) |
Unit |
|
|
|
|
|
|
|
Pos in Veh. |
|
Last Name |
First |
Middle Initial |
|
|
|
|
|
|
Date of Birth (mm/dd/yyyy) |
|
|
|
|
|
Sex |
||||||||||||||||||||||||||||||
|
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|
Injured |
|
|
Passenger |
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||||
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|
Witness |
|
|
Prop. Owner |
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||||
(58) |
Address |
|
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|
City |
|
|
State |
Zip |
|
Telephone |
|
(Use Area |
|
Code) |
|
|
|
|
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|
|||||||||||||||||||
|
Same as Driver |
|
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|||||||
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|
(59) |
Injury Severity / Type |
|
OP Use |
|
Air Bag Ejected Extricated Transported by |
|
|
To |
Medical |
|
Facility |
|
|
|
|
Property Type |
|
|
|
|
|
|
|||||||||||||||||||||||||||||||||||
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|
(60) |
Unit |
|
|
|
|
|
|
|
Pos in Veh. |
|
Last Name |
First |
Middle Initial |
|
|
|
|
|
|
Date of Birth (mm/dd/yyyy) |
|
|
|
|
|
Sex |
||||||||||||||||||||||||||||||
|
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|
|
Injured |
|
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Passenger |
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||||
|
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|
Witness |
|
|
Prop. Owner |
|
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||||
(61) |
Address |
|
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|
City |
|
|
State |
Zip |
|
Telephone |
|
(Use Area |
|
Code) |
|
|
|
|
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|
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|
|||||||||||||||||||
|
Same as Driver |
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|||||||
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|
(62) |
Injury Severity / Type |
|
OP Use |
|
Air Bag Ejected Extricated Transported by |
|
|
To |
Medical |
|
Facility |
|
|
|
|
Property Type |
|
|
|
|
|
|
|||||||||||||||||||||||||||||||||||
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|
(63) |
Unit |
|
|
|
|
|
|
|
Pos in Veh. |
|
Last Name |
First |
Middle Initial |
|
|
|
|
|
|
Date of Birth (mm/dd/yyyy) |
|
|
|
|
|
Sex |
||||||||||||||||||||||||||||||
|
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|
|
Injured |
|
|
Passenger |
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||||
|
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|
Witness |
|
|
Prop. Owner |
|
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||||
(64) |
Address |
|
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|
City |
|
|
State |
Zip |
|
Telephone |
|
(Use Area |
|
Code) |
|
|
|
|
|
|
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|
|||||||||||||||||||
|
Same as Driver |
|
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|||||||
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|
(65) |
Injury Severity / Type |
|
OP Use |
|
Air Bag Ejected Extricated Transported by |
|
|
To |
Medical |
|
Facility |
|
|
|
|
Property Type |
|
|
|
|
|
|
|||||||||||||||||||||||||||||||||||
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|
(66) |
Unit |
|
|
|
|
|
|
|
Pos in Veh. |
|
Last Name |
First |
Middle Initial |
|
|
|
|
|
|
Date of Birth (mm/dd/yyyy) |
|
|
|
|
|
Sex |
||||||||||||||||||||||||||||||
|
|
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|
|
Injured |
|
|
Passenger |
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||||
|
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|
Witness |
|
|
Prop. Owner |
|
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||||
(67) |
Address |
|
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|
City |
|
|
State |
Zip |
|
Telephone |
|
(Use Area |
|
Code) |
|
|
|
|
|
|
|
|
|||||||||||||||||||
|
Same as Driver |
|
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(68) |
Injury Severity / Type |
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OP Use |
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Air Bag Ejected Extricated Transported by |
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To |
Medical |
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Facility |
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Property Type |
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238
OFFICIAL OKLAHOMA TRAFFIC COLLISION REPORT
DIAGRAM SUPPLEMENTAL
Case Number
Pg of
Indicate North
by Arrow
239
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OFFICIAL OKLAHOMA TRAFFIC COLLISION REPORT |
Pg |
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of |
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Case Number |
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ADDITIONAL NARRATIVE |
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240