Ops 209 form is the key to your success in the trucking industry. It is a document that provides important information about your driving history and experience. When you fill out this form, you are telling potential employers about your skills and qualifications as a truck driver. Make sure to complete it accurately and honestly so that you can showcase your strengths and stand out from the competition.
This knowledge will help you grasp better the details of the ops 209 form before you begin filling it out.
| Question | Answer |
|---|---|
| Form Name | Ops 209 Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | new york state civilian accident report, civilian accident report ny dmv, ny civilian accident report, civilian police report |
REV. 8/08 |
|
NEW YORK STATE PARKS AND RECREATION |
|
SNOWMOBILE UNIT |
|
EMPIRE STATE PLAZA AGENCY BUILDING 1 |
|
ALBANY, NY 12238 |
REGISTRATION NUMBER |
DATE OF THIS REPORT |
OF REPORTING SNOWMOBILE |
SNOWMOBILE ACCIDENT REPORT
Pursuant to the provisions of Section 25.25 of the New York State Parks and Recreation Law, the operator of a snowmobile involved in an accident resulting in death, personal injury or damage to property of $1,000.00 or more must report the accident to Parks and Recreation, Snowmobile Unit within 7 days. If the operator is physically incapable of making such report, and there is another participant in the accident, then such participant shall make the report. In cases where the operator and the participants are physically incapable of making such report, then the owner shall make the report. Failure to comply with these requirements shall constitute an offense punishable by a fine of not more than one hundred dollars.
1. TIME AND PLACE OF ACCIDENT
A. Date of Accident |
B. Time |
AM □ |
C. State |
D. Nearest City, Town, etc. |
|
|
|
E. County |
|
||||
|
|
PM □ |
|
|
|
|
|
|
|
|
|
|
|
F. Exact Location (Name of trail/area, GPS coordinates; fix location precisely) |
|
|
|
|
|
G. Type of Terrain |
|
|
|
||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1. |
Trail |
|
3. |
Groomed Trail |
|
4. |
Roadway |
6. Other (Specify) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
2. |
Woods |
|
4. |
Field/Lawn |
|
5. |
Body of Water |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
2. DATA (Check all appropriate items in box to the left of the number or fill in)
A. Name & Address of Operator |
|
B. Operator's Age |
|
|
C. Operator's Experience |
|
|
|||||
|
|
|
|
|
|
|
|
|
|
|||
|
|
|
|
|
|
1. |
< 1 Year |
|
3. |
> 5 Years |
||
|
|
|
|
|
|
2. |
|
4. |
Unknown |
|||
D. Name & Address of Owner |
|
E. Have you ever |
completed |
a Snowmobile Safety |
Course? |
Yes □ No □ |
||||||
|
|
|
F. Helmets |
Was the operator wearing a helmet? |
Yes |
□ |
No □ |
|||||
|
|
|
|
|
Was the passenger wearing a helmet? |
Yes □ No □ |
||||||
|
G. Snowmobile |
H. Snowmobile Track: Studded? |
|
I. Estimated Speed |
|
|
(MPH) |
|||||
Make |
Model |
Year Built |
|
Yes |
|
|
|
J. Was the operator familiar with |
||||
|
|
|
|
|
|
|
|
the area? Yes □ No □ |
|
|||
Ownership: |
|
No |
|
|
|
|
||||||
3. WEATHER AND SNOW CONDITIONS (Check all appropriate items in box to left of number or fill in)
|
|
|
|
|
A. Weather Conditions |
|
|
B. Visibility |
C. Snow Conditions |
|
|
D. Wind |
|
|
|||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1. |
Clear |
|
4. |
Snow |
|
7. Other (Specify) |
|
1. |
Good |
|
1. |
Smooth |
|
1. |
None |
|
4. |
Strong |
|
|
|
|
|
|
|
|
||||||||||||
|
2. |
Cloudy |
|
5. |
Sleet/Hail/Freezing Rain |
|
|
|
2. |
Fair |
|
2. |
Rough |
|
2. |
Light |
|
5. |
Storm |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
3. |
Rain |
|
6. |
Fog/Smog/Smoke |
|
|
|
3. |
Poor |
|
3. |
None |
|
3. |
Moderate |
|
|
|
4. OPERATION AT TIME OF ACCIDENT (Check all appropriate items in box to left of number or fill in)
|
|
|
A. Underway |
|
|
|
|
|
B. Not Underway |
|
||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1. |
Cruising |
|
4. |
Towing (Other) |
|
7. Other (Specify) |
|
1. |
Attended |
|
|
3. |
Fueling |
|
2. |
Maneuvering |
|
5. |
Being Towed |
|
|
|
2. |
Parked |
|
|
4. |
Other (Specify) |
|
3. |
Towing Sled |
|
6. |
Racing |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
C. Number of Persons on Snowmobile (Specify)
5.TYPE, NATURE OF CLASSIFICATION OF ACCIDENT (Check all appropriate items in box to left of number or fill in)
A.Cause of the Accident
|
1. |
Struck by Other Snowmobile |
|
6. |
Fire or Explosion (Fuel) |
|
|
|
|
11. |
Ran off Roadway/Trail |
16. Other (Specify) |
|
|
|
|
|
|
|
|
|||||||
|
2. |
Collision with Another Snowmobile |
|
7. |
Fire or Explosion (Other than Fuel) |
|
|
12. |
Overturning |
|
|||
|
3. |
Collision with Person |
|
8. |
Struck Hidden Object in Snow |
|
|
|
13. |
Skidding |
|
||
|
4. |
Collision with Motor Vehicle |
|
9. |
Disappearance of Snowmobile |
|
|
14. |
Fell Off |
|
|||
|
5. |
Collision with a Fixed Object |
|
10 Submersion |
|
|
|
|
15. |
Track Injury |
|
||
|
|
B. PERSONAL INJURIES |
|
|
|
|
|
|
|
|
C. Property Damage |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1. |
Burns or Scalds |
|
5. |
|
Item Damage |
|
|
This Vehicle |
Other Vehicle |
|||
|
2. |
Crushed or Pinched |
|
6. |
Other (Specify) |
1. |
Snowmobile |
|
|
$ |
$ |
||
|
|
|
|
|
|
||||||||
|
3. |
Concussion |
|
|
|
2. |
Accessory Equipment |
|
$ |
$ |
|||
|
4. |
Abrasion |
|
|
|
3. |
Damage to Other Property (Describe on Reverse) |
$ |
|||||
6. GIVE A BRIEF, BUT CLEAR DESCRIPTION OF THE ACCIDENT. USE ADDITIONAL SHEETS IF NECESSARY.
NOTE - |
MAKE 2 COPIES OF THIS FORM. SEND THE ORIGINAL TO NYS PARKS SNOWMOBILE UNIT. SEND 1 TO THE LAW |
ENFORCEMENT AGENCY IN THE AREA WHERE THE ACCIDENT OCCURRED AND KEEP 1 FOR YOUR RECORDS. |
|
|
|
|
OVER |
7. WHAT, IN YOUR OPINION, CAUSED THE ACCIDENT?
8. LIVES LOST |
9. PERSONS INJURED |
A. List Names & Addresses |
A. List Names & Address, Nature & Extent of Injuries |
|
|
10. PROPERTY DAMAGE
Describe Property Damage, Include Name and Address of Owner
11. WITNESSES |
12. ASSISTANCE FURNISHED |
A. List Names & Addresses of All Known Witnesses |
A. List Known Police, Fire Dept., Rescue Squads, Etc. |
|
|
13. PERSONS ON SNOWMOBILE (Other than Operator)
NAME |
ADDRESS |
AGE |
|
|
|
NAME |
ADDRESS |
AGE |
|
|
|
NAME |
ADDRESS |
AGE |
14. REMARKS (Include opinion how similar accidents can be prevented in the future)
15. NAME, ADDRESS OF OPERATOR AND REGISTRATION NUMBER OF OTHER VEHICLES INVOLVED
I declare under the penalties of perjury that to the best of my knowledge and belief, the description and statements made herein are true and correct.
OPERATOR'S SIGNATURE
TELEPHONE NUMBER
(COMPLETE ALL APPLICABLE SECTIONS OR FORMS WILL BE RETURNED)