CJ 205 Project Two Motor Vehicle Crash Report Template
To complete this template, replace the bracketed text with the relevant information. Note that a formal motor vehicle crash report will have additional details. This template is to be completed based on the information provided in the scenario.
| 1. Date of Crash | [Insert date of crash.] |
| 2. Time of Crash
(Military Time) |
[Insert time of crash.] |
| 3. Day of Week | [Insert day of week.] |
| 4. Date of Report | [Insert date of report.] |
| 5. Type of Crash
List all that apply from these options:
O1 Fatality 02 Injury 03 Property Damage Only 04 Hit and Run 05 Pedestrian 06 Non-collision 07 Commercial Vehicle 99 Other (Specify) |
[Insert type or types of crash.] |
| 6. Location
Indicate direction (north, south, east, or west) from bridge—e.g., north from Center Street Bridge. |
[Insert direction from bridge—north, south, east, or west.] |
| 7. Number of Vehicles Involved | [Insert number of vehicles involved.] |
| 8. Number of Injured Persons | [Insert number of injured persons.] |
| 9. Number of Occupants (Including Driver) by Vehicle | [Insert number of occupants in vehicle 1.]
[Insert number of occupants in vehicle 2.]
[Insert number of occupants in vehicle 3.]
[Insert number of occupants in vehicle 4.] |
| 10. Number of Fatalities | [Insert number of fatalities.] |
| 11. Striking Object Type
Indicate the striking object type from these options:
O1 Driver 02 Pedestrian 03 Bicyclist 04 Parked Car 05 Animal 06 N/A 07 Other Fixed Object (Specify) |
[Insert striking object type.] |
| 12. Striking Object Information
Indicate the color, license number, and vehicle type. |
[Insert color of vehicle.]
[Insert license number.]
[Insert type of vehicle.] |
| 13. Struck Object Type
List all that apply from these options:
O1 Driver 02 Pedestrian 03 Bicyclist 04 Parked Car 05 Animal 06 N/A 07 Other Fixed Object (Specify) |
[Insert struck object type.] |
| 14. Witnesses | [Insert witnesses.] |
| 15. Involved Persons | [Insert involved persons.] |
| 16. Detailed Narrative | [Give a concise statement in your own words of the facts in 1 to 2 paragraphs. Be sure to address who, what, when, where, how, and why.] |