8 ADDITIONAL INFORMATION Be sure your answers are marked INSIDE THE BOXES BELOW WHERE APPLICABLE. PEDESTRIAN / BICYCLIST / OTHER PEDESTRIAN LOCATION 1) Pedestrian / Bicyclist / Other Pedestrian at intersection 2) Pedestrian / Bicyclist / Other Pedestrian NOT at Intersection PEDESTRIAN / BICYCLIST / OTHER PEDESTRIAN ACTION 1) Crossing, With Signal 2) Crossing, Against Signal 3) Crossing, no Signal, Marked Crosswalk 4) Crossing, no Signal or Crosswalk 5) Riding / Walking / Skating Along Highway With Traffic 6) Riding / Walking / Skating Along highway Against Traffic 7) Emerging from in Front of / Behind Parked Vehicle 8) Going to / From Stopped School bus 9) Getting On / Off Vehicle Other Than School bus 11) Working in Roadway 12) Playing in Roadway 13) Other Actions in Roadway 14) Not in Roadway TRAFFIC CONTROL 1) None 2) Traffic Signal 3) Stop Sign 4) Flashing light 5) Yield Sign 6) Officer/Guard 7) No Passing Zone 8) RR Crossing Sign 9) RR Crossing Flashing Light 10) RR Crossing Gates 11) Stopped School Bus-Red Lights Flashing 12) Construction Work Area 13) Maintenance Work Area 14) Utility Work Area 15) Police/Fire Emergency 16) School Zone 20) Other LIGHT CONDITIONS 1) Daylight 2) Dawn 3) Dusk 4) Dark-Road Lighted 5) Dark-Road unlighted ROADWAY CHARACTER 1) Straight and Level 2) Straight and Grade 3) Straight at Hillcrest 4) Curve and Level 5) Curve and Grade 6) Curve at Hillcrest ROADWAY SURFACE CONDITION 1) Dry 2) Wet 3) Muddy 4) Snow / Ice 5) Slush 6) Flooded 0) Other WEATHER 1) Clear 2) Cloudy 3) Rain 4) Snow 5) Sleet / Hail / Freezing Rain 6) Fog / Smog / Smoke 0) Other DIRECTION OF TRAVEL Vehicle 1 1) North 2) Northeast 3) East 4) Southeast 5) South 6) Southwest 7) West 8) Northwest Vehicle 2 1) North 2) Northeast 3) East 4) Southeast 5) South 6) Southwest 7) West 8) Northwest PRE-ACCIDENT VEHICLE ACTION Vehicle 1 1) Going Straight Ahead 2) Making Right Turn 3) Making Left Turn 4) Making U Turn 5) Starting from Parking 6) Starting in Traffic 7) Slowing or Stopping 8) Stopped in Traffic 9) Entering Parked Position 10) Parked 11) Avoiding Object in Roadway 12) Changing Lanes 13) Passing 14) Merging 15) Backing 16) Making Right Turn on Red 17) Making Left Turn on Red 18) Stopped in Traffic 20) Other Vehicle 2 1) Going Straight Ahead 2) Making Right Turn 3) Making Left Turn 4) Making U Turn 5) Starting from Parking 6) Starting in Traffic 7) Slowing or Stopping 8) Stopped in Traffic 9) Entering Parked Position 10) Parked 11) Avoiding Object in Roadway 12) Changing Lanes 13) Passing 14) Merging 15) Backing 16) Making Right Turn on Red 17) Making Left Turn on Red 18) Stopped in Traffic 20) Other LOCATION OF FIRST EVENT 1) On Roadway 2) Off Roadway TYPE OF ACCIDENT First event Collision with Collision with fixed object No collision Second event vehicle 1 Collision with Collision with fixed object No collision Second event vehicle 2 Collision with Collision with fixed object No collision Back Next Share This Page:
