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ADDITIONAL INFORMATION


Be sure your answers are marked INSIDE THE BOXES BELOW WHERE APPLICABLE.


PEDESTRIAN / BICYCLIST / OTHER PEDESTRIAN LOCATION


PEDESTRIAN / BICYCLIST / OTHER PEDESTRIAN ACTION


TRAFFIC CONTROL


LIGHT CONDITIONS


ROADWAY CHARACTER


ROADWAY SURFACE CONDITION


WEATHER


DIRECTION OF TRAVEL

Compass

PRE-ACCIDENT VEHICLE ACTION


LOCATION OF FIRST EVENT


TYPE OF ACCIDENT




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