Sample Form Fr300p - Police Crash Report Page 2
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6Commonwealth of Virginia
Department of Motor Vehicles
FR300P (Rev 1/12)
•
Officer Initials________ Badge # __________
Police Crash Report
Page _______ of _______
Revised Report
CRASH
Crash
MM DD YYYY
MILITARY Time (24 hr clock) County of Crash
Local Case Number
City of
Date
Town of
DRIVER INFORMATION
VEHICLE INFORMATION
Veh
Veh
Veh
Veh
Veh
Veh
Veh
Veh
V1
V4
P1
Vehicle Maneuver
Vehicle Damage
Driver’s Action
Driver Vision Obscured P3
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
1. Unknown
1. No Improper Action
1. Going Straight Ahead
1. Not Obscured
2. Exceeded Speed Limit
2. Making Right Turn
2. No damage
2. Rain, Snow, etc. on Windshield
3. Exceeded Safe Speed
3. Making Left Turn
3. Overturned
3. Windshield Otherwise Ob scured
4. Motor
But Not Speed Limit
4. Making U-Turn
4. Vision Obscured by Load on
4. Overtaking On Hill
5. Undercarriage
5. Slowing or Stopping
Vehicle
5. Overtaking On Curve
6. Merging Into Traffic Lane
6. Totaled
5. Trees, Crops, etc.
6. Overtaking at Intersection
7. Starting From Parked Position
7. Fire
6. Building
7. Improper Passing of School Bus
8. Stopped in Traffic Lane
8. Other
7. Embankment
8. Cutting In
9. Ran Off Road – Right
8. Sign or Signb oard
9. Other Improper Passing
10. Ran Off Road – Left
9. Hillcrest
10. Wrong Side of Road –
11. Parked
10. Parked Vehicle(s)
V5
Vehicle Condition
N/A
N/A
Not Overtaking
12. Backing
11. Moving Vehicle(s)
1. No Defects
11. Did Not Have Right-of-Way
13. Passing
12. Sun or Headlight Glare
2. Lights Defective
12. Following Too Close
14. Changing Lanes
13. Other
3. Brakes Defective
13. Fail to Signal or Improper Signal
15. Other
14. Blind Spot
4. Steering Defective
14. Improper Turn – Wide Right Turn
16. Entering Street From Parking Lot
15. Smoke/Dust
5. Puncture/Blowout
15. Improper Turn –
16. Stopped Vehicle(s)
6. Worn or Slick Tires
Cut Corner on Left Turn
7. Motor Trouble
16. Improper Turn From Wrong Lane
Skidding Tire/Mark
V2
8. Chains In Use
N/A
N/A
17. Other Improper Turn
P4
Type of Driver
N/A
N/A
9. Other
1. Before Application of Brakes
18. Improper Backing
Distractions
10. Vehicle Altered
2. After Application of Brakes
19. Improper Start From Parked
1. Looking at Roadside Incident
11. Mirrors Defective
3. Before and After Application of Brakes
Position
2. Driver Fatigue
12. Power Train Defective
4. No Visible Skid Mark/Tire Mark
20. Disregarded Officer or Flagger
3. Looking at Scenery
13. Suspension Defective
21. Disregarded Traffic Signal
4. Passenger(s)
14. Windows/Windshield Defective
22. Disregarded Stop or Yield Sign
5. Radio/CD, etc.
15. Wipers Defective
Vehicle Body Type
V3
23. Driver Distraction
N/A
N/A
6. Cell Phone
16. Wheels Defective
24. Fail to Stop at Through High
1. Passenger car
7. Eyes Not on Road
17. Exhaust System
way – No Sign
2. Truck – Pick-up/Passenger Truck
8. Daydreaming
25. Drive Through Work Zone
3. Van
9. Eating/Drinking
26. Fail to Set Out Flares or Flags
4. Truck – Single Unit Truck (2-Axles)
10. Adjusting Vehicle Controls
Special Function
V6
27. Fail to Dim Headlights
N/A
N/A
7. Motor Home, Recreational Vehicle
11. Other
Motor Vehicle
28. Driving Without Lights
8. Special Vehicle – Oversized
12. Navigation Device
29. Improper Parking Location
1. No Special Function
Vehicle/Earthmover/Road Equipment
13. Texting
30. Avoiding Pedestrian
2. Taxi
14. No Driver Distraction
9. Bicycle
31. Avoiding Other Vehicle
3. School Bus (Public or Private)
10. Moped
Drinking
P5
N/A
N/A
32. Avoiding Animal
4. Transit Bus
11. Motorcycle
33. Crowded Off Highway
1. Had Not Been Drinking
5. Intercity Bus
12. Emergency Vehicle
34. Hit and Run
2. Drinking – Obviously Drunk
6. Charter Bus
N/A
N/A
(Regardless of Vehicle Type)
35. Car Ran Away – No Driver
3. Drinking – Ability Im paired
7. Other Bus
13. Bus – School Bus
36. Blinded by Headlights
4. Drinking – Ability Not Impaired
8. Military
14. Bus – City Transit Bus/ Privately
37. Other
5. Drinking – Not Known Whether
9. Police
Owned Church Bus
Impaired
38. Avoiding Object in Roadway
10. Ambulance
15. Bus – Commercial Bus
6. Unknown
39. Eluding Police
11. Fire Truck
16. Other (Scooter, Go-cart, Hearse,
40. Fail to Maintain Proper Control
12. Tow Truck
Bookmobile, Golf Cart, etc.
41. Improper Passing
13. Maintenance
18. Special Vehicle – Farm Machinery
42. Improper or Unsafe Lane Change
14. Unknown
19. Special Vehicle – ATV
Method of Alcohol
P6
N/A
N/A
43. Over Correction
21. Special Vehicle – Low-Speed Vehicle
Determination (by police)
22. Truck – Sport Utility Vehicle (SUV)
P2
Condition of Driver
1. Blood
N/A
N/A
V7
23. Truck – Single Unit Truck
EMV in service
Contributing to the Crash
N/A
N/A
2. Breath
(3 Axles or More)
1. Yes
3. Refused
1. No Defects
25. Truck – Truck Tractor (Bobtail-No Trailer)
2. No
4. No Test
2. Eyesight Defective
3. Hearing Defective
4. Other Body Defects
5. Illness
P7
Drug Use
Truck Cover
V8
N/A
N/A
N/A
N/A
6. Fatigued
1. Yes
1. Yes
7. Apparently Asleep
2. No
2. No
8. Other
3. Unknown
9. Unknown
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