Traffic Accident Form Colorado Springs Police
ADVERTISEMENT
1
2
3For questions or to complete online,
please go to:
https://crash.state.co.us
Colorado State Patrol
Instructions for completing a counter crash report
This reporting procedure cannot be used for any crash involving loss of human life,
injuries which are evident at the scene, drugs, or alcohol use.*
Print the information using blue or black ink. You have been provided with a template
and a blank report. Fill in the information on the blank form (you may make as many
copies as you need); do not fill in the shaded areas -- complete only those numbered
areas indicated below:
1.
Date and time of your crash.
2.
City (if applicable) and County in which the crash occurred.
3.
Today’s date.
4.
Total vehicles involved in the crash, including your vehicle.
5.
Place an “X” in this box if public property (a road sign, utility pole, etc.) was
involved or if the accident occurred at a railroad crossing, in a construction zone,
or on a bridge.
6.
Enter the road on which the crash occurred, approximated distance (feet or
miles) from the nearest town, intersection, road, street, or milepost. If it occurred
at an intersection, first enter the road you were traveling on, then the intersecting
road.
7.
You are vehicle #1, the other driver is vehicle #2, 3, etc. If any of the vehicles
were parked or a bicycle or pedestrian was involved, place an “X” by the word
“Parked”, “Bicycle”, or “Pedestrian”, as appropriate.
8.
Fill out as much information as you have for all parties involved.
9.
Vehicle information. Year, make, model, etc. If you are the driver as well as the
owner, leave this portion blank for the vehicle owner.
10.
The front of the vehicle points to the left of the page. Using the damage severity
codes (1=slight, 2=moderate, 3=extreme), enter a 1, 2, or 3 in the area of the car
diagram that corresponds to the damage each vehicle received as a result of this
crash.
11.
Provide complete insurance information for your vehicle and provide all the
insurance information available to you on the other vehicle(s) involved.
12.
Enter the owner of any property, other than a vehicle, that was damaged in the
crash (e.g., lawn, fence, mailbox, horse, etc.).
13.
Describe the crash in your own words. Refer to yourself as Vehicle #1, and the
other party/parties as Vehicle #2, Vehicle #3, etc. You may draw a diagram if you
wish, but it is not necessary.
14.
Sign the report and send it in to the address at the top right of the form or drop it
off at your nearest Colorado State Patrol office.
* Law enforcement must be notified immediately whenever a crash involves drugs,
alcohol, injuries, or the loss of human life.
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business