Traffic Accident Form Colorado Springs Police Page 3
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3STATE OF COLORADO TRAFFIC ACCIDENT REPORT
MAIL TO: State of Colorado
Motor Vehicle Division
Traffic Records
DR-447 (REV 2/01) - E
Denver, CO 80261-0016
Sheet _____ of _____ sheets
DATE /TIME OF ACCIDENT
CITY
COUNTY
DATE OF REPORT
TOTAL VEHICLES
PUBLIC PROPERTY
LOCATION ROUTE, STREET ROAD _____ MILES _____ FEET
N
E
S
W
OF
RAILROAD CROSSING
CONSTRUCTION ZONE
BRIDGE
________________________________________
AT _____________________________________
VEH #1 OR _____
BICYCLE# ____PEDESTRIAN# _____ PARKED ____
VEH #1 OR _____
BICYCLE# ____PEDESTRIAN# _____ PARKED ____
LAST NAME
FIRST
MI
LAST NAME
FIRST
MI
STREET ADDRESS
RES. PHONE
STREET ADDRESS
RES. PHONE
CITY
STATE
ZIP
BUS. PHONE
CITY
STATE
ZIP
BUS. PHONE
DRIVERS LIC.NUMBER
STATE
SEX
DOB
DRIVERS LIC.NUMBER
STATE
SEX
DOB
YEAR
MAKE
MODEL
BODY TYPE
YEAR
MAKE
MODEL
BODY TYPE
LIC. PLATE NO.
STATE
COLOR
LIC. PLATE NO.
STATE
COLOR
VEHICLE ID NO
VEHICLE ID NO.
VEHICLE OWNER LAST NAME
FIRST
MI
VEHICLE OWNER LAST NAME
FIRST
MI
ADDRESS
CITY
STATE
ZIP
ADDRESS
CITY
STATE
ZIP
1- SLIGHT
1-SLIGHT
2- MODERATE
2-MODERATE
3 - EXTREME
3-EXTREME
3
4
5
6
7
8
3
4
5
6
7
8
2
9
2
9
17
18
19
17
18
19
10
10
1
1
16
16
15
14
13
12
11
15
14
13
12
11
_____ 20
_____ 20
Undercarriage
Undercarriage
INSURANCE CO.
EXP. DATE
INSURANCE CO.
EXP. DATE
POLICY NO.
POLICY NO.
OWNER DAMAGED PROP. LAST NAME
FIRST
MI
OWNER DAMAGED PROP LAST NAME
FIRST
MI
ADDRESS
CITY
STATE
ZIP
ADDRESS
CITY
STATE
ZIP
DESCRIBE ACCIDENT
Information contained on this report furnished in total by reporting parties. No on-scene investigation.
Report filed by: ____________________________________________________________
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