Investigating Officer's Report of Motor Vehicle Accident Code Sheet

INVESTIGATING OFFICER'S REPORT OF MOTOR VEHICLE ACCIDENT

CODE SHEET

Form 433014 (04-18)

Page 1 of 4

Vehicle Configuration

1 - Passenger car 21 - Motor home/recreational vehicle

2 - Four-tire truck (pick-up)

3 - Sport utility vehicle 22 - School bus (seats >15)

4 - Passenger van (seats <9) 23 - Small school bus (seats 9-15)

5 - Passenger van (seats 9-15) 24 - Other bus (seats >15)

25 - Other small bus (seats 9-15)

6 - Cargo/panel van

7 - Single-unit truck (2-axle, 6-tire) 26 - Farm tractor

8 - Single-unit truck (>=3 axles) 27 - Farm equipment

9 - Other light truck (<=10,000 lbs) (explain in narrative)

10 - Vehicle <=10,000lbs, placarded 28 - All-terrain vehicle (ATV)

for hazardous materials 29 - Snowmobile

11 - Truck/trailer 30 - Golf cart

12 - Truck tractor (bobtail) 31 - Street legal, low-speed vehicle

13 - Tractor/semi-trailer

14 - Tractor/doubles 32 - Limousine/taxi (seats 8 or less)

15 - Tractor/triples 33 - Limousine/taxi (seats 9-15)

16 - Other heavy truck (>10,000 lbs) 34 - Limousine/taxi (seats >15)

(cannot classify)

35 - Maintenance/construction vehicle

17 - Motorcycle 36 - Train

18 - 3-wheeled, enclosed

19 - 3-wheeled, unenclosed 98 - Other (explain in narrative)

20 - Moped 99 - Unknown

Placard

1 - Yes

2 - No

3 - Not applicable

99 - Unknown

Involvement

1 - Yes

2 - No

3 - Not applicable

99 - Unknown

Released

1 - Yes

2 - No

3 - Not applicable

99 - Unknown

Underride / Override

1 - None

2 - Underride, compartment intrusion

3 - Underride, no compartment

intrusion

4 - Underride, compartment intrusion

unknown

5 - Override, moving vehicle

6 - Override, parked/stationary

vehicle

8 - Other

9 - Unknown

Extent of Damage

1 - None

2 - Minor Damage

3 - Functional damage

4 - Disabling damage

5 - Severe, vehicle totalled

9 - Unknown

Initial Travel Direction

(prior to coded Vehicle Action)

1 - North

2 - East

3 - South

4 - West

99 - Unknown

Vehicle Action

1 - Movement essentially straight

2 - Turning Left

3 - Turning right

4 - Making U-turn

5 - Overtaking/passing

6 - Changing lanes

7 - Entering traffic lane (merging)

8 - Leaving traffic lane

9 - Backing

10 - Slowing/stopping (decelerating)

11 - Stopped in traffic

12 - Legally parked

13 - Illegally parked/unattended

14 - Negotiating a curve

15 - Starting in road

16 - Accelerating in road

17 - Leaving a parked position

18 - Entering a parked position

98 - Other (explain in narrative)

99 - Unknown

Point of Initial Impact

Most Damaged Area

14 - Undercarriage

15 - Non-collision/no damage

16 - Cargo loss

98 - Other (explain in narrative)

99 - Unknown

Vehicle Defect

1 - None 11 - Headlights

2 - Brake system 12 - Tail lights

3 - Steering 13 - Turn signal

4 - Blowout 14 - Body/doors

5 - Other tire defect (explain in narrative) 15 - Power train

6 - Wheels 16 - Suspension

7 - Windows/windshield 17 - Exhaust

8 - Wipers 18 - Safety systems

9 - Mirrors 98 - Other

(explain in narrative)

10 - Trailer hitch/truck coupling, safety chain 99 - Unknown

Towed Field

1 - Driven away

2 - Disabled - privately arranged

3 - Disabled - officer arranged

4 - Not disabled - privately arranged

5 - Not disabled - officer arranged

6 - Abandoned/left at scene

Cargo Body Type

1 - Not applicable

2 - Van/enclosed box

3 - Dump (grain/gravel)

4 - Cargo tank

5 - Flatbed

6 - Concrete mixer

7 - Auto transporter

8 - Garbage/refuse

9 - Hopper (grain, chips, gravel)

10 - Pole trailer

11 - Log trailer

12 - Intermodal container chassis

13 - Small utility trailer (one-axle)

14 - Large utility trailer (2+axles)

15 - Boat

16 - Camper

17 - Large mobile home

18 - Oversize load

19 - Towed vehicle

20 - Bus

98 - Other (explain in narrative)

99 - Unknown

Special Function of Vehicle

1 - No special function

2 - Police

3 - Fire

4 - Ambulance

5 - Incident response vehicle

6 - Non-transport emergency service

vehicle

7 - Military

8 - Snow plow

9 - Taxi

10 - School

98 - Other (explain in narrative)

99 - Unknown

Emergency Status

1 - Not applicable

2 - Yes, warning equipment used

3 - Yes, warning equipment not used

4 - No, non-emergency, non-transport

5 - No, non-emergency, transport

99 - Unknown

Bus Use

1 - School (public or private)

2 - Transit/commuter

3 - Intercity

4 - Charter/tour

5 - Shuttle

6 - Modified for personal/private use

7 - Church

98 - Other (explain in narrative)

99 - Unknown

W E

11 112

Front

10 2

13 39

8 4

6 57

Vehicle Characteristics

Hazardous Materials

(cargo only)

Special Vehicles

Commercial Motor Vehicle

Converter Dolly

1 - Yes

2 - No dolly used

3 - N

o informatiom/label or unreadable

9 - Unknown

Gross Vehicle Weight Rating

(GVWR)

1 - 10,000 lbs or less

2 - 10,001 lbs -26,000 lbs

3 - 26,001 lbs or more

INVESTIGATING OFFICER'S REPORT OF MOTOR VEHICLE ACCIDENT

CODE SHEET

Form 433014 (04-18)

Page 2 of 4

Alcohol Test Given

1 - None

2 - Blood

3 - Urine

4 - Breath

5 - Vitreous

9 - Refused

Driver Characteristics

Contributing Circumstances, Driver (up to two)

1 - Ran traffic signal Failed to yield right-of-way (FTYROW):

2 - Ran Stop sign 40 - From Stop sign

3 - Exceeded authorized speed 41 - From Yield sign

4 - Driving less than the posted speed limit 42 - Making left turn

5 - Driving too fast for conditions 43 - Making right turn on red signal

6 - Lost control 44 - From driveway

7 - Followed too close 45 - From parked position

8 - Operating vehicle in a reckless, erratic 46 - To non-motorist

careless, negligent manner 47 - At uncontrolled intersection

9 - Improper or erratic lane changing 97 - Other FTYROW (explain in narrative)

10 - Aggressive driving/road rage

11 - Made improper turn Other (explain in narrative):

12 - Failed to yield to emergency vehicle 50 - Vision obstructed

13 - Traveling wrong way/on wrong side 51 - Operating without required equipment

14 - Traveling on prohibited traffic way 52 - Failure to obey displayed vehicle

15 - Over-correcting/over-steering warnings or instructions

16 - Failed to keep in proper lane 53 - Disregarded signs/road markings

17 - Failure to signal intentions 54 - Illegal off-road driving

18 - Swerved to avoid: vehicle, object 55 - Towing improperly

non-motorist, or animal in roadway 56 - Getting off/out of vehicle

19 - Starting or backing improperly 57 - Overloading/improper loading

20 - Failure to dim lights/have lights on with passengers/cargo

21 - Vehicle stopped on railroad tracks

22 - Vehicle drove around grade crossing gates

58 - Operator inexperience

Passing

30 - On wrong side 88 - No improper action

31 - Where prohibited by signs/markings

32 - With insufficient distance/inadequate visibility 98 - Other (explain in narrative)

33 - Through/around barrier 99 - Unknown

96 - Other passing (explain in narrative)

Driver Condition

1 - Apparently normal 8 - Physical impairment

2 - Emotional (e.g., depressed, angry) 9 - Walks with a cane/crutches

3 - Asleep/fatigued 10 - Paraplegic/wheelchair restricted

4 - Illness/fainted 11 - Impaired due to previous injury

5 - Medical condition (seizure, reaction)

12 - Hearing impaired/deaf

6 - Under the influence of alcohol 13 - Visually impaired

7 - Under the influence of drugs/meds 98 - Other (explain in narrative)

99 - Unknown

Vision Obscured

1 - Not obscured 11 - Broken/dirty windshield

2 - Trees/crops 12 - Frosted windows/windshield

3 - Embankment 13 - External mirrors

4 - Hillcrest 14 - Blowing snow

5 - Building(s)

15 - Fog/smoke/dust

6 - Sign/billboard 16 - Splash/spray of passing vehicle

7 - Parked vehicle(s) 17 - Inadequate vehicle lighting

8 - Moving vehicle(s) 18 - Exterior angle/blind spot on vehicle

9 - Person/object in or on vehicle 98 - Other (explain in narrative)

10 - Blinded by sun or headlights 99 - Unknown

Alcohol/Drug Testing

Accident Environment

Drug Test Given

1 - None

2 - Blood

3 - Urine

4 - Breath

5 - Vitreous

9 - Refused

Drug Test Result

1 - Negative 6 - Inhalants

2 - Cannabis 7 - Narcotic

3 - Central Nervous Analgesics

Sys. depressants 8 - Disociative

4 - Central Nervous Anesthetic (PCP)

Sys, stimulants 9 - Prescription Drug

5 - Hallucinogens 98 - Other (explain

in narrative)

Light Conditions

1 - Daylight 4 - Dark, roadway lighted

2 - Dusk 5 - Dark, roadway not lighted

3 - Dawn 6 - Dark, unknown roadway lighting

9 - Unknown

Driver Re-Examination Needed:

1 - Yes (explain in narrative)

2 - No

Driver Distraction:

1 - Not applicable/no driver

2 - Not distracted

Electronic devices:

3 - Manual operation of an electronic

communication device (texting, typing, dialing)

4 - Talking on hand-held device

5 - Talking on hands free device

6 - Adjusting devices (radio, climate)

96 - Other activity with electronic device

(explain in narrative)

Other distraction inside vehicle:

10 - Passenger

11 - Unrestrained animal

12 - Eating or drinking related

13 - Smoking related

14 - Reaching for object(s)/fallen object(s)

15 - Inattentive/lost in thought

16 - Looked but did not see

97 - Other distraction inside vehicle

(explain in narrative)

98 - Distraction outside vehicle

(explain in narrative)

99 - Unknown

Location of First Harmful Event

1 - On roadway

2 - Shoulder

3 - Median

4 - Roadside

5 - Gore

6 - Outside trafficway

7 - In parking lane/zone

8 - Continuous left turn lane

9 - Separator

98 - Other (explain in narrative)

99 - Unknown

Surface Conditions

1 - Dry

2 - Wet

3 - Ice/Frost

4 - Snow

5 - Slush

6 - Mud, dirt

7 - Water (standing or moving)

8 - Sand

9 - Oil

10 - Gravel

98 - Other (explain in narrative)

99 - Unknown

Manner of Crash/Collision

1 - Non-collision (single vehicle)

2 - Head-on (front to front)

3 - Rear end (front to rear)

4 - Angle, oncoming left turn

5 - Broadside (front to side)

6 - Sideswipe, same direction

7 - Sideswipe, opposite direction

8 - Rear to rear

9 - Rear to side

98 - Other (explain in narrative)

99 - Unknown

Weather Conditions (up to two)

1 - Clear

2 - Cloudy

3 - Fog, smoke, smog

4 - Freezing rain/drizzle

5 - Rain

6 - Sleet, hail

7 - Snow

8 - Blowing snow

9 - Severe winds

10 - Blowing sand, soil, dirt

98 - Other (explain in narrative)

99 - Unknown

INVESTIGATING OFFICER'S REPORT OF MOTOR VEHICLE ACCIDENT

CODE SHEET

Form 433014 (04-18)

Page 3 of 4

Vertical Alignment (grade):

1 - Level

2 - At crest

3 - Traversing uphill

4 - Traversing downhill

5 - At sag (bottom of hill)

98 - Other (explain in narrative)

99 - Unknown

Traffic Controls

1 - No controls present

2 - Traffic signals

3 - Flashing traffic control signal

4 - Stop signs

5 - Yield signs

6 - No passing zone (marked)

7 - Warning sign

8 - School zone signs

9 - Railway crossing device

10 - Traffic director (person)

11 - Work zone sign

12 - Inoperative (not functioning properly)

13 - Traffic sign missing

98 - Other (explain in narrative)

99 - Unknown

Location

1 - Before work zone warning sign

2 - Advance warning area

3 - Transition area

4 - Within or adjacent to work activity

5 - Termination area

98 - Other (explain in narrative)

99 - Unknown

Harmful EventsWork Zone Related?

Work Zone Activity

1 - Construction

2 - Maintenance

3 - Utility

98 - Other (explain in narrative)

99 - Unknown

Type

1 - Lane closure

2 - Lane switch/crossover

3 - Work on shoulder or median

4 - Intermittent or moving work

98 - Other (explain in narrative)

99 - Unknown

Workers Present?

1 - Workers only

2 - No workers present

3 - Workers and officer present

4 - Law enforcement only

5 - No one present

98 - Other (explain in narrative)

99 - Unknown

Sequence of Events --- Most harmful Event --- First Harmful Event

Pre-crash events: Collision with fixed object:

1 - Ran off road, right 40 - Bridge overhead structure

2 - Ran off road, straight 41 - Bridge pier or support

3 - Ran off road, left 42 - Bridge/bridge rail parapet

4 - Crossed centerline (undivided) 43 - Curb/island/raised median

5 - Crossed median (divided)

44 - Ditch

6 - Evasive action (swerve, panic braking, avoidance) 45 - Embankment

7 - Downhill runaway 46 - Ground

8 - Cargo/equipment loss or shift 47 - Culvert/pipe opening

9 - Equipment failure (tires, brakes, etc.) 48 - Guardrail - face

10 - Towed portion came apart (separation of units) 49 - Guardrail - end

11 - Loss of traction 50 - Concrete

traffic barrier (median or right side)

12 - Trailer fishtailing or swaying 51 - Other traffic barrier (explain in narrative)

13 - Animal (avoided hitting) 52 - Cable barrier

94 - Other pre-crash (explain in narrative) 53 - Impact attenuator/crash cushion

54 - Utility pole/light support

55 - Traffic sign support

56 - Traffic signal support

57 - O

ther post/pole/support (explain in narrative)

58 - Fire hydrant

59 - Mailbox

60 - Tree

61 - Landscape/shrubbery

62 - Snow bank

63 - Fence

64 - Wall

65 - Building

97 - Other fixed object (explain in narrative)

Miscellaneous events:

70 - Fire/explosion

71 - Immersion

72 - Hit and run

73 - Eluding law enforcement

74 - Gas inhalation/asphyxiation

75 - Vehicle out of gear/rolled

98 - Other (explain in narrative)

99 - Unknown

Non-collision events:

20 - Overturn/rollover

21 - Jackknife

22 - Non-contact vehicle (phantom)

23 - Vehicle went airborne

24 - Fell/jumped from vehicle

95 - Other non-collision (explain in narrative)

Collision with:

30 - Thrown or falling object

31 - Animal

32 - Non-motorist (see non-motorist section

- NOT a unit)

33 - Vehicle in traffic

34 - Re-entering roadway

35 - Parked motor vehicle

36 - Work zone maintenance equipment

37 - Railway vehicle/train

38 - Struck/struck by object/cargo/person

from other vehicle

96 - Other non-fixed object (explain in narrative)

Contributing Circumstances, Environment

1 - None apparent

2 - Weather conditions

3 - Visual obstruction

4 - Non-motorist action

5 - Glare

6 - Animal in roadway

7 - Severe crosswind

98 - Other (explain in narrative)

99 - Unknown

Contributing Circumstances, Roadway

1 - None apparent

2 - Surface condition (e.g., wet, icy)

3 - Debris

4 - Ruts, holes, bumps

5 - Work Zone (roadway-related)

6 - Slippery, loose, or worn surface

7 - Obstruction in roadway

8 - Traffic control obscured

9 - Shoulders (none, low, soft, high)

10 - Non-highway work

11 - Traffic backup, prior crash

12 - Traffic backup, regular congestion

13 - Traffic backup, prior non-recurring incident

14 - Disabled vehicle

98 - Other (explain in narrative)

99 - Unknown

Interchange-related:

20 - On-ramp merge area

21 - Off-ramp, diverge area

22 - On-ramp

23 - Off-ramp

24 - Mainline, between ramps

98 - Other interchange (explain in narrative)

99 - Unknown

Intersection-related:

10 - Roundabout

11 - Traffic circle

12 - Four-way intersection

13 - T-intersection

14 - Y-intersection

15 - Five points or more

16 - L-intersection

17 - Shared use path or trail

18 - Intersection with ramp

97 - Other intersection (explain in narrative)

Type of Roadway Junction/Feature

Non-intersection:

1 - Non-junction/no special feature

2 - Bike lanes

3 - Railroad grade crossing

4 - Driveway access (within)

5 - Driveway access (related, not in)

6 - Alley

7 - Crossover-related

96 - Other non-intersection (explain in narrative)

Horizontal Alignment (curve):

1 - Straight

2 - Traversing curve to left

3 - Traversing curve to right

98 - Other (explain in narrative)

99 - Unknown

Roadway Characteristics

INVESTIGATING OFFICER'S REPORT OF MOTOR VEHICLE ACCIDENT

CODE SHEET

Form 433014 (04-18)

Page 4 of 4

Safety Equipment

1 - Not applicable 6 - Protective pads

2 - None 7 - Multi-equipment (explain in

3 - Helmet narrative)

4 - Reflective clothing 98 - Other (explain in narrative)

5 - Lighting 99 - Unkown

Condition

1 - Apparently normal

2 - Emotional (e.g., depressed, angry)

3 - Asleep/fatigued

4 - Illness/fainted

5 - Medical condition (seizure,

reaction)

6 - Under the influence of alcohol

7 - Under the influence of drugs/meds

8 - Physical impairment

9 - Walks with a cane/crutches

10 - Paraplegic/wheelchair restricted

11 - Impaired due to previous injury

12 - Hearing impaired/deaf

13 - Visually impaired/blind

98 - Other (explain in narrative)

99 - Unknown

Action (prior to crash)

1 - Entering or crossing roadway

2 - Waiting to cross roadway

3 - Going to/coming from school

4 - Working in trafficway

5 - Approaching or leaving vehicle

6 - Entering/exiting vehicle

7 - Playing on or working on vehicle

8 - Disabled vehicle-related/pushing

vehicle

Movement:

10 - Along roadway with traffic

11 - Along roadway against traffic

12 - Along roadway (direction

unknown)

13 - On shoulder/median

14 - On sidewalk

98 - Other (explain in narrative)

99 - Unknown

Contributing Circumstances

1 - No improper action

2 - Not visible (dark clothing)

3 - Improper crossing

4 - Darting/dashing

5 - Inattentive

(talking, eating, texting)

6 - Riding/walking on wrong side of road

7 - Failure to obey traffic signs, signals,

or officer

8 - Failure to yield right-of-way

9 - Failure to have lights on when required

10 - Operating without required equipment

11 - Improper riding (more riders than

seats)

12 - Improper turn/merge

13 - Improper passing

14 - Passing with insufficient distance or

inadequate visibility

15 - Improper/erratic lane changing

16 - Failure to remain in proper lane

17 - Operating in a reckless, erratic,

careless, negligent manner

18 - Improper exit/entry from trafficway

19 - In roadway improperly (standing,

sitting, lying, working, playing)

20 - Disabled vehicle-related (working on,

pushing, leaving/approaching)

21 - Entering/exiting parked/standing

vehicle

98 - Other (explain in narrative)

99 - Unknown

Non-motorist (see non-motorist section below)

1 - Pedestrian

2 - Pedalcyclist (

bicycle, tricycle, unicycle,pedal car)

3 - Pedalcycle passenger

4 - In or on building

5 - Horse and Buggy

6 - Skater, personal conveyance, wheelchair

98 - Other non-motorist (explain in narrative)

99 - Unknown

Location (prior to impact)

Intersection:

1 - Within marked crosswalk

2 - Within unmarked crosswalk

3 - Not within crosswalk

4 - Unknown location

Non-intersection (midblock):

5 - Within marked crosswalk

6 - Within unmarked crosswalk

7 - Not within crosswalk

8 - Unknown location

9 - Parking lane/zone

10 - Pedalcycle lane

11 - Sidewalk

12 - Driveway access

13 - Shared path or trail

14 - Shoulder/roadside

15 - Median/crossing island

16 - Non-trafficway

17 - Travel lane, other location

98 - Other (explain in narrative)

99 - Unknown

Ejection

1 - Not applicable

2 - Not ejected

3 - Partially ejected

4 - Totally ejected

9 - Unknown

Type of Primary Incident

1 - Vehicle Crash

2 - Traffic Stop

3 - Roadway Debris

4 - Motorist Assist

5 - Other

(Explain in narrative)

Injury Status

1 - Fatal

2 - Suspected serious/incapacitating

3 - Suspected minor/non-incapacitating

4 - Possible (complaint of pain/injury)

5 - Uninjured

7 - Fatal, not crash-related

9 - Unknown

Non-Motorist

Occupant Protection

1 - Not applicable

2 - None used

3 - Shoulder and lap belt used

4 - Lap belt only used

5 - Shoulder belt only used

6 - Child safety seat (forward-facing)

7 - Child safety seat (rear-facing)

8 - Child safety seat (type unknown)

9 - Booster seat

10 - Helmet (DOT compliant)

11 - Helmet (other)

98 - Other (explain in narrative)

99 - Unknown

Airbag Deployment

1 - Not applicable

2 - Airbag turned off

3 - Not deployed

4 - Deployed front of person

5 - Deployed side of person

6 - Deployed both front/side

7 - Deployed curtain

98 - Other deployment (explain in narrative)

99 - Unknown

Ejection Path

1 - Not ejected/not applicable

2 - Through front windshield

3 - Through side window

4 - Through side door

5 - Through roof

6 - Through back window

7 - Through back door/tailgate opening

98 - Other (explain in narrative)

99 - Unknown

Injury/Protective Devices

Died at Scene/Enroute

1 - Not applicable

2 - Died at scene

3 - Died enroute

4 - Died at hospital

5 - Died later (w/in 30 days)

98 - Other (explain in narrative)

99 - Unknown

Source of Transport

1 - Not transported

2 - EMS air

3 - EMS ground

4 - Law enforcement

5 - Parent/spouse/friend

6 - Self

7 - To funeral home/morgue

98 - Other (explain in narrative)

99 - Unknown

Trapped/Extricated

1 - Not trapped/applicable

2 - Extricated by non-mechanical means

3 - Extricated by mechanical means

9 - Unknown

16 - In 6th row or greater

17 - In enclosed passenger/cargo area

18 - In unenclosed passenger/cargo area

19 - Sleeper

20 - Trailing unit

21 - Riding on exterior of vehicle

22 - Hanging onto vehicle

23 - Passenger of motorcycle/moped/ATV

98 - Other vehicle-related (explain in narrative)

99 - Unknown