no 10364 cra 65 1 13 codes Form 2019-2024

no 10364 cra 65 1 13 codes Form: What You Should Know

For other possible causes please fill out the next section titled “If Medical Care Not Necessary”. Injured person not taken to a medical facility? To report an accident, please use this form to submit: Note: Crash Reports do not include crashes on private property. For information on traffic-related collisions, call. If You Have Been Injured in a Crash First Name Last Name Phone No. Emergency contact Name of Responding Agency. Date Reported? Any date from last week. If this is a personal injury, please state: Incident type: 1. Minor accident. 2. Minor crash. If this is more serious, please describe it. If the crash is your fault, please enter the following information: Date of the crash: 4 Crash occurred, and you were injured when the vehicle was involved in a collision with a vehicle that was  attempting to pass. The driver of the vehicle that was involved in the collision did not have a valid license. Please enter the license plate information: ~~ If a vehicle was involved in a collision and your injuries resulted from the collision with that car,  please enter the license plate information, also: ~~ Crash occurred, and you were injured in a collision with a pedestrian. Please enter the name of the person/persons with whom the crash occurred, also: ~~ If you were injured in a traffic crash, please enter the license information of the car involved. Please enter the color or type of car involved, also: ~~  The driver of the vehicle was arrested and not convicted of any criminal offenses. Please enter the license plate information of the vehicle: ~~ Note: All personal data entered on this form must be accurate. If the personal data is  inconsistent with the information entered then please  fill out the Report as Missing In Custody. If you were involved in a crash, but other people involved in the crash also suffered  serious injuries, please include the crash and injuries reported in paragraph 4a and 4b of the  section titled “What You Had to Lose”. (See “What You Had to Lose” section above.) Crash occurred, and you were injured due to a collision with a train. Please enter the train information listed on your incident report: ~~ Crash occurred, and you were injured because of an illegal or unsafe practice.

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