Free Oregon Dmv Accident Report Form in PDF

Free Oregon Dmv Accident Report Form in PDF

The Oregon DMV Accident Report Form is a crucial document for drivers involved in a traffic crash that meets certain criteria, such as damages exceeding $2500, any injury regardless of severity, death, or when a vehicle is towed due to damage. This form must be filed with the Oregon DMV within 72 hours of the incident to avoid potential suspension of driving privileges. The form not only aids in the efficient management of crash reports but also ensures compliance with state laws regarding traffic accidents.

To make sure you meet all legal requirements after a traffic accident in Oregon, click the button below to fill out your Oregon DMV Accident Report Form promptly.

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The Oregon Department of Motor Vehicles (DMV) Accident Report form plays a crucial role in ensuring all traffic crashes within the state are duly recorded, evaluated, and handled in accordance with the law. As outlined in this document, drivers involved in collisions leading to vehicle damage exceeding $2500, any form of injury regardless of severity, damage to another person's property over $2500, death, or any situation necessitating a vehicle to be towed from the scene must file a Crash & Insurance Report. The form stipulates a 72-hour window post-accident for submission, emphasizing the significance of timeliness to avoid possible suspension of driving privileges—even for those licensed in other states or non-residents. It importantly differentiates the DMV's role, which includes recording but not determining fault, and offers detailed guidance on completing both sides of the form to ensure accuracy, from insurance verification to accurately describing the crash. Supplemental reports are provided for incidents involving additional vehicles, and separate processes are outlined for commercial motor vehicle operators and cases where a vehicle is considered "totaled." The overarching message communicates the importance of diligent compliance with these procedures to maintain safety, accountability, and legal standing following traffic accidents in Oregon.

Preview - Oregon Dmv Accident Report Form

OREGON TRAFFIC CRASH AND INSURANCE REPORT

Tear this sheet off your report, read and carefully follow the directions.

ONLY drivers involved in a crash resulting in any of the following MUST file a Crash & Insurance Report:

Damage to your vehicle is over $2500

Damage to any one person’s property over $2500

Injury (No matter how minor)

Any vehicle has damage over $2500 and any vehicle is

Death

towed from the scene as a result of damages

Oregon law requires these reports be filed within 72 hours of the crash. If you are not able to file within the 72 hours, submit it as soon as possible. If you fail to report the crash to DMV, it may result in suspension of your driving privileges. If the police department files a police report, you are still required to file your own Crash and Insurance Report with DMV. When required to report, even if you are licensed in another state, or you are not an Oregon resident, you still must file a report with Oregon DMV. DMV does not determine fault in a crash, but does post the crash to the driving record of those drivers required to report, unless the vehicle is parked. If you have questions, please call DMV Crash Reporting Unit at (503) 945-5098.

INSTRUCTIONS

PRINT OR TYPE ALL INFORMATION. (Use black or dark blue ink and press firmly.)

Complete both sides of the form.

If additional vehicles were involved in the crash, complete the attached Supplemental Report (Form 735-32B), or on a blank piece of paper, write all the information as requested in Section 4, the “Other Driver” Section.

DMV Headquarters will verify the insurance information submitted. Complete the insurance section or a suspension of your driving privileges may occur.

SECTION 1

DATE, LOCATION AND TIME — Clearly identify the date, location and time of the crash. The correct date, location and time is critical to processing your report. If you are unsure of the county, contact any local law enforcement agency for assistance.

SECTION 2

Your vehicle is Vehicle #1. Complete ALL fields. Provide Insurance company name (not agent), policy number, and Vehicle identification number (VIN). Failure to provide complete insurance and vehicle information may result in DMV issuing Notice of Suspension due to incomplete information.

SECTION 3

Failure to complete this section may result in DMV sending Notice of Suspension for failure to file a report. Principle purpose of driving and being paid to drive does not mean driving to reach a destination to perform a service. Property: Includes, but is not limited to, fixed or real property, landscaping, signs, parked vehicles, and animals.

COMMERCIAL MOTOR VEHICLE OPERATORS: In addition to this report, Oregon Administrative Rule requires that Form

735-9229, Motor Carrier Crash Report, MUST be filed within 30 days of a commercial motor vehicle crash when there is a FATALITY, INJURY (requiring treatment away from the scene), or when a vehicle is TOWED from the scene because of disabling damage. Form 735-9229 (attached on back) MUST be submitted with Oregon Traffic Crash and Insurance Report (Form 735-32) to DMV. Call (503) 986-3507 for questions regarding the Motor Carrier Crash Report.

You may now file the Motor Carrier Crash Report at: www.oregontruckingonline.com/cf/MCAD/pubMetaEntry/accidentRpt/

SECTION 4

OTHER VEHICLE (# 2) — Completion of this information will help DMV match all driver's crash reports more efficiently. If additional vehicles were involved in the crash, complete attached Supplemental Report (Form 735-32B).

SECTION 5

DESCRIPTION AND SIGNATURE — Describe what happened. It is important for you to sign and date the form. Only a family member may sign and date this form on behalf of a driver when the driver is incapacitated or physically unable to sign. No other signatures will be accepted.

COMPLETING AND FILING REPORT

HOW TO SUBMIT A REPORT TO DMV:

Email to OregonDMVAccidents@odot.oregon.gov

Fax to 503-945-5267

Mail to DMV Crash Reporting Unit 1905 Lana Ave NE, Salem, Oregon 97314

Deliver to a DMV office

Keep a copy of the report and documentation that shows when you submitted your report to Oregon DMV. Under ORS 802.220(5), DMV is not authorized to provide you with a copy of the report that you file. If submitting by:

Email, DMV sends an autoreply that your email was received. Save that autoreply.

Fax, many fax machines provide the option to generate a fax confirmation report. Save that report.

DMV Field Office, request and save that receipt.

PURSUANT TO OREGON INSURANCE LAW, AN INSURANCE COMPANY CAN NOT REQUIRE REPAIRS BE MADE TO A MOTOR VEHICLE BY A PARTICULAR PERSON OR REPAIR SHOP.

735-32 (3-23)

STK# 300009

INSTRUCTIONS

TOTALED VEHICLE NOTICE

DEFINITIONS AND INSTRUCTIONS FOR TOTALED VEHICLES

IF YOUR CRASH HAS RESULTED IN A “TOTALED” VEHICLE, YOU ARE REQUIRED BY LAW TO

FOLLOW APPROPRIATE INSTRUCTIONS IN THIS NOTICE.

DEFINITION OF “TOTALED” VEHICLE

“Totaled Vehicle” or “Totaled” as defined in Oregon law (ORS 801.527) means:

A vehicle that is declared a total loss by an insurer who is obligated to cover the loss or a vehicle that the insurer takes possession of or title to.

A vehicle that has sustained damage that is not covered by an insurer and the estimated cost to repair the vehicle is equal to at least 80% of the retail market value prior to the damage. “Retail market value” is defined as the amount shown in publications used by financial institutions (banks or lenders) in this state.

A vehicle that is stolen, if it is not recovered within 30 days of theft and the loss is not covered by an insurer. In this situation, you must notify DMV within 60 days of the theft.

FOLLOW THESE INSTRUCTIONS IF YOUR VEHICLE IS TOTALED

If your vehicle is totaled, in addition to completing the crash report, follow the instruction that is applicable to your case. Either:

1.SURRENDER the title to the insurer if the damage is covered by an insurer who declares the vehicle to be a “total loss,” and the insurer takes possession of the vehicle; or

2.SURRENDER the title to DMV and apply for salvage title if the damage is covered by an insurer who declares the vehicle to be a “total loss,” but you keep possession of the vehicle; or

3.SURRENDER the title to DMV and apply for salvage title if the damage was not covered by an insurer and the estimated cost of repair is at least 80% of the retail market value of the vehicle before the damage; or

4.NOTIFY DMV that your vehicle has been totaled if, for some reason, you are unable to obtain the title for surrender. You must provide DMV with a signed statement which includes:

A description of the vehicle which includes the year model, make, plate number and vehicle identification number.

A statement indicating the vehicle has been totaled.

A statement that you are unable to obtain the title and why.

DO NOT SUBMIT THE TITLE WITH THE CRASH REPORT. You can obtain the Application for Salvage Title (Form 735-229) from any DMV office, by calling (503) 945-5000, or on-line at www.oregondmv.com. Application instructions and fee information are on the back of the form 735-229. If you have questions about salvage titles, call (503) 945-5122.

NOTE: It is a Class A misdemeanor with a penalty of imprisonment and/or fine if you fail to comply with the above requirements. (ORS 819.012)

OREGON TRAFFIC CRASH AND INSURANCE REPORT

COMPLETE BOTH SIDES

Print Form

Reset Form

Complete this form if the traffic crash occurred on a highway or premise open to the public and meets at least one of the reporting requirements outlined in Section 3. Failure to report when required may result in DMV issuing Notice of Suspension. Call 503-945-5098 for assistance in completing the report.

SECTION 1

CRASH DATE

DAY OF WEEK TIME OF DAY

 

COUNTY

 

 

 

 

 

DMV USE ONLY

 

 

 

M T W TH F

AM

 

 

 

 

 

CRASH REF # _________________________________ ALIR

INS CO

 

S SN

PM

 

 

 

 

 

ROAD ON WHICH CRASH OCCURRED (Name of street, road or route )

MILE POST

 

TYPE OF CRASH - The crash involved one or more of the following:

(Mark all that apply)

 

 

 

 

 

 

 

 

Two vehicles

ATV / Snowmobile

Parked vehicle

NAME OF NEAREST INTERSECTING ROAD

WITHIN

FEET

N

S

E

W

More than two vehicles

Motorcycle

Overturned vehicle

Motor Home / RV

 

 

NEAR

MILES

N

S

E

W

Fatality

Animal

 

 

 

Motorized Scooter

 

NAME OF NEAREST CITY / TOWN

WITHIN

FEET

N

S

E

W

Bicycle

Personal (assisted)

Fixed object / property

 

 

NEAR

MILES

N

S

E

W

Pedestrian

mobility device

Other ____________________

 

 

Train

SECTION 2 (YOUR INFORMATION)

Complete ALL fields. Failure to provide complete information may result in DMV issuing Notice of Suspension.

DRIVER’S LAST NAME

FIRST NAME

MIDDLE NAME

DRIVER’S LICENSE NUMBER

STATE DATE OF BIRTH

GENDER

 

 

 

M

F

X

DRIVER’S RESIDENCE ADDRESS

CITY

STATE

ZIP CODE

CHECK BOX

 

 

 

 

IF ADDRESS

MAILING ADDRESS (IF DIFFERENT THAN RESIDENCE)

CITY

STATE

ZIP CODE

CHANGE

 

 

VEHICLE OWNER’S NAME AND ADDRESS

 

CITY

STATE

ZIP CODE

SAME

 

 

 

 

RENTAL?

 

 

 

 

INSURANCE COMPANY NAME (NOT AGENT) AND ADDRESS

CITY

STATE

ZIP CODE

POLICY NUMBER

VEHICLE IDENTIFICATION NUMBER

 

STATE VEHICLE PLATE NUMBER

YEAR MAKE & MODEL

Check all statements that apply:

SECTION 3

Damage to your vehicle was more than $2500.

Damage to any one person’s property (other than vehicle) was more than $2500.

Your vehicle was towed from the scene as a result of damages.

You or passengers in your vehicle were injured.

Collision with a parked vehicle.

The crash occurred while you were driving your employer’s vehicle.

You were driving on your job and being paid for the principal purpose of driving.

You were being paid to drive and/or deliver persons or property.

You were operating a government owned vehicle marked for transporting mail in accordance with government rules. You were operating an authorized emergency vehicle.

The crash occurred in a work or maintenance zone. ORS 811.230

 

 

 

A police officer came to the scene.

City

County

State Police

Name of police department: __________________________

You were operating a commercial motor vehicle requiring you to have a commercial driver license. You were transporting hazardous material.

A citation was issued to you. The citation was: ________________________________________________________

SECTION 4 (OTHER VEHICLE # 2)

DRIVER’S NAME (LAST, FIRST, MIDDLE)

DRIVER’S LICENSE NUMBER

STATE

DATE OF BIRTH

GENDER

 

 

 

 

 

M F X

 

 

 

 

 

 

DRIVER’S ADDRESS

CITY

 

STATE

ZIP CODE

 

 

 

 

 

 

 

VEHICLE OWNER’S NAME AND ADDRESS

CITY

 

STATE

ZIP CODE

 

SAME

INSURANCE COMPANY NAME (NOT AGENT) AND ADDRESS

 

POLICY NUMBER

VEHICLE IDENTIFICATION NUMBER

STATE VEHICLE PLATE NUMBER YEAR MAKE & MODEL

IF ADDITIONAL VEHICLES WERE INVOLVED IN THE CRASH, USE ATTACHED SUPPLEMENTAL REPORT (Form 735-32B).

DESCRIBE WHAT HAPPENED: (IF MORE SPACE IS NEEDED, SUBMIT ADDITIONAL PAGE)

5

 

 

SECTION

I certify all information given on this report is true and accurate to the best of my knowledge.

 

 

SIGNATURE OF PERSON MAKING REPORT

PRINTED NAME OF PERSON MAKING REPORT

 

X

REASON DRIVER IS UNABLE TO SIGN REPORT

 

IF NOT DRIVER’S SIGNATURE, STATE RELATIONSHIP

735-32 (3-23) COMPLETE THE OTHER SIDE OF THIS PAGE

DMV COPY

DAYTIME PHONE #

 

DATE SIGNED

 

(

)

 

 

 

 

 

 

PHONE NUMBER OF DRIVER

 

 

(

)

 

 

 

 

 

 

 

 

 

 

 

 

 

STK# 300009

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WEATHER CONDITIONS

 

 

 

 

 

 

 

 

 

 

 

 

 

YOU INTENDED TO...

YOUR VEHICLE

 

 

 

 

 

 

 

 

 

 

YOUR RESIDENCE

 

 

Go straight ahead

 

 

Passenger car, pickup, van

 

 

 

Clear

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Local resident

 

 

 

 

 

Make right turn

 

 

 

Military vehicle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Raining

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(within 25 miles of crash site)

 

 

Make left turn

 

 

 

Taxicab

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Snowing

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Residing elsewhere in state

 

 

Make “U” turn

 

 

 

Emergency vehicle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fog

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Non–resident of this state:

 

 

Back–Up

 

 

 

Any of the above and trailer

 

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

College student

 

 

Enter driveway (also

 

 

Private or public agency

 

 

 

 

 

 

 

ROAD SURFACE

 

 

 

 

 

 

Military

 

 

 

 

 

mark left or right turn)

 

 

transit vehicle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Dry

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Temporary job

 

 

 

 

 

Remain stopped in traffic

 

 

Bus

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Wet

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YOU WERE HEADED

 

 

Enter parked position

 

 

School bus

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Snowy

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

North

 

East

 

 

 

 

 

Slow or Stop

 

 

 

Other publicly-owned veh.

 

 

 

 

 

 

Icy

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

South

 

West

 

 

 

 

 

Leave driveway (also

 

 

Motorcycle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

On: ____________________

 

 

mark left or right turn)

 

 

Motor Home / RV

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LIGHT CONDITIONS

 

 

 

 

Start in traffic lane

 

 

Motor–scooter/bike

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Daylight

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(name of street, road or route)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OTHER DRIVER WAS HEADED

 

 

Leave parked position

 

 

Personal (assisted) mobility device

 

 

 

Dawn or dusk

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

North

 

East

 

 

 

 

 

 

 

Truck tractor & semi trailer

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Remain parked

 

 

 

 

 

 

Darkness (lighted)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

South

 

West

 

 

 

 

 

Overtake and pass

 

 

Truck/truck tractor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Darkness (unlighted)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other truck combination

 

 

 

 

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

On: ____________________

 

 

 

 

 

 

 

 

 

Farm tractor/farm equip.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(name of street, road or route)

 

WITNESS INFORMATION:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If this crash involved a pedestrian or

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

bicyclist, complete the following:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PEDESTRIAN NAME

 

BICYCLIST NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pedestrian or bicyclist was going:

 

 

 

 

 

 

 

OCCUPANT INJURY AND SAFETY EQUIPMENT INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

N

 

 

 

 

S

 

E

W

 

 

SAFETY EQUIPMENT CODES

 

 

 

 

INJURY CODE FOR OCCUPANTS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ALONG OR ACROSS: (name of street, road or route)

 

 

WRITE one of the codes (0–10) in column C

 

WRITE one of the codes (1–5) in column D

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

0 No seat belt available

 

 

 

 

1

Fatal

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

From:

 

 

 

 

 

 

 

 

 

 

 

 

 

1 Seat belt available but NOT used

 

 

 

 

2

Suspected Serious: severe laceration, broken

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2 Seat belt available and in use

 

 

 

 

 

or distorted limb, crush injury, significant burns,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3 Child restraint device available but NOT used

 

 

unconsciousness, paralysis

 

 

 

 

 

 

To:

 

 

 

 

 

 

 

 

 

 

 

 

 

4 Child restraint device in use

 

 

 

 

3 Suspected Minor: lump, abrasions, bruises,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5 Child restraint device not available

 

 

 

 

 

minor lacerations

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EXAMPLE: (From: NE corner To: SE corner (or) From: East side To: West side, etc.)

 

 

6 Helmet NOT in use

 

 

 

 

4 Possible

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7

Helmet in use

 

 

 

 

 

5 No apparent

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Gender and age of pedestrian / bicyclist:

 

 

8

Air bag deployed

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

M

F

 

X

Age: _____

 

 

 

 

 

9

Air bag available - NOT deployed

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10

Air bag NOT available

 

 

 

 

GENDER CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Extent of pedestrian / bicyclist injury:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WRITE M, F or X in column A

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fatal

 

 

 

 

 

Complaint of Pain

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SEAT

 

 

OCCUPANTS' NAMES

(your vehicle)

 

 

 

A

 

 

B

 

C

 

 

D

 

 

 

 

 

 

 

 

 

Suspected Serious

No apparent injury

 

 

POSITION

 

 

GENDER

 

 

AGE

 

SFTY

AIR

INJURY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EQP

BAG

 

 

 

 

 

 

 

 

Visible injury

 

 

(or none noted)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pedestrian / bicyclist action: (mark one)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FRONT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CENTER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Crossing at intersection or crosswalk

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FRONT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Crossing not at intersection or crosswalk

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RIGHT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MIDDLE

*

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Walking / riding in roadway with traffic

 

 

 

 

 

LEFT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Walking / riding in roadway against traffic

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MIDDLE

*

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CENTER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Standing in roadway

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MIDDLE

*

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pushing or working on vehicles in roadway

 

 

RIGHT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other working in road

 

 

 

 

 

 

 

 

REAR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LEFT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Playing in road

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REAR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hitchhiking

 

 

 

 

 

 

 

 

 

 

CENTER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REAR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Not in roadway

 

 

 

 

 

 

 

 

RIGHT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other________________________________

 

 

 

 

*Use only for vehicles with middle row of seats (i.e., vans, SUVs, etc.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(specify)

 

 

 

 

Vehicle Damage

 

 

 

 

 

 

Diagram

 

Number each vehicle:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

street,

route)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FRONT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Show path by:

 

 

 

 

 

 

 

 

 

 

 

 

U

 

 

 

 

 

 

 

(nameof roador

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Show pedestrian/bicyclist by:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Show railroad tracks by:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

USE ARROW TO SHOW

Vehicle towed

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Show fixed object by:

 

 

 

 

 

X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FIRST IMPACT (SHADE

Rollover

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IN DAMAGED AREA)

Under car

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Totaled

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Your Vehicle (No. 1) damage: $ __________ .

 

 

 

 

 

 

 

 

(name of street,

 

 

 

 

 

 

 

 

 

 

 

(name of street,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

road or route)

 

 

 

 

 

 

 

 

 

 

 

 

 

road or route)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SUPPLEMENTAL REPORT

OREGON TRAFFIC CRASH

Supplemental for more than two drivers involved in the crash.

Attach this form to your OREGON TRAFFIC CRASH AND INSURANCE REPORT.

 

CRASH DATE

DAY OF WEEK

TIME OF DAY

AM

COUNTY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

M T W TH F

 

 

 

 

DO NOT WRITE

 

 

 

 

 

 

 

 

 

 

 

 

S SN

 

PM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IN THIS SPACE

 

 

 

 

 

 

 

 

 

 

ROAD ON WHICH CRASH OCCURRED (Name of street, road or route )

MILE POST

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE

INSURANCE COMPANY NAME (NOT AGENCY)

 

 

 

 

 

POLICY NUMBER

 

 

 

 

 

 

#3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE IDENTIFICATION NUMBER

 

 

 

VEHICLE PLATE NUMBER

STATE

YEAR

MAKE & MODEL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OTHER DRIVER’S FULL NAME (LAST, FIRST, MIDDLE)

 

 

 

DRIVER’S LICENSE NUMBER

 

STATE

 

DATE OF BIRTH

GENDER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

M

F

X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER’S ADDRESS

 

 

 

 

 

CITY

 

 

STATE

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE OWNER’S NAME AND ADDRESS

 

 

 

CITY

 

 

STATE

ZIP CODE

 

 

 

 

 

SAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE

INSURANCE COMPANY NAME (NOT AGENCY)

 

 

 

 

 

POLICY NUMBER

 

 

 

 

 

 

#4

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE IDENTIFICATION NUMBER

 

 

 

VEHICLE PLATE NUMBER

STATE

YEAR

MAKE & MODEL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OTHER DRIVER’S FULL NAME (LAST, FIRST, MIDDLE)

 

 

 

DRIVER’S LICENSE NUMBER

 

STATE

 

DATE OF BIRTH

GENDER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

M

F

X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER’S ADDRESS

 

 

 

 

 

CITY

 

 

STATE

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE OWNER’S NAME AND ADDRESS

 

 

 

CITY

 

 

STATE

ZIP CODE

 

 

 

 

 

SAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE

INSURANCE COMPANY NAME (NOT AGENCY)

 

 

 

 

 

POLICY NUMBER

 

 

 

 

 

 

#5

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE IDENTIFICATION NUMBER

 

 

 

VEHICLE PLATE NUMBER

STATE

YEAR

MAKE & MODEL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OTHER DRIVER’S FULL NAME (LAST, FIRST, MIDDLE)

 

 

 

DRIVER’S LICENSE NUMBER

 

STATE

 

DATE OF BIRTH

GENDER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

M

F

X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER’S ADDRESS

 

 

 

 

 

CITY

 

 

STATE

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE OWNER’S NAME AND ADDRESS

 

 

 

CITY

 

 

STATE

ZIP CODE

 

 

 

 

 

SAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE

INSURANCE COMPANY NAME (NOT AGENCY)

 

 

 

 

 

POLICY NUMBER

 

 

 

 

 

 

#6

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE IDENTIFICATION NUMBER

 

 

 

VEHICLE PLATE NUMBER

STATE

YEAR

MAKE & MODEL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OTHER DRIVER’S FULL NAME (LAST, FIRST, MIDDLE)

 

 

 

DRIVER’S LICENSE NUMBER

 

STATE

 

DATE OF BIRTH

GENDER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

M

F

X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER’S ADDRESS

 

 

 

 

 

CITY

 

 

STATE

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE OWNER’S NAME AND ADDRESS

 

 

 

CITY

 

 

STATE

ZIP CODE

 

 

 

 

 

SAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE

INSURANCE COMPANY NAME (NOT AGENCY)

 

 

 

 

 

POLICY NUMBER

 

 

 

 

 

 

#7

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE IDENTIFICATION NUMBER

 

 

 

VEHICLE PLATE NUMBER

STATE

YEAR

MAKE & MODEL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OTHER DRIVER’S FULL NAME (LAST, FIRST, MIDDLE)

 

 

 

DRIVER’S LICENSE NUMBER

 

STATE

 

DATE OF BIRTH

GENDER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

M

F

X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER’S ADDRESS

 

 

 

 

 

CITY

 

 

STATE

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE OWNER’S NAME AND ADDRESS

 

 

 

CITY

 

 

STATE

ZIP CODE

 

 

 

 

 

SAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

735-32B (3-23)

SUPPLEMENTAL REPORT – USE IF MORE THAN TWO VEHICLES

CRASH ANALYSIS & REPORTING UNIT OREGON DEPARTMENT OF TRANSPORTATION POLICY, DATA & ANALYSIS DIVISION

555 13th ST NE STE 2 SALEM OR 97301 TELEPHONE 503-986-3507 FAX 503-986-3592

MOTOR CARRIER CRASH REPORT

(For CMV Drivers Only)

INSTRUCTIONS: IF YOU CHECKED A BOX UNDER THE QUALIFYING VEHICLE COLUMN AND A BOX UNDER THE CRITERIA COLUMN, COMPLETE THE MOTOR CARRIER CRASH REPORT AND SUBMIT TO THE ADDRESS SHOWN ABOVE. IF YOU HAVE ANY QUESTIONS REGARDING FILLING

OUT THE MOTOR CARRIER CRASH REPORT, PLEASE CALL (503) 986-3507. www.oregontruckingonline.com/cf/MCAD/pubMetaEntry/accidentRpt/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

QUALIFYING VEHICLE

 

 

 

 

 

 

 

 

 

CRITERIA

 

 

 

 

 

 

 

 

 

 

 

COMMERCIAL TRUCK (GVWR OVER 10,000 LBS OR ACTUAL WT

 

ANY PERSON SUSTAINING A FATALITY (WITHIN 30 DAYS OF THE

 

AT TIME OF CRASH EVEN IF GVWR IS SET UNDER 10,000 LBS )

 

 

 

CRASH)

 

 

 

 

 

 

 

 

 

 

 

HAZARDOUS MATERIAL PLACARD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANY PERSON SUSTAINING INJURIES REQUIRING TREATMENT AWAY

 

COMMERCIAL BUS (DESIGNED FOR 8 OR MORE PASSENGERS)

 

 

 

FROM THE SCENE

 

 

 

 

 

 

 

 

 

FARM TRUCK INTERSTATE (OVER 10,000 LBS.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANY VEHICLE INCURRING DISABLING DAMAGE REQUIRING

 

FARM TRUCK FOR-HIRE (4 OR MORE AXLES)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REMOVAL FROM THE SCENE BY A TOW TRUCK OR ANOTHER

 

FARM TRUCK TOWING TRIPLE TRAILERS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MOTOR VEHICLE

 

 

 

 

 

 

 

 

 

FARM TRUCK (OVER 80,000 LBS.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MOTOR CARRIER NAME

 

 

 

 

 

 

 

 

US DOT NUMBER

 

 

 

 

AUTHORITY/FILE NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

CITY

 

 

 

 

 

STATE

 

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER NAME (LAST, FIRST, MIDDLE)

 

 

 

 

 

 

 

 

DATE OF BIRTH

 

 

 

LENGTH OF EMPLOYMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MONTHS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YEARS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CDL / DL NUMBER

 

 

STATE

 

 

 

 

 

LICENSE CLASS

 

 

 

 

 

EXPIRATION DATE OF MEDICAL CERTIFICATE

 

 

 

 

 

 

 

 

 

 

 

A

B

C

D

M

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COMPLETE THE FOLLOWING TWO QUESTIONS AS IF DOING A RECAP OF HOURS IN TIME DOCUMENTS AT TIME OF THE CRASH.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AT TIME OF THE CRASH, TOTAL HOURS

 

 

 

 

TOTAL HOURS ON DUTY DURING THE PREVIOUS

 

 

7 CONSECUTIVE DAYS ____________

 

DRIVING SINCE LAST OFF-DUTY PERIOD.

 

 

 

 

(FILL OUT ONE ONLY, BASED ON TIME DOCUMENTS)

 

 

8 CONSECUTIVE DAYS ____________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DOES YOUR DRIVER HAVE A MEDICAL WAIVER

 

 

 

TYPE OF WAIVER (SIGHT, DIABETES, AMPUTEE, ETC.)

 

 

 

 

 

 

 

 

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER INJURY INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YOUR DRIVER KILLED

 

YOUR DRIVER INJURED

 

 

RELIEF DRIVER KILLED

RELIEF DRIVER INJURED

 

TOTAL NUMBER OF PASSENGERS

 

YES

NO

 

YES

NO

 

YES

NO

 

YES

NO

 

_____KILLED

_____ INJURED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OTHER DRIVER INJURY INFORMATION

TOTAL NUMBER OF OTHER DRIVERS

_____KILLED

_____ INJURED

TOTAL NUMBER OF OTHER PASSENGERS

 

TOTAL NUMBER OF PEDESTRIANS

 

TOTAL NUMBER OF BICYCLISTS

_____KILLED

_____ INJURED

 

_____KILLED

_____ INJURED

 

_____KILLED

_____ INJURED

 

 

 

 

 

 

 

 

OTHER MOTOR CARRIER INFORMATION (IF 2 OR MORE MOTOR CARRIERS WERE INVOLVED)

MOTOR CARRIER NAME

VEHICLE LICENSE # AND STATE

DRIVER'S NAME

DRIVER'S LICENSE # AND STATE

MOTOR CARRIER VEHICLE INFORMATION

YEAR

MAKE

UNIT NUMBER

LICENSE PLATE # & STATE - TRUCK/TRACTOR/BUS

TOTAL NO. OF AXLES

 

INCLUDING TRAILERS

 

 

 

TRACTOR TYPE (SELECT APPROPRIATE TYPE)

 

 

 

 

 

 

1

 

 

 

 

5

Standard

 

 

 

9

Heavy Haul

 

Triples (tractor with 3 trailers

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6

Tractor/Semi Trailer

 

 

 

 

Bus/Van (8 or more

 

 

 

 

 

 

 

 

 

 

2

 

Triples (truck with 2 trailers)

 

 

Straight Truck

 

 

10

 

 

 

 

 

 

 

3

 

 

 

 

7

 

 

 

11

passenger capacity)

 

 

 

 

 

 

 

 

Straight truck-full trailer

 

 

 

 

 

Auto/Pickup

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

 

Doubles (any)

 

 

8

Saddlemount

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

735-9229 (3-23)

COMPLETE REVERSE SIDE

 

 

 

 

 

 

 

SUPPLEMENTAL – MOTOR CARRIER CRASH REPORT

TRAILER TYPE (CHECK ONE)

 

VAN

 

FLATBED

 

TANKER

 

 

CONTAINER

 

 

POLE/LOG

 

DUMP

 

 

BELLY-DUMP

 

 

CAR CARRIER

 

LIVESTOCK

 

 

 

 

 

 

 

 

 

 

 

 

 

MOBILE HOME TOTER

 

PASSENGER

 

DROP-BOX

 

GARBAGE

 

 

BULK-HOPPER

 

 

 

MIXER

 

SADDLEMOUNT

 

 

 

 

 

 

 

 

 

 

 

WRECKER

 

FIXED LOAD

 

HEAVY HAUL

 

 

UTILITY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COMMODITY INFORMATION

COMMODITY BEING TRANSPORTED AT TIME OF CRASH

WAS A HAZARDOUS COMMODITY BEING HAULED

YES NO

WAS HAZARDOUS MATERIAL RELEASED FROM THE VEHICLE CARGO(NOT A FUEL RELEASE)

YES NO

HAZARD CLASS

CRASH INFORMATION

LOCATION OF CRASH (NEAREST CITY OR TOWN)

 

HIGHWAY AND MILEPOINT/STREET/COUNTY ROAD

 

DIRECTION OF YOUR VEHICLE (CHECK)

 

 

 

 

 

 

 

 

 

N

S

E

W

 

 

 

 

 

 

 

 

 

 

 

 

DATE OF CRASH

TIME

 

 

AM

DAY OF THE WEEK (CHECK ONE)

 

 

 

 

 

 

 

 

 

 

PM

MON

TUES WED THU

FRI

SAT

SUN

CONDITIONS AT TIME OF CRASH

 

 

 

 

 

 

 

 

 

 

 

 

 

WEATHER (CHECK ONE)

1. CLEAR

2. RAIN

3. SNOW

4. CLOUDY

5. SLEET

6. FOG

7. OTHER

 

 

ROAD SURFACE (CHECK ONE)

1. DRY

2. WET

3. SNOWY

4. ICY

5. OTHER

 

 

 

 

 

 

 

 

LIGHT CONDITION (CHECK ONE)

1. DAY

2. DAWN

3. DUSK

4. ARTIFICIAL LIGHTS

5. DARK

6. OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DESCRIBE WHAT HAPPENED BY CHECKING ALL BOXES THAT APPLY. YOUR VEHICLE IS ALWAYS NO.1. IF OTHER VEHICLES WERE INVOLVED, COMPLETE COLUMNS 2 & 3 TO CORRESPOND TO THE ACTIONS OF THE SAME NUMBERED VEHICLES LISTED ABOVE UNDER "OTHER DRIVER INFORMATION".

VEHICLES 1 2 3

ACTION

SLOWING - STOPPING

STOPPED

REAR-END

BACKING

MAKING RIGHT TURN

MAKING LEFT TURN

MAKING U TURN

PROCEEDING STRAIGHT

INTERSECTION

ENTERING TRAFFIC (FROM SHOULDER, MEDIAN, PARKING STRIP OR PRIVATE DRIVE)

VEHICLES 1 2 3

ACTION

PASSING

CHANGING LANES

SIDESWIPE

HEAD-ON

SKIDDING

VEHICLE OUT OF CONTROL

ROLL-AWAY

CONTROLLED RR CROSSING

UNCONTROLLED RR CROSSING

RAN OFF ROAD

VEHICLES 1 2 3

ACTION

JACKKNIFE

OVERTURN

SEPARATION OF UNITS

FIRE

EXPLOSION

CARGO SHIFT

CARGO SPILL (HAZARDOUS)

CARGO SPILL (NON-HAZARDOUS)

OTHER (DEER, GUARDRAIL, ETC)

DID YOUR VEHICLE STRIKE A PARKED VEHICLE

YES NO

WAS YOUR PARKED VEHICLE STRUCK BY ANOTHER VEHICLE

YES NO

DESCRIPTION OF CRASH (BY CARRIER OR DRIVER)

NAME AND TITLE OF PERSON SIGNING REPORT

TELEPHONE NUMBER(S)

 

 

SIGNATURE I CERTIFY THE INFORMATION PROVIDED IS TRUE AND ACCURATE

DATE

X

 

Document Specs

Fact Name Description
Reporting Requirements Drivers must file a Crash & Insurance Report if damage to any vehicle or property is over $2500, there is any injury regardless of severity, death occurs, or if a vehicle is towed from the scene due to damages.
Filing Deadline Oregon law mandates these reports be submitted within 72 hours of the crash event. Late submissions should be filed as soon as possible to avoid potential penalties.
Potential Consequences for Non-Compliance Failing to report a qualifying crash to the DMV can lead to the suspension of driving privileges.
Insurance Verification DMV Headquarters verifies the insurance information provided. Incomplete insurance sections can result in a suspension of driving privileges.
Additional Reporting for Commercial Motor Vehicles Operators of commercial motor vehicles must also file Form 735-9229 within 30 days of a crash involving fatality, injury, or disabling damage requiring a vehicle to be towed, in addition to the standard Oregon Traffic Crash and Insurance Report.
Governing Laws and Penalties Filing the report is governed by ORS 802.220(5). Failure to comply with the report requirements for "Totaled" vehicles as defined in ORS 801.527 is a Class A misdemeanor, punishable by imprisonment and/or a fine.

Instructions on Writing Oregon Dmv Accident Report

Filling out the Oregon DMV Accident Report form is a necessary step after being involved in a traffic crash that meets specific criteria such as damage over $2500, injuries, death, or a vehicle being towed from the scene. It's important to complete and submit this form within 72 hours to avoid potential suspension of your driving privileges. This process not only fulfills legal obligations but also assists in the accurate recording of the incident for insurance and record-keeping purposes. To help guide you through this process, follow these detailed steps:

  1. Before you start, ensure you have a pen with black or dark blue ink ready, as the form must be filled out legibly in one of these colors.
  2. Complete Section 1 with the crash date, day of the week, time of day, and county. If you're unsure of the county, you can contact local law enforcement for assistance.
  3. Identify your vehicle as Vehicle #1 in Section 2 and fill in all required fields, including your insurance company name (not the agent’s), policy number, and your vehicle identification number (VIN).
  4. In Section 3, check all boxes that apply to your situation, such as the extent of damage to your vehicle, any injuries, and other specific circumstances related to the crash.
  5. If there was another vehicle involved, complete Section 4 with the other driver's information to help the DMV more efficiently match all drivers' crash reports.
  6. In Section 5, provide a detailed description of what happened during the crash. Sign and date the form, ensuring accuracy to the best of your knowledge. If you are not the driver or the driver is unable to sign, a family member may sign on their behalf, stating their relationship and the reason the driver couldn’t sign.
  7. For vehicles beyond two involved in the crash, use the attached Supplemental Report (Form 735-32B), following the same format for each additional vehicle.
  8. After completing the form, you can submit it to the Oregon DMV through email at OregonDMVAccidents@odot.oregon.gov, fax at 503-945-5267, or mail to DMV Crash Reporting Unit, 1905 Lana Ave NE, Salem, Oregon, 97314. You may also deliver it in person to a DMV office. Be sure to keep a copy of the report and any proof of submission.

Remember, your thorough and prompt action in submitting the Oregon DMV Accident Report form aids in the proper documentation of the incident and helps ensure that your driving record and insurance claims process can be accurately updated and assessed. Do not hesitate to contact the DMV Crash Reporting Unit for assistance or clarification when filling out or submitting your report.

Understanding Oregon Dmv Accident Report

When must I file an Oregon DMV Accident Report?

You need to file an Oregon DMV Accident Report if you're involved in an accident where: the damage to your vehicle is over $2500, the damage to any one person’s property exceeds $2500, there's an injury (regardless of how minor), a death occurs, or if any vehicle involved in the accident has over $2500 in damages and is towed from the scene. This report must be filed within 72 hours of the accident.

What happens if I don't file the report within 72 hours?

If you're unable to file the report within the 72-hour window, you should submit it as soon as possible. Failing to report the crash to the DMV may result in the suspension of your driving privileges.

If the police file a report, do I still need to file one with the DMV?

Yes, even if the police department files a report, you are still required to file your own Crash and Insurance Report with the DMV.

I'm not an Oregon resident, do I still need to file a report for an accident that occurred in Oregon?

Yes. Whether you are licensed in another state or not a resident of Oregon, you are still obligated to file a report with the Oregon DMV if involved in an accident as described in the report requirements.

Does the Oregon DMV decide who was at fault in the crash?

No, the DMV does not determine fault in a crash. However, the crash will be posted to the driving records of those drivers required to report, unless the vehicle was parked.

What information do I need to include in the insurance section of the report?

You must complete the insurance section with your insurance company's name (not the agent's), your policy number, and your vehicle identification number (VIN). Failing to provide complete insurance and vehicle information could lead to a suspension of your driving privileges.

What if there were more vehicles involved?

If additional vehicles were involved in the crash, you should complete the attached Supplemental Report (Form 735-32B), or on a blank piece of paper, include all the information requested in Section 4, the "Other Driver" section.

How can I submit my Oregon DMV Accident Report?

You can submit your Oregon DMV Accident Report via email to OregonDMVAccidents@odot.oregon.gov, fax to 503-945-5267, mail it to DMV Crash Reporting Unit 1905 Lana Ave NE, Salem, Oregon 97314, or deliver it to a DMV office. Be sure to keep a copy of the report and documentation showing when you submitted your report to the Oregon DMV.

Common mistakes

When filling out the Oregon DMV Accident Report form, a common mistake is not reporting within the 72-hour window. Oregon law mandates that these reports be filed within this timeframe if the crash resulted in vehicle damage over $2500, property damage over $2500, injury, or death. Late submissions could lead to a suspension of driving privileges.

Another error involves incomplete information regarding insurance and vehicle details in Section 2. Providing the insurance company name, policy number, and Vehicle Identification Number (VIN) is crucial. Failing to do so may lead to the DMV issuing a Notice of Suspension because of the incomplete information.

Often, individuals mistakenly believe that if the police file a report, they do not need to file their own with the DMV. Regardless of police involvement, drivers involved in a crash that meets the reporting criteria must also submit their own Crash and Insurance Report to the DMV.

Incorrectly identifying the date, location, and time of the crash in Section 1 is a frequent issue. This information is critical for processing the report. If there is any uncertainty about the county where the incident occurred, it's advised to reach out to local law enforcement for clarification.

Some individuals fail to complete both sides of the form or to use dark ink as instructed, which can lead to processing delays. Every section of the form, including the description of what happened, must be completed thoroughly for the report to be considered valid and complete.

Forgetting to sign and date the form under Section 5 is another common oversight. Only the driver involved in the crash or a family member, if the driver is incapacitated, may sign. The absence of a proper signature can render the report invalid.

Failing to report a "totaled" vehicle correctly according to the instructions provided is a significant error. If a vehicle is deemed "totaled," one must follow specific steps, such as surrendering the title to the insurer or DMV, depending on the situation. Not adhering to these instructions can lead to legal penalties.

When additional vehicles are involved, neglecting to complete the attached Supplemental Report (Form 735-32B) or to provide all the required information on a separate sheet of paper for Section 4 can also be problematic. It's necessary to include all relevant details about each vehicle to ensure the DMV can efficiently match all drivers' crash reports.

Lastly, a frequent mistake is not retaining a copy of the report and proof of submission. It’s important to keep these documents as evidence that the report was filed timely with the Oregon DMV, especially since the DMV does not provide copies of submitted reports.

Documents used along the form

Filing an Oregon DMV Accident Report form is a crucial step after being involved in a vehicle accident, especially when it results in injury, death, or significant property damage. However, this form is often just one part of a suite of documents that can be needed to comprehensively address the aftermath of a crash. Understanding these additional forms can help ensure that all necessary information and steps are taken to comply with legal requirements, facilitate insurance claims, and support any needed legal actions.

  • Police Report: An official account from law enforcement officers who investigate the scene. This report can provide an objective view of the accident, which is valuable for insurance claims and legal proceedings.
  • Insurance Claim Form: Filed with your insurance company to initiate the process of obtaining coverage for damages and injuries sustained in the accident. These forms detail the policyholder's account of the incident and request compensation according to the policy terms.
  • Medical Records: Documentation of any medical treatment received as a result of the accident. These records are essential for insurance claims and lawsuits to prove the extent of injuries and related expenses.
  • Supplemental Report (Form 735-32B): Used if more than two vehicles are involved in the accident. This form provides the Oregon DMV with details on any additional parties and vehicles involved.
  • Vehicle Repair Records: Invoices and receipts for repairs done on the vehicle(s) involved in the crash. These documents can support insurance claims and demonstrate the financial impact of the accident.
  • Witness Statements: Written accounts from individuals who observed the accident. These can corroborate details of the incident and provide additional perspectives that might support your version of events.
  • Photographic Evidence: Photos can document the scene of the accident, vehicle damage, road conditions, and any injuries sustained. This visual evidence can be powerful in insurance claims and legal cases.

Familiarizing oneself with these documents and ensuring their accurate completion can significantly affect the outcome of insurance claims and any potential legal proceedings. It's always a good idea to consult with a legal professional or your insurance company to ensure you're taking all necessary steps following a vehicle accident. By taking these considerations to heart, individuals can navigate the post-accident process more confidently and effectively.

Similar forms

The Oregon Traffic Crash and Insurance Report shares similarities with various other documents used in different contexts, demonstrating the structured way in which incidents and information must be reported across different fields. Here are nine documents with comparable purposes and structures.

1. Police Incident Report: Similar to the DMV Accident Report, a Police Incident Report is filled out by law enforcement officials to record details of events such as crimes, disturbances, or other situations requiring police attention. Both documents capture essential information like date, time, location, individuals involved, and descriptions of the event for official records and further action.

2. Insurance Claim Form: This document is used by individuals to report an incident to their insurance company for the purpose of initiating a claim. Like the DMV Accident Report, it requires detailed information about the event, including damages, involved parties, and a narrative of the incident, to assess the claim thoroughly.

3. Medical Incident Report: In healthcare settings, when an unexpected event occurs that harms or could potentially harm a patient, staff must complete a Medical Incident Report. Both this and the DMV form are critical for documenting incidents accurately and initiating investigations if necessary.

4. Occupational Safety and Health Administration (OSHA) Report: OSHA requires employers to report work-related injuries, illnesses, and incidents. Like the Oregon DMV form, it collects data on the incident specifics to improve workplace safety and prevent future incidents.

5. Motor Carrier Crash Report: Commercial trucking accidents require a specific report, much like the Supplemental Report mentioned in the DMV document. Both types of reports collect detailed information about the vehicles, drivers, and circumstances surrounding crashes and are essential for regulatory compliance.

6. Vehicle Maintenance Log: Though not an incident report, a Vehicle Maintenance Log tracks a vehicle's history of repairs and maintenance work. It shares the attention to detail seen in the DMV Accident Report, with thorough record-keeping essential for both documents.

7. Property Damage Report: When property damage occurs, especially within communal or rental properties, a Property Damage Report may be filed. This document, like the DMV's, collects details about the damage, responsible parties, and circumstances for resolution and accountability purposes.

8. Federal Aviation Administration (FAA) Incident Report: This report is used to document incidents involving aircraft or airports that may not result in accidents but could affect safety. The structured format for collecting detailed event information is akin to what the Oregon DMV requires for crash reporting.

9. Coast Guard Boating Accident Report: Required for significant boating incidents, this report captures detailed information about the accident, vessels, and individuals involved. The emphasis on timely, accurate information parallels the requirements of the Oregon DMV form, helping authorities in investigations and improving boating safety.

Dos and Don'ts

Filling out the Oregon DMV Accident Report form accurately and promptly is important for all drivers involved in an accident. Here are some guidelines to follow:

  • Do ensure that all information provided on the form is true and accurate to the best of your knowledge.
  • Do print or type all information in black or dark blue ink, pressing firmly to ensure legibility.
  • Do complete both sides of the form, providing comprehensive details about the accident and insurance information.
  • Do file the report within 72 hours of the crash, as required by Oregon law, to avoid potential suspension of driving privileges.
  • Do keep a copy of the report and any documentation showing when you submitted the report to the Oregon DMV.
  • Don't leave any sections incomplete, especially regarding vehicle and insurance information, which could result in a Notice of Suspension.
  • Don't forget to complete and attach a Supplemental Report (Form 735-32B) if more than two vehicles were involved in the crash.
  • Don't neglect to sign and date the form. If the driver is incapacitated or physically unable to sign, a family member may do so on their behalf.
  • Don't underestimate the importance of accurately identifying the date, location, and time of the crash, as this information is critical to the processing of your report.

By adhering to these guidelines, drivers can ensure that their accident report complies with Oregon state requirements, aiding in the accurate and efficient processing of their report.

Misconceptions

When it comes to completing the Oregon DMV Accident Report form, there are many misconceptions that can lead to errors or omissions. Understanding these misconceptions can ensure that those involved in accidents are accurately following Oregon law and avoiding potential complications. Below are eight common misconceptions and clarifications about the form:

  • If the police report the accident, you don't need to file a DMV accident report. This is incorrect. Regardless of a police report being filed, drivers involved in accidents that meet certain criteria (such as damage over $2,500, injury, death, or a towed vehicle) are required to file a DMV accident report within 72 hours.
  • You only need to report if you're an Oregon resident. This is not the case. Even if you are licensed in another state or not a resident of Oregon, you must file an accident report with the Oregon DMV if the accident occurred within Oregon and meets the reporting criteria.
  • The DMV will determine who is at fault for the accident. The Oregon DMV does not determine fault in an accident. Their role is to record the crash on the driving records of those required to report it.
  • You don't have to complete all sections of the form if they don't apply to you. Every section of the form must be completed. Incomplete forms can result in a suspension notice because the form requires comprehensive information about the accident, vehicles, drivers, and insurance.
  • If your vehicle is damaged but drivable, you don't need to report the accident. Regardless of whether the vehicle can be driven after the accident, if the damage to any vehicle or property exceeds $2,500, the accident must be reported.
  • Insurance information is optional on the report. Providing complete insurance information is mandatory. Failure to do so may lead to a suspension of driving privileges as the DMV verifies the insurance information submitted with the report.
  • You must submit the title of a totaled vehicle with the crash report. If your vehicle is considered "totaled," follow the specific instructions related to totaled vehicles, but do not submit the vehicle title with the crash report. Different instructions apply depending on whether an insurer declares the vehicle a total loss, among other factors.
  • Filing the report immediately within the 72-hour window is mandatory. While Oregon law requires the report to be filed within 72 hours, it acknowledges that might not always be possible. The law stipulates to file it within 72 hours or as soon as possible thereafter. Failure to report can lead to suspension of your driving privileges.

Clearing up these misconceptions ensures that individuals involved in an accident in Oregon can file their DMV accident report accurately and in compliance with state laws.

Key takeaways

When you find yourself in the unfortunate situation of being involved in a traffic accident in Oregon, filling out the Oregon DMV Accident Report form is a critical step you'll need to take. Here are five key takeaways to remember about this process:

  • Timeliness is Key: Oregon law mandates that the crash report be filed within 72 hours of the accident. Filing within this timeframe is crucial to avoid potential suspension of driving privileges. If it's not possible to meet this deadline, it's advised to submit the report as soon as you can.
  • Accuracy and Completeness Matter: Make sure to fill out both sides of the form with all the required information. This includes details of the crash, insurance information, and any additional vehicles involved. Incomplete or inaccurate reports can lead to a Notice of Suspension from the DMV.
  • Insurance Information is Critical: Providing accurate insurance details is paramount. The DMV verifies this information, and failure to complete this section properly might result in the suspension of your driving privileges. This emphasizes the importance of double-checking all entered insurance information.
  • Mandatory for All Drivers: Regardless of whether an individual is an Oregon resident, licensed in another state, or the nature of the vehicle's insurance, all drivers involved in an accident fitting the report criteria are required to file. This rule underscores the universal applicability of the reporting requirement to ensure all pertinent accidents are documented.
  • Vital for Record Accuracy and Insurance Purposes: Although the DMV does not determine fault, completing this report is essential for accurate record-keeping on your driving record, especially for incidents involving parked vehicles, which can be exempt from being posted. Moreover, it can be an important document for insurance claims and legal proceedings that may follow the accident.

Understanding these key points can help ease the process of dealing with post-accident procedures and ensure compliance with Oregon's legal requirements. Remember, always keeping a copy of the submitted report and any confirmation of submission can prove invaluable for your records and any necessary follow-up.

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