Crash Information

L O C A T I O N	Date of Accident 4/23/2011	Time of Accident 05:05 PM	County Fayette - 33	Accident occurred within corporate limits of (city)	Law Enforcement Case Number: 2011024507
	Literal Description W051 / CEDAR RD and Iowa 0056 / FILMORE RD				Legal Intervention? No	Private Property? No
					X-Coordinate: 609708.4
					Y-Coordinate 4750683.

U N I T 1	Driver's Name - Last KNAPP			First KENNETH			Middle WILLIAM		Suffix
	City FAYETTE			State IA - Iowa, US				Zip 521420000
	Driver's Age 53					Citation Charge Code 1 321.322		Citation Charge 1 FAILURE TO YIELD FOR STOP SIGN
	Gender Male	State IA - Iowa, US	Class A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more	Endorsements	Restrictions L - Veh w/o Airbrakes	Citation Charge Code 2		Citation Charge 2
	Alcohol Test Given? 1 - None			Drug Test Given? 1 - None		Citation Charge Code 3		Citation Charge 3
						Citation Charge Code 4		Citation Charge 4
	Seating Position 01 - Front: Left Side / Motorcycle Driver	Injury Status 5 - Uninjured	Occupant Protection 2 - Shoulder and lap belt used		Airbag Deployment 5 - Not deployed	Airbag Switch Status 9 - Unknown		Ejection 1 - Not ejected	Ejection Path	Trapped 1 - Not trapped
	Transported to:					Transported by:
	Insurance Co. Name
	Year 2005		Make Ford - FORD		Model F15		Style PK		Approximate Cost to Repair or Replace 5000
	Initial Travel Direction 3 - South	Vehicle Action 01 - Movement essentially straight	Speed Limit 55	Point of Initial Impact 01 - Front	Most Damaged Area 01 - Front	Extent of Damage 4 - Disabling damage	Underride/Override 1 - None
	Total Occupants 1	Traffic Controls 04 - Stop signs	Vehicle Config. 02 - Four-tire light truck (pick-up, panel)	Cargo Body Type 01 - Not applicable	Vehicle Defect 01 - None	Driver Condition 1 - Apparently normal	Vision Obscured 01 - Not obscured	Contributing Circumstances, Driver (up to 2)
	SEQUENCE OF EVENTS			First Event 21 - Vehicle in traffic	Second Event 06 - Evasive action (swerve, panic braking, etc.)	Third Event	Fourth Event	Most Harmful Event (by vehicle) 21 - Vehicle in traffic
	Emergency Vehicle Type 1 - Not applicable					Emergency Status 3 - Not Applicable
	Carrier Name			City		State			Zip
	Number of Axles			Gross Vehicle Weight Rating		Placard #			Hazardous Materials Released?

U N I T 2	Driver's Name - Last HARRE			First DOUGLAS			Middle JUNIOR		Suffix
	City ALLISON			State IA - Iowa, US				Zip 506020000
	Driver's Age 20					Citation Charge Code 1		Citation Charge 1
	Gender Male	State IA - Iowa, US	Class C - Non-commercial vehicle or commercial Veh w/26000 GVWR or less & either 16 Pass Design or Hazmat	Endorsements None	Restrictions None	Citation Charge Code 2		Citation Charge 2
	Alcohol Test Given? 1 - None			Drug Test Given? 1 - None		Citation Charge Code 3		Citation Charge 3
						Citation Charge Code 4		Citation Charge 4
	Seating Position 01 - Front: Left Side / Motorcycle Driver	Injury Status 3 - Non-incapacitating	Occupant Protection 2 - Shoulder and lap belt used		Airbag Deployment 5 - Not deployed	Airbag Switch Status 9 - Unknown		Ejection 1 - Not ejected	Ejection Path	Trapped 1 - Not trapped
	Transported to: PALMER HOSPITAL - WEST UNION					Transported by: NE IA AMBULANCE
	Insurance Co. Name
	Year 2008		Make Pontiac - PONT		Model GRA		Style 4D		Approximate Cost to Repair or Replace 5000
	Initial Travel Direction 2 - East	Vehicle Action 01 - Movement essentially straight	Speed Limit 55	Point of Initial Impact 07 - Left Side	Most Damaged Area 07 - Left Side	Extent of Damage 4 - Disabling damage	Underride/Override 1 - None
	Total Occupants 3	Traffic Controls 01 - No controls present	Vehicle Config. 01 - Passenger car	Cargo Body Type 01 - Not applicable	Vehicle Defect 01 - None	Driver Condition 1 - Apparently normal	Vision Obscured 01 - Not obscured	Contributing Circumstances, Driver (up to 2)
	SEQUENCE OF EVENTS			First Event 21 - Vehicle in traffic	Second Event 01 - Ran off road, right	Third Event	Fourth Event	Most Harmful Event (by vehicle) 21 - Vehicle in traffic
	Emergency Vehicle Type 1 - Not applicable					Emergency Status 3 - Not Applicable
	Carrier Name			City		State			Zip
	Number of Axles			Gross Vehicle Weight Rating		Placard #			Hazardous Materials Released?

P R O P E R T Y D A M A G E	If Property other than vehicles damaged explain	Object Damaged STOP SIGN		Estimate of Damage 100
	Owner's Name - Last STATE OF IOWA	First	Middle	Suffix
	Owner Company Name
	City	State		Zip

ACCIDENT ENVIRONMENT		ROADWAY CHARACTERISTICS Major Contributing Circumstances:	WORKZONE RELATED?	SEQUENCE OF EVENTS
Location of First Harmful Event 1 - On Roadway	Weather Conditions (up to two) 03 - Cloudy	Environment 1 - None apparent	Location	First Harmful Event of Crash (use codes 11-42 only) 21 - Vehicle in traffic
Manner of Crash/Collision 5 - Broadside	Weather Conditions (up to two) 03 - Cloudy	Roadway 01 - None apparent	Type
Light Conditions 1 - Daylight	Surface Conditions 1	Type of Roadway Junction/Feature 01 - No special feature	Workers Present?

P
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R
S
O
N

I
N
J
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R
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D

Name- Last
HARRE

First
STEPHANIE

Middle
RENEE

Suffix

City

State

Zip Code

Age
20

Sex
Female

Unit No.
2

Seating Position
03 - Front: Right Side

Injury Status
3 - Non-incapacitating

Occupant Protection
2 - Shoulder and lap belt used

Airbag Deployment
5 - Not deployed

Airbag Switch Status
9 - Unknown

Ejection
1 - Not ejected

Ejection Path
1 - Not ejected/not applicable

Trapped
1 - Not trapped

Transported to:
PALMER HOSPITAL - WEST UNION

Transported by:
NE IA AMBULANCE

NON-MOTORIST

Type

Location

Action

Condition

Safety Equipment

Contributing Circumstances

Unit No. of Vehicle Striking

P
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R
S
O
N

I
N
J
U
R
E
D

Name- Last
CORNWELL

First
CANDICE

Middle
RENEE

Suffix

City

State

Zip Code

Age
39

Sex
Female

Unit No.
2

Seating Position
08 - Rear: Center

Injury Status
2 - Incapacitating

Occupant Protection
1 - None used

Airbag Deployment
6 - Not applicable

Airbag Switch Status
3 - No ON/OFF switch present