U
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I
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1
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Driver's Name - Last STEINBACH |
First CLARENCE |
Middle JUNIOR |
Suffix SR |
City COLLEGE SPRINGS |
State IA - Iowa, US |
Zip 516370000 |
Driver's Age 37 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State IA - Iowa, US |
Class A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more |
Endorsements
|
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 2 - Incapacitating |
Occupant Protection 1 - None used |
Airbag Deployment 6 - Not applicable |
Airbag Switch Status 3 - No ON/OFF switch present |
Ejection 4 - Not applicable (motorcycle, bicycle, etc.) |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to: CLARINDA REGIONAL HOSP |
Transported by: BEDFORD AMBULANCE |
Insurance Co. Name
|
Year 2001 |
Make
|
Model FLHT |
Style MOTO |
Approximate Cost to Repair or Replace 2000 |
Initial Travel Direction 4 - West |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 55 |
Point of Initial Impact 01 - Front |
Most Damaged Area 02 - Right Front |
Extent of Damage 3 - Functional damage |
Underride/Override 1 - None |
Total Occupants 1 |
Traffic Controls 06 - No Passing Zone (marked) |
Vehicle Config. 14 - Motorcycle |
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 05 - Animal or object in roadway |
Second Event 25 - Animal |
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 25 - Animal |
Emergency Vehicle Type 1 - Not applicable |
Emergency Status 3 - Not Applicable |
Carrier Name
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City
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State
|
Zip
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Number of Axles
|
Gross Vehicle Weight Rating
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Placard #
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Hazardous Materials Released?
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