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Driver's Name - Last SMITH |
First THEODORE |
Middle RAY |
Suffix
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City GEORGE |
State IA - Iowa, US |
Zip 51237 |
Driver's Age 51 |
Citation Charge Code 1
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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
|
Restrictions
J - Tem Rest License |
Citation Charge Code 2
|
Citation Charge 2
|
Alcohol Test Given? 2 - Blood |
Drug Test Given? 2 - Blood |
Citation Charge Code 3
|
Citation Charge 3
|
Citation Charge Code 4
|
Citation Charge 4
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Seating Position 01 - Front: Left Side / Motorcycle Driver |
Injury Status 1 - Fatal |
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
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Trapped 1 - Not trapped |
Transported to: JURRENS FUNERAL HOME |
Transported by: JURRENS FUNERAL HOME |
Insurance Co. Name
|
Year 2003 |
Make
|
Model FLSTSI |
Style MC |
Approximate Cost to Repair or Replace 10000 |
Initial Travel Direction 1 - North |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 55 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 5 - Severe, vehicle totaled |
Underride/Override 1 - None |
Total Occupants 01 |
Traffic Controls 01 - No controls present |
Vehicle Config. 14 - Motorcycle |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 99 - Unknown |
Driver Condition 9 - Unknown |
Vision Obscured 99 - Unknown |
Contributing Circumstances, Driver (up to 2)
|
SEQUENCE OF EVENTS |
First Event 05 - Animal or object in roadway |
Second Event 01 - Ran off road, right |
Third Event
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Fourth Event
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Most Harmful Event (by vehicle) 05 - Animal or object in roadway |
Emergency Vehicle Type 1 - Not applicable |
Emergency Status 3 - Not Applicable |
Carrier Name
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City
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State
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Zip
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Number of Axles
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Gross Vehicle Weight Rating
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Placard #
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Hazardous Materials Released?
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