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Driver's Name - Last SEWARD |
First LARRY |
Middle DEAN |
Suffix
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City ATLANTIC |
State IA - Iowa, US |
Zip 500220000 |
Driver's Age 47 |
Citation Charge Code 1 321.20B-A |
Citation Charge 1 VIOLATION - FINANCIAL LIABILITY COVERAGE |
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
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Citation Charge 4
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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 3 - No ON/OFF switch present |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 2 - Freed by non-mechanical means |
Transported to:
|
Transported by:
|
Insurance Co. Name
|
Year 1999 |
Make Ford - FORD |
Model XPL |
Style SW |
Approximate Cost to Repair or Replace 5000 |
Initial Travel Direction 1 - North |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 50 |
Point of Initial Impact 08 - Left Front |
Most Damaged Area 07 - Left Side |
Extent of Damage 5 - Severe, vehicle totaled |
Underride/Override 1 - None |
Total Occupants 1 |
Traffic Controls 01 - No controls present |
Vehicle Config. 04 - Sport utility vehicle |
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 25 - Animal |
Second Event 06 - Evasive action (swerve, panic braking, etc.) |
Third Event
|
Fourth Event 33 - Ditch/embankment |
Most Harmful Event (by vehicle) 06 - Evasive action (swerve, panic braking, etc.) |
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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