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KANSAS MOTOR VEHICLE ACCIDENT REPORT CODING MANUAL

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Occupants & Vehicles<br />

<strong>VEHICLE</strong># 03 SPECIAL DATA<br />

850B Continued<br />

(01, 03, N3, X3, etc)<br />

OWNER Last Name ("Same" if Driver) OWNER First Name Middle Name<br />

Same<br />

OWNER ADDRESS (Number, Street)<br />

New address? Personal Phone<br />

<strong>VEHICLE</strong>#<br />

SPECIAL DATA<br />

Local Case No. Page of<br />

Example 2 6 7<br />

(02, 04, N2, X4, etc)<br />

OWNER Last Name ("Same" if Driver) OWNER First Name Middle Name<br />

OWNER ADDRESS (Number, Street)<br />

New address? Personal Phone<br />

CITY ST ZIP Work Phone<br />

CITY ST ZIP Work Phone<br />

COLOR YEAR MAKE MODEL BODY STYLE ST<br />

GRY 2001 PONT SNF 2D OK<br />

LICENSE PLATE # County Exp YR Removed by: MC CCs<br />

LOR 321 RS 2012 Tucker Tow<br />

<strong>VEHICLE</strong> IDENTIFICATION NUMBER Dir of Travel # Occupants<br />

1G2JB1237X7557054<br />

W 1<br />

Insurance Company<br />

Policy Number<br />

City Insurance 1413187<br />

SPECIAL CONDITIONS FOR 1 2 3 4 5 Odometer<br />

Fire?<br />

TRAFFIC UNITS 7<br />

110000<br />

1 Hit & Run 2 Non-Contact 3 Stolen 7 Towed away<br />

4 Legally Parked 5 Pursued by LE 6 Driverless due to damage<br />

01 <strong>VEHICLE</strong> BODY TYPE LARGE / HEAVY <strong>VEHICLE</strong> (GCVWR over 10,000lbs)<br />

01 Automobile<br />

10 Single heavy truck >10,000 lbs<br />

02 Motorcycle<br />

11 Truck & trailer(s)<br />

Calculated speed<br />

03 Motor scooter or Moped 12 Tractor-trailer(s) at impact<br />

63<br />

04 Van<br />

13 Cross country bus<br />

05 Pickup truck 10,000 lbs<br />

02 Motorcycle<br />

11 Truck & trailer(s)<br />

03 Motor scooter or Moped 12 Tractor-trailer(s)<br />

Calculated speed<br />

at impact<br />

04 Van<br />

13 Cross country bus<br />

05 Pickup truck

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