KANSAS MOTOR VEHICLE ACCIDENT REPORT CODING MANUAL

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Accident Diagram 850A continued SPECIAL EVENT SPECIAL DATA Local Case No. Page of Blizzard Conditions Example 8 2 5 04 ROADWAY ROAD CHARACTER SPECIAL JURISDICTION NUMBER OF LANES ON AT ON AT A basic diagram is required for all state reportable 00 Normal Jurisdiction (Not Special) accidents showing movements, direction, and positions 01 Straight & Level 01 One 01 National Park Service of all traffic units in relationship to the trafficway. 02 Straight on grade/slope Identify (label) the street(s) and traffic unit(s) along 02 Two 02 Military with the area of impact (AOI) where possible. Refer 03 Straight on hillcrest to vehicles and pedestrians by unique numbers 03 Three 03 Indian Reservation assigned in this report. 04 Curved & level 04 Four to Six 04 College / University Campus 05 Curved on grade/slope 05 Seven or more 88 Other: 99 Unknown 06 Curved on hillcrest 88 Other: 99 Unknown 05 Other Federal property 88 Other: 99 Unknown Indicate North Direction Draw scene as observed or recreate per statements and evidence available
Occupants & Vehicles KDOT Form 850B Rev. 1-2009 DRIVER & PASSENGER INFORMATION (record pedestrians on supplemental form 854) Investigating Officer / Badge No. Local Case No. Page of Frank Smith 144 Example 8 3 5 TU# VIOLATIONS CHARGED CITATION# TU# VIOLATIONS CHARGED More violations in narrative CITATION# D1 35 E 04 E 05 OR 02 OR 03 Unit # Seat Type TU ST TU 01 DRIVER Last Name DRIVER First Name Cleaver OFFICER'S OPINION OF APPARENT CONTRIBUTING CIRCUMSTANCES - ENTER AS MANY AS APPLY TO THIS <strong>ACCIDENT</strong> (FACTOR TYPE, TU#, CC CODE) Middle Name Date of Birth MN Charles DOB DRIVER ADDRESS (Number, Street, Suffix, etc.) City State Zip New address? 1275 Sunset AVE 01 Ward 06/17/1927 Palo Alto CA 93811 MN New address? Personal Phone Number Work Phone Number Personal (321) 555-3315 Work Personal Gender Age M 83 SE Used Eject/Trap S N Inj Severity Eject Path D Transpt Unit Extrication? ST DOB Work 01 01 TRAFFIC UNIT# (01, 03, N3, X3, etc) DL State Driver's License Number DL Class Driving for Employer? CA 1778326419 DP - Illegal drugs ingested METHOD OF DETERMINATION (mark all that apply) ALCOHOL DRUGS 00 No evidence of impairment 01 Evidential Test (Breath,Blood,etc) 02 Preliminary Breath Test PBT 03 Behavioral Tests: HGN, walk-and-turn, one leg stand, etc. 04 Passive Alcohol Sensor (detects alcohol from driver's mouth) 05 Observed (Odor, staggering, slurred speech, etc) 06 Other (e.g. saliva test) A L C O H O L C MC - Medication contributed IMPAIRMENT TEST (mark all that apply) NG - No Test given TR - Test Refused (Alcohol/Drug) PT - Prelim Positive Test (PBT) TG - Evidentiary Test given RP - Results pending Evidentiary Breath Eye Fluid 0. 0. Blood (BAC) 0. Drug screen result Other 0. CDL? TRAFFIC UNIT# (02, 04, N2, X4, etc) DL State Driver's License Number DL Class Driving for Employer? DR LICENSE RESTRICT COMPLY COMMERCIAL ENDORSEMENTS DR LICENSE RESTRICT COMPLY COMMERCIAL ENDORSEMENTS COMPLY 1 2 3 4 COMPLY 00 Not licensed Restrictions? Y 00 Not licensed Restrictions? 1 2 3 4 01 Valid License Driver's Lic Complied? Z - None 01 Valid License Driver's Lic Complied? Z - None 02 Suspended Restrictions Y N T - Double/Triple Trailer 02 Suspended Restrictions Y N T - Double/Triple Trailer 03 Revoked 1 B Y P - Passenger Vehicle 03 Revoked 1 P - Passenger Vehicle 04 Expired N - Tank Vehicle 04 Expired N - Tank Vehicle 2 05 Cancld or Denied G Y 2 H - Placarded Haz. Material 05 Cancld or Denied H - Placarded Haz. Material 06 Disqualified 3 X - Combination Tank/HazMat 06 Disqualified 3 X - Combination Tank/HazMat 07 Restricted S - School Bus 07 Restricted S - School Bus 4 4 99 Unknown U - Unknown 99 Unknown U - Unknown SUBSTANCE USE SUBSTANCE USE AP - Alcohol ingested AC - Alcohol contributed (mark all that apply) DC - Illegal drugs contributed MP - Medication ingested AP - Alcohol ingested AC - Alcohol contributed (mark all that apply) DC - Illegal drugs contributed MP - Medication ingested DP - Illegal drugs ingested METHOD OF DETERMINATION (mark all that apply) ALCOHOL DRUGS 00 No evidence of impairment 01 Evidential Test (Breath,Blood,etc) 02 Preliminary Breath Test PBT 03 Behavioral Tests: HGN, walk-and-turn, one leg stand, etc. 04 Passive Alcohol Sensor (detects alcohol from driver's mouth) 05 Observed (Odor, staggering, slurred speech, etc) 06 Other (e.g. saliva test) A L C O H O L MC - Medication contributed IMPAIRMENT TEST (mark all that apply) NG - No Test given TR - Test Refused (Alcohol/Drug) PT - Prelim Positive Test (PBT) TG - Evidentiary Test given RP - Results pending Evidentiary Breath Eye Fluid 0. 0. Blood (BAC) 0. Drug screen result Other 0. CDL? Unit # Seat Type TU ST TU 01 PASSENGER Last Name PASSENGER First Name Cleaver Middle Name Date of Birth MN Patsy DOB PASSENGER ADDRESS (Number, Street, Sfx, etc.) City State Zip New address? 1275 Sunset AVE 03 June 05/24/1929 Palo Alto CA 93811 MN New address? Personal Phone Number Work Phone Number Personal (321) 555-3315 Work Personal Gender Age F 81 SE Used Eject/Trap S N Inj Severity Eject Path I Transpt Unit Extrication? ST DOB Work TU MN New address? Personal ST DOB Work TU MN New address? Personal ST DOB Work Transport Unit EMS Time Notified Injured taken by: Transport Unit EMS Time Notified Injured taken by: EMS Arrived EMS Time@Hosp Injured taken to: EMS Arrived EMS Time@Hosp Injured taken to: Transport Units: A, B, C, ..., N
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KANSAS MOTOR VEHICLE ACCIDENT REPOR
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ADDITIONAL PASSENGERS & PEDESTRIANS
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Organization of the Accident Forms:
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ACCIDENT REPORTING QUALIFICATION, S
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BASIC TERMS AND QUALIFICATIONS Many
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GENERAL INFORMATION AND INSTRUCTION
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Special Notes on Working Vehicles A
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ACCIDENT LEVEL CODING 850A INVESTIG
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850A MILEPOST Enter the state milep
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Service or Rest Areas: Milepost: R
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TIME OCCURRED, TIME NOTIFIED, TIME
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property damage on the 850A in thes
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850A ACCIDENT LOCATION The Accident
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The Interchange diagram below indic
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Measuring Interchanges: For ramps,
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850A CODE '21' (1st harm occurs bey
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ACCIDENT CLASSES - CONTINUED 850A N
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850A Basic Sample Diagrams for CWOV
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LIGHT CONDITIONS Mark the option th
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850A BACK SIDE OF THE 850A COLLISIO
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TRAFFIC UNIT INFORMATION 850B SPECI
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DO NOT code legally parked vehicles
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850B DRIVER INFORMATION VIOLATIONS
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850B DRIVER ADDRESS Transcribe the
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850B EXTRICATION: Mark the extricat
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850B NON-COMMERCIAL DL A - For oper
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850B COMMERCIAL ENDORSEMENTS Enter
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850B PASSENGER INFORMATION PASSENGE
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850B CODING EXAMPLES FOR PASSENGERS
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850B REMOVED BY Record who removed
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10,000 lbs, record code ‘11.’ 8
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Present (‘P’) or Damaged (‘D
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852 COMMERCIAL MOTOR VEHICLES Vehic
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852 Important data fields for ident
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852 If this vehicle is leased or re
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Canadian carriers will not have any
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852 HAZMAT/ROADWAY INFORMATION Indi
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854 ADDITIONAL PASSENGERS & PEDESTR
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UNUSUAL ACCIDENT CODING SITUATIONS
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Towing Vehicles Vehicles in the lin
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DEFINITIONS / CLARIFICATIONS ACCIDE
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DEFINITIONS / CLARIFICATIONS HARMFU
Page 85 and 86: DEFINITIONS / CLARIFICATIONS Exampl
Page 87 and 88: DEFINITIONS / CLARIFICATIONS TRUCK
Page 89 and 90: ACCIDENT PHOTOGRAPHS An important p
Page 91 and 92: disappear and must be photographed
Page 93 and 94: 90 COUNTY ABBREVIATIONS The followi
Page 95 and 96: NCIC CODES FOR COMMON AUTOMOBILE MA
Page 97 and 98: A. DRIVER INFORMATION: INSURANCE VE
Page 99 and 100: ACCIDENT CODING EXAMPLES Example No
Page 101 and 102: Accident Diagram 850A continued SPE
Page 103 and 104: Occupants & Vehicles VEHICLE# 01 SP
Page 111 and 112: 02 Kansas Motor Vehicle Accident Re
Page 113 and 114: Occupants & Vehicles KDOT Form 850B
Page 115 and 116: Accident Narrative KDOT Form 851 Re
Page 117 and 118: 100 F N AT I470 SN TOPEKA 3200 Gage
Page 127 and 128: 0.5 M W AT K023 Public Works Lane C
Page 131 and 132: Passengers & Pedestrians KDOT Form
Page 133 and 134: EXAMPLE 7A Driver has Intent to Ent
Page 135: 120.0 I070 FWY 70 11/09/2012 13:20
Page 145 and 146: Investigating Department Reviewed b
Page 155 and 156: Hays Hays KS 67601 02 Kansas Motor
Page 165 and 166: Kansas Motor Vehicle Accident Repor
Page 175 and 176: 175 F N AT 8th 01 Kansas Motor Vehi
Page 181 and 182: 190 F W AT 2nd 01 Kansas Motor Vehi
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Investigating Department Reviewed b
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Occupants & Vehicles KDOT Form 850B
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Accident Narrative KDOT Form 851 Re
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Accident Diagram 850A continued SPE
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Occupants & Vehicles VEHICLE# 01 SP
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Passengers & Pedestrians 854 contin
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Example 20
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ROUNDABOUT CHARACTERISTICS EXAMPLE
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EXAMPLE 22 (3 OF 3) ROUNDABOUT ACCI
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1 EXAMPLE 23 2 of 2 “1” locatio
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Investigating Department (Agency)
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Accident Code Sheet CONTRIBUTING CI
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