Description of Figure 5. State of Kansas Motor Vehicle Accident Report Form, Part 1

This figure shows an example of a standard accident investigation form used by law enforcement officers in Kansas. This figure is the first part of a two-part form.

At the top of the form, checkboxes are shown for fatal, injury, PDO over $500, PDO under $500, private property, hit and run accident, KDOT property damage, and KDOT construction zone.

The form shows the following fields to be filled in: location and date of the accident, speed limit, photos by, investigating officer and badge number, reviewed by, diagram of collision, description of property damage, date and time of accident, time of accident notification, time of officer arrival, name and address of property owner, specific road location points and codes, driver identification, driver phone numbers, vehicle identification, vehicle owner identification, vehicle owner phone numbers, number of occupants in vehicle, insurance company, special data area, policy number, special conditions (such as stolen vehicle), and EMS unit identification.