CJ 205 Project Two Motor Vehicle Crash Report Template
To complete this template, replace the bracketed text with the relevant information. Note that a formal motor vehicle crash report will have additional details.
This template is to be completed based on the information provided in the scenario.
1. Date of Crash 07 January 2019
2. Time of Crash
(Military Time)
0230
3. Day of Week Monday
4. Date of Report 07 January 2019
5. Type of Crash
List all that apply from these options:
O1 Fatality
02 Injury
03 Property Damage Only
04 Hit and Run
05 Pedestrian
06 Non-collision
07 Commercial Vehicle
99 Other (Specify)
O1 Fatality
02 Injury
6. Location
Indicate direction (north, south, east,
or west) from bridge—e.g., north
from Center Street Bridge.
Westbound from Beachside City into Main City across the Central Bridge
7. Number of Vehicles Involved 1
8. Number of Injured Persons 2
9. Number of Occupants (Including
Driver) by Vehicle
2 - Black SUV
10. Number of Fatalities 1
11. Striking Object Type 01 Driver
Indicate the striking object type from
these options:
O1 Driver
02 Pedestrian
03 Bicyclist
04 Parked Car
05 Animal
06 N/A
07 Other Fixed Object (Specify)
12. Striking Object Information
Indicate the color, license number,
and vehicle type.
Black, License Plate #YME 007, Sports Utility Vehicle
13. Struck Object Type
List all that apply from these options:
O1 Driver
02 Pedestrian
03 Bicyclist
04 Parked Car
05 Animal
06 N/A
07 Other Fixed Object (Specify)
07 Other fixed object: Barrier wall
14. Witnesses Male witness in a Black BMW who called emergency services
15. Involved Persons 2 occupants in Black SUV
16. Detailed Narrative On January 07, 2019, I responded to an accident scene after a witness in a black BMW called emergency
services at 0230. A black SUV crashed into a wall barrier while traveling westbound from Beachside City
towards Main City. The male and female occupants were found unresponsive with open beer and alcohol bottles
in the vehicle. Fire/rescue arrived at 0235 and transported both victims to Main City Trauma. The male victim
was pronounced dead upon arrival, while the female remains critical. The deceased was identified as the mayor's
son by the hospital and sheriff's department. News media arrived seeking confirmation and further information.
Traffic resumed at 0530, with runners and cyclists directed away from the scene. At 0330, the media followed
up with inquiries at the trauma center, where hospital staff planned to provide a statement alongside the police
department.
