Police Guide for Preparing
Motor Vehicle Crashes
Revised 2011 2
This comprehensive manual was created by a dedicated group of professionals to help you understand what the requirements are in filing the NJTR- 1. Each data element is explained in detail and provides you with information supported by law and expert opinion.
N.J.S.A. 39:4-131 states:
―Every law enforcement officer who investigates a vehicle accident* of which report must be made as required in this Title, or who otherwise prepares a written report as a result of an accident* or thereafter by interviewing the participants or witnesses, shall forward a written report of the accident* to the division, on forms furnished by it, within five days after this investigation of the accident*.‖
The investigation and reporting of motor vehicle crashes is a necessary duty of a police officer. Reports are intended to help reduce the number of crashes, deaths and injuries through the collection of data elements and study how they occur. You play a vital role in the collection of this data and it is imperative that you understand each piece of information that you enter.
We gratefully acknowledge the following individuals for making this manual a reality.
NJDOT, Bureau of Safety Programs – STRCC Chairman, William Beans
New Jersey State Police; Committee Chairmen – Sergeant First Class Robert Parlow
NJDOT, Information Technology; NJTR1 Designer – Thomas Kennedy
Voorhees Township Police Department; NJTR-1 Manual Designer-
Lieutenant Mark J. Wilson
New Jersey State Police – Sergeant Scott Wishart
Washington Township Police Department, Gloucester County – Sergeant Steven Branco
Washington Township Police Department, Bergen County – Chief William Cicchetti
Bergenfield Police Department – Chief Thomas Lucas
Colts Neck Police Department – Sergeant Richard Maxwell
New Jersey Division of Highway Traffic Safety – Al Tindall
New Jersey Motor Vehicle Commission – Marcy Klein, Patricia Jones
New Jersey State Police, FARS Unit – Lisa Glodowski, Sandra Jenkins
New Jersey State Office of Information Technology – Joseph Decker, Debbie Johnson
New Jersey Motor Vehicle Commission – Stanley Cierniak
University of Rutgers, Police Training – Kennard Wondrack, Raymond Chintall
Federal Highway Administration – Karen Yunk
NJDOT, Bureau of Safety Programs – Kevin Conover, Lisa Kaye, Penny Jones
* Statutory Language 3
History of Crash Reporting
Historically, most traffic crash reports were intended, and used, primarily as simple ―Who, What, Where, When and maybe Why‖ chronicles. In this age of ever decreasing resources, and ever increasing needs, the ability to provide timely, accurate data to Highway Safety Officials becomes increasingly urgent, because it allows traffic safety officials to ―do more with less‖.
Each traffic Crash Report is a memorialization of a ―reportable‖ crash. The circumstances are rarely ideal as the officer must perform triage in attending to injured persons, minimize the impact and risk to surrounding traffic and then survey and analyze the crash scene.
Pursuant to the requirements of N.J.S.A. 39:4-131, an officer investigating a motor vehicle crash must submit to Motor Vehicle Commission a completed crash report within five (5) days. The reports are submitted by all law enforcement agencies in the State for any ―reportable‖ motor vehicle traffic crash resulting in injury to or death of any person, or damage to property of any one person in excess of $500.00. As a result, approximately 310,000 (2010) crash reports are produced annually.
The Division of Highway Traffic Safety (DHTS) and the New Jersey Department of Transportation are responsible for allocating funds from the National Highway Traffic Safety Administration (NHTSA) and the Federal Highway Administration (FHWA) for the purpose of creating programs aimed at improving the safety of New Jersey roadways. Traffic crash analysis is often the foundation of these and other agencies’ safety initiatives. Accuracy of the crash report is critical for this analysis.
Some of them are:
Division of Highway Traffic Safety
Motor Vehicles Commission
Division of State Police
Department of Transportation
Department of the Treasury
Department of Insurance
Department of Education
Department of Human Services
Office of Emergency Management Services
County and Municipal Traffic Engineers
County and Municipal Traffic Officers 4
Preliminary Instruction Guide
On July 16, 1997, The National Safety Council’s Board of Directors passed a motion to eliminate the word ACCIDENT and replace it with the word CRASH. The reason for the motion was to change people’s way of thinking about crashes. An accident is defined as ―An unexpected or undesired event, chance or fortune‖ while a crash is ―to cause a vehicle or aircraft to have a collision, to be involved in a crash.‖ This reinforces the philosophy that crashes don’t just happen; they have causes and can be prevented.
Although Title 39 has not yet changed to reflect this new trend in terminology the changes have been made in this manual.
The most recent NJTR-l went into effect on January 1, 2006. The report was renumbered through input from officers to assist you in the completion of the form. Some changes throughout the new report should be noted:
The report was changed from 124 blocks to 144 blocks.
• All 144 boxes on the Crash Report must be completed, even if you only enter a dash.
• Be very specific when entering the location of the crash. This information must be completed in order to pinpoint the exact location of the crash for geo-code processing.
• All reportable crash reports, including fatals, must be forwarded to the New Jersey Department of Transportation through the New Jersey Motor Vehicle Commission.
• Use a dash (-) to indicate non-applicable information in all blocks.
• Use double zeros (00) to indicate the required information is unknown in blocks 96 -133.
• 99 ―Other‖ is no longer shown in each category. Write in ―99‖ in the boxes where no choices for ―Other‖ apply and you will explain in the narrative.
• If a box calls for a two digit numeric answer be sure to fill in both digits, i.e. 01,02,03
• List and number vehicles, bicyclists, and pedestrians in order of the sequence of crash events.
• When entering intersecting municipal street names, enter the numeric streets first and then the alpha streets in alphabetical order.
• A pedalcycle, when involved in a crash with a motor vehicle in transport, is considered a vehicle for purposes of crash reporting, except when coding ejection from vehicle (box 85). A pedalcyclist is not coded as being ejected from the cycle if involved in a crash.
A person sitting behind the wheel of a parked vehicle should not have their information listed in the operator boxes (26-34, 56-64) but listed that information in the narrative (box 135)
If a vehicle or a pedestrian caused the crash and DID NOT have any contact with a motor vehicle, explain the pedestrian information box 135 and enter a dash (-) in boxes 26 and/or 56.
Write the pedestrian’s identification in boxes 26 and 56. Do not list the driver’s license number in boxes 32 and 62 for pedestrians.
1. Motor vehicle and traffic laws regarding taking of crash reports
A. Requirements for drivers
1. N.J.S.A.39: 4-130 requires that any driver of a vehicle or street car involved in an accident which results in injury or death of any person or damage to property of any one person in excess of $500 shall by the quickest means of communication notify the local police department or nearest office of the county police or state police of the accident.
2. The driver is further required to forward a written report of such accident within 10 days to Motor Vehicle Services on forms furnished by it.
3. A written report of an accident shall not be required by this section if a law enforcement officer submits a written report to Motor Vehicle Services pursuant to N.J.S.A.39: 4- 131.
B. Requirement for police officers
1. N.J.S.A.39: 4-131 requires the following:
a. That Motor Vehicle Services shall prepare and supply to police departments forms for accident* reports. These forms will contain detailed information about the motor vehicle accident*, including the cause, the conditions then existing, and the persons and vehicles involved.
b. Every law enforcement officer who investigates a vehicle accident* of which report must be made or who otherwise prepares a written report as a result of an accident* shall forward a written report of the accident* to Motor Vehicle Services, on the forms furnished by it, within 5 days after his or her investigation of the accident*
c. The written report required to be forwarded by law enforcement officers and the information contained therein shall not be privileged or held confidential. Every citizen of this state shall have the right, during business hours and under supervision, to inspect and copy such reports and shall also have the right to purchase copies of the reports at the fee established by law.
2. Private property crashes are to be reported in the same manner as crashes occurring on public roadways. This includes crashes in parking lots, on private streets, and on any other location in the State.
C. Completing Accident* Report Form NJTR-1
I. The State of New Jersey Police Accident* Report Form NJTR-l is to be completed by the police officer for all investigations of motor vehicle crashes.
2. Form NJTR-1 A Motor Vehicle Accident* Description is to be completed if more than five people were involved in the crash or if additional space is needed for the description.
3. Form NJTR-l B Motor Vehicle Accident* Diagram, or other diagrams, shall be used in all crash cases involving serious injury or a fatality in lieu of block 134 on form NJTR-l. When using an NJTR-1B or other diagram write: SEE ATTACHED DIAGRAM‖ in block 135.
D. NJTR-1A Motor Vehicle Accident* Description
1. Use this form if more room is needed for the Accident* Description Box 135 and/or if there were more than five passengers in the vehicle(s).
E. Additional Report Pages
1. In many instances, the police officer conducting a crash investigation will find that it is necessary to submit more than one NJTR-1 form, to correctly report the investigation.
2. The need for an additional NJTR-1 report page would occur when the crash involved three or more cars, three or more pedestrians or pedalcyclists, or five or more vehicle occupants. This is necessary because an NJTR- 1 has space for only two vehicles and five occupants. Pedestrians and pedalcyclists are identified in the ―Driver‖ parts of the NJTR-1 by listing name and address but not by including their driver’s license.
3. When an additional form page is needed, the minimum entries required for the additional report are boxes 1 through 7, as outlined in the sections with the bold black lines.
a. For example, if an additional report page is submitted because there were more than two vehicles, pedestrians, or pedalcyclists in the crash, the additional report pages need only reflect items 1 through 7 and all other items relating to the additional vehicles, pedestrians, or pedalcyclists covered in boxes 106-133.
A. Change Reports
1) Whenever it is necessary to make a change in information set out on a report which has already been submitted to Department of Transportation, a new report must be submitted showing the changes, with the change box checked at the top of the report form. One example would be a hit-and-run crash in which a report is submitted before the offender is identified. An additional report would be required to show the offender’s identity and other pertinent new information developed and not previously reported. Another instance where a ―Change Report‖ is required is when an injured party from a motor vehicle crash dies from their injuries after the initial crash report is submitted. Note that the NJSP & NJMVC are notified via the NLETS teletype and the NJDOT is to be notified via fax as per NJTR1 protocol information sheet.
2) The bold black lines (blocks 1-7) are always the minimum number of mandatory fields for additional NJTR-1s in the change report along with the names of Driver 1 and Driver 2 on the original report should be carefully printed in boxes 26 and 56, ―Driver’s Name‖, of the Change Report.
3) When submitting a change report only submit the information that needs to be changed or added. Do not fill in all of the blocks if there is no change in the original report.
B. Fatal Crashes
1. All fatal motor vehicle crashes shall be reported to the New Jersey State Police via CJIS2000 notification within 24 hours of occurrence.
2. In addition, a photocopy of the initial investigation report shall be submitted, in a special envelope, to the MVC Fatal Accident Review Board within 72 hours (N.J. Statute 39:5-30). This should NOT be one of the two copies marked as ―State Copy‖.
3. Upon completion of the investigation, a photocopy of the completed report shall be mailed to:
Division of State Police
Fatal Accident Investigation Unit
PO Box 7068
West Trenton, New Jersey 08628-7068
II. Recommended Procedures for the Handling of Motor Vehicle Crashes Not Investigated at the Scene.
1. The Department of Transportation has submitted the following recommended procedure for a late report of a motor vehicle crash that is not investigated at the scene.
a. Police personnel should make an entry in their watch log indicating the date and time the reporting individual reported the motor vehicle crash to the police department.
b. The department should then provide the reporting individual with an SR1 form (Motor Vehicle Accident Report)
c. The reporting individual shall complete the form for reportable crashes. It is suggested that the reporting individual provide a copy to the police department for its files but follow your departmental procedures in this matter.
d. The reporting individual shall mail a copy of the report to the agency indicated on the SR1 form.
e. Police personnel should emphasize to the reporting individual that they should indicate in box 20 on the report that the police did not investigate the crash.
f. If a department chooses to use a NJTR-1 report as a SR-1, ―SR-1‖ should be written on the top of the report in bold letters.
To help you understand what an insurance company considers an ―At-fault‖ crash, we have provided you with an excerpt from the New Jersey Department of Insurance, dated 8/18/97.
Department of Insurance
11:3-34.3 Definition of “At Fault Accident*”
―At-fault accident‖ is any accident involving a driver insured under the policy which resulted in a payment by the insurer of at least $500.00, and for which the driver is at least proportionately responsible based on the number of vehicles involved.
A driver is [considered] proportionately responsible if 50 percent responsible for an accident* involving two drivers; if 33 1/3 percent responsible for an accident* involving three drivers, etc.
An at-fault accident* SHALL NOT INCLUDE the following:
1) Involvement in an accident* in which the motor vehicle owned or operated by the insured or other driver insured under the policy was lawfully parked.
2) Involvement in an accident* in which the motor vehicle was struck by a hit and run driver, if such accident* was reported to the proper authorities within 24 hours.
3) Involvement in an accident* in connection with which neither the named insured nor any other driver insured under the policy was convicted of a moving traffic violation and the owner or operator of another vehicle involved in such accident* was so convicted.
4) For physical damage losses other than collision.
5) For an accident* in which the motor vehicle was struck in the rear by another vehicle and a driver insured under the policy has not been convicted of a moving violation in connection with the accident*.
6) For an accident* occurring as a result of operation of any motor vehicle in response to an emergency if the operator at the time of the accident* was responding to the call to duty as a paid or volunteer member of any police or fire department, first aid squad, or any law enforcement agency.
* Statutory Language 9
At the top left corner of the report, there is a space: PAGE _______ of _______, make sure that this area is filled in. It will tell the reader how many pages there are for the crash report. Page numbers should be numbered consecutively in the upper left-hand corner of each additional page.
REPORTABLE/NON-REPORTABLE, CHANGE REPORT
At the top of the report, there are three small boxes (Reportable, Non-Reportable or Change). Make sure that ONE of these boxes is checked. This indication will advise the processing agency as to where specific data elements should be sent.
Reportable Crash: an accident that results in injury or death of any person or damage to property of any one person in excess of $500. (NJSA 39:4-130)
Check this box at the top of the report if the crash involves a fatality. This box needs to be checked even though it will be reported elsewhere in the report. If the fatality occurs after the initial investigation report, you must submit a change report. (refer to NJSA 39:5-30d fatal protocol)
BOX 1- CASE NUMBER
Enter the DEPARTMENT CASE NUMBER where the crash occurred. Make sure that this number is present on ALL additional pages and any changes that you forward later.
Mutual Aid: If you are investigating a crash in another jurisdiction as part of mutual aid, then use a case number from the jurisdiction where the crash occurred. Municipalities who contract police services to other municipalities will regulate who is to be the custodian of records as part of that agreement. Indicate the investigating officer’s agency in Box 135.
DO NOT WRITE ANY OTHER INFORMATION IN THIS BOX.
BOX 2- POLICE DEPARTMENT OF
Enter the name of the Police Department that generated the case number in box 1. Enter one of the CODES listed below for the Police Agency:
01- Municipal Police 02 - State Police 03 - County Police 04 - Port Authority Police 99 - Other Police
Mutual Aid: If you are investigating a crash in another jurisdiction as part of mutual aid, then use a case number from the jurisdiction where the crash occurred. Indicate the investigating officer’s agency in Box 135.
Enter the Station/Precinct if applicable for your department; otherwise enter a dash (-). 10
BOX 4- DATE OF CRASH
Enter the date that the crash occurred. Fill in all boxes i.e.: 10-02-64
BOX 5- DAY OF WEEK
Circle the appropriate day of the week that the crash occurred. Make sure it corresponds with the date of crash in Box 4.
Enter the time of the crash. If the time is unknown, enter the time that the crash was reported to your agency. Make sure to use military time (e.g., 0730 hrs or 2200 hrs).
BOX 7-MUNICIPALITY CODE
Enter the 4-digit NCIC Municipal Code where the crash occurred.
BOX 8- TOTAL KILLED
Enter the number of persons killed as a result of this crash. Use a two digit number i.e.: 01,02,03. Verify the ―Fatal‖ box is checked at the top of the report. If no one was killed as a result of this crash, enter dashes (--).
If there is an entry other than dashes in this box, make sure that Box 86 (victim’s physical condition) is coded as a 01 (killed) and the name/address/date and time of death is recorded in the area next to Box 95. Note: Notify the State Police within 24 hours of the fatal as per NJSA 39:5-30d.
BOX 9- TOTAL INJURED
Enter the number of persons injured as a result of this crash. Use a two-digit number, i.e.: 01,02,03. If no one was injured as a result of this crash, enter dashes (--). If there is an entry other than dashes in this box, make sure there are entries in Boxes 86, 89, 90 & 91. There should never be 01 in Box 86 (Victim’s Physical Condition) for just an injury crash.
If a person is injured they are not listed as killed in Box 8. 11
BOXES 10 THROUGH 22- CRASH LOCATION
The location where the crash occurred is generally deemed to be the location of the first harmful event. If a vehicle leaves the roadway in one jurisdiction and strikes another vehicle or object in another jurisdiction it is generally assumed that the investigating jurisdiction will be the one where the vehicle first left the roadway.
It is IMPORTANT to understand that boxes 10 through 22 MUST be filled out accurately and completely.
This new form was redesigned to take advantage of new technologies in crash data collections as well as to support existing manual methods. (GIS) geographic information system is used by the Processing Agency to pinpoint the locations of accidents and provide vital information to various agencies, in the interest of traffic safety and crash prevention.
This area of the report has been one of the most INCOMPLETE parts of the crash report and it becomes difficult, if not impossible to provide accurate location data. You must remember that this data is available to your agency, through the N.J.D.O.T., but is only as accurate as you make it.
Please remember to enter as much detailed information in these boxes to provide the necessary data for the Processing Agency to properly code the locations of all crash reports. If there are two municipal streets, list them in numeric order first, then the alpha name in alphabetical order, eg: 1st Street and Alpine Way, regardless of which one is the main roadway.
Note: the box for the street address has been omitted from this report. All crash locations that occurred on a street or highway will use the nearest intersecting road method of plotting locations. Parking lot crashes can be listed by a street address on line 10 because it is not located on a roadway (see examples). 12
BOX 10 CRASH OCCURRED ON
Enter the Road Name or the name of the state, county, municipal or US government authority roadway or parking lot where the crash occurred. If the crash occurred on a state, interstate, toll or county highway, enter the route number and approximate milepost of the crash in boxes 12 and 13. If you enter a Route number in box 12, you must also enter the milepost number in box 13.
List the highest road authority first in Box 10. If there are two roadways of the same hierarchy, list them in numeric order first, then the roadway names in alphabetical order, e.g.: 1st street and Alpine Way, regardless of which one is the main roadway.
Be as specific as possible for geo-coding purposes. You may use the street addresses along with the name of the business or the words ―Parking Lot‖ on this line for parking lot crashes. Phrases such as ―in front of‖ or ―near‖ should not be used here.
The direction on line 10 is for divided roadways and one-way streets only. The direction of the road in block 10 should be recorded as the nominal direction as posted on road signs or identified on maps, i.e.: straight-line diagram for that street/road/highway where the crash occurred.
Even though a north-south road may actually run east-west for a segment, the direction should not change from the nominal direction for reporting purposes.
Note: Ramps and jug handles are plotted for this report with a different method then previously used. Please refer to BOXES 19-20 ―RAMP IDENTIFICATION‖ for entering these locations on this report.
BOX 11 SPEED LIMIT
Enter the speed limit for the road in Box 10. Remember to put the statutory (NJSA 39:4-98) or posted speed limit and not the advisory speed limit. Advisory speeds are the speed limit signs with a yellow background and black letters and are used as a warning for a potential driving hazard ahead.
BOXES 12 & 13- ROUTE NUMBER AND MILEPOST
If the crash occurred on a State, Interstate, Toll authority, or county route, you shall enter the route number and the route suffix, where applicable. State and interstate roadways must have milepost numbers.
Enter the approximate milepost in box 13. Note that the box requires three digits to the left and two digits to the right. Make sure that you place the digits in the correct boxes.
Example: A crash occurred on the Spur of county Route 518 at milepost 1.1. Boxes 12 and 13 will look like this:
12 Route No. Suffix
Suffix is not to be used to indicate north (N) or south (S).
Straight-line diagrams may be utilized to obtain the milepost numbers.
ROUTE SUFFIX CHOICES
A = Alternate
B = Business
C = Freeway
M-Mercer Alignment (I-95 only)
P =Pennsylvania Extension (NJ Turnpike Only)
S = Spur (County Routes Only)
T- Truck (Rt. 1 & 9 Only)
U-Upper (State Route 139 Only)
L = Lower (State Route 139 Only)
W=Western Alignment (NJ Turnpike, Rt. 9, Rt. 173)
BOXES 14, 15, 16, 17- DISTANCE FROM NEAREST CROSS ROAD
Enter the NAME of, DISTANCE to, and DIRECTION to the nearest intersecting or non-intersecting cross road from the crash location. If the Crash occurred at an intersection, (39:1-1) intersection means the area embraced within the prolongation of the lateral curb lines or, if none, the lateral boundary lines of two or more highways which join one another at an angle, whether or not one such highway crosses another) indicate by placing an X in the ―AT INTERSECTION WITH‖ Box 15 and place the cross road name in Box 17. For crashes that do not occur at intersections the distance measurements in Box 14 shall be measured from the center of the intersection to the point of impact for the crash.
Indicate the units of measurement to the nearest intersection in item 14.
Note: The NJTR- 1 does not contain space for a second intersecting street for locating between intersection crashes. The accuracy of identifying the name of, distance to and direction to the nearest cross road name is essential. Most engineering agencies use distance increments of 1/100 of a mile when determining locations for crashes.
e.g. Crash between two vehicles occurred on Route 22, 500 feet west of Rock Road. Boxes10 thru 18 will look like this:
10 CRASH 11 Speed limit
CCURRED 0N Route 22 N 25 0 0 2 2 - 0 5 2 . 1 0
ROAD NAME Dir
12 ROUTE NO SUFFIX 13 MILEPOST
AT INTERSECTION WITH
18 Speed Limit
0500 FEET N E OF : Rock Road___ 25_____
14 17 Cross Road Name
BOX 18 SPEED LIMIT
Enter the speed limit for the road in Box 17. Put the statutory (NJSA 39:4-98) or posted speed limit and not the advisory speed limit in Box 18. Advisory speeds are the speed limit signs with a yellow background and black letters and are used as a warning for a potential driving hazard ahead. 14
BOXES 19-20 RAMP IDENTIFICATION
A ramp is defined as ―An auxiliary roadway used for entering or leaving through-traffic lanes‖. A ―Jug Handle‖ is also considered a ramp. If the crash occurred on a ramp from one roadway (state, interstate, toll authority, county, or local) to another, the crash is considered occurring on the ramp and will be entered as such:
#10 Road Name/Route #
#19 Exits will be checked ―to‖, Entrances will be checked ―from‖.
#14 Distance to or from the secondary roadway
#15 Check feet or miles (never check “at intersection with” for a ramp)
#20 Exit, route, or secondary road name
#20 Enter NB-Northbound SB-Southbound EB-Eastbound WB-Westbound
After having already filled in the name and route number for the primary roadway in Box 10, place an ―X‖ in either the ―To‖ or ―From‖ box, then write the name and/or route number that the vehicle was traveling to or from in Box 20. Then check whether the vehicle was traveling northbound, southbound, eastbound or westbound. If any ramp or surface street has a street name, then use the street name also.
Ramp entries are made by first determining the appropriate road hierarchy involved in the interchange or intersection. Road hierarchy involves determining which road is listed first in Box 10. The road hierarchy is, in descending order:
U.S Government Property
State Park or Institution
County Authority, Park or Institution
Municipal Authority, Park or Institution
Determine which road is the primary
A ramp is an extension of the main roadway. It is important to determine which roadway is the main roadway and which is the secondary roadway. The main roadway will always be listed in Box 10. The secondary roadway will always be listed in Box 20. Box 19 will be used to describe if the crash occurred on a ramp to or from the secondary roadway. Box 14 will be used to locate the crash on the ramp. A distance will be listed to or from the secondary roadway listed in Box 20.
Box 10. Enter the name or route number of the primary roadway, including direction of travel
Box 11. Enter Speed Limit of the primary roadway listed in Box 10
Box 12. Enter the route number of the Roadway listed in Box 10 and the suffix if applicable.
Box 20. Enter the secondary roadway and the direction to which the ramp connects.
Box 19. If the collision occurred on a ramp leading to the roadway listed in Box 20, check the ―To‖ box
If the collision occurred on a ramp leading from the roadway listed in Box 20, check the ―From‖ box
Box 14. Enter the distance of the collision relative to or from the roadway listed in Box 20
Generally speaking the lower numbered highway of highways on the same hierarchy will be the primary highway in regards to completing this report.
If the crash did not occur on a ramp, place a dash (-) in Box 20. 15
"The following is an example for coding a crash that occurred on a ramp leading from I-295 North to SH 73 South approximately 200 feet from SH 73"
CRASH 11 Speed limit
CCURRED 0N Route 295 N 55 0 2 9 5 - 0 3 6 . 8 6
10 ROAD NAME Dir
12 ROUTE NO SUFFIX 13 MILEPOST
AT INTERSECTION WITH
18 Speed Limit
200 FEET N E OF : __ ______
14 17 Cross Road Name
15 16 19 x TO NB EB
Ramp FROM Rt. 73 x SB WB
20 (Route No.)
BOXES 21 & 22- LATITUDE AND LONGITUDE
If you are equipped with Global Positioning System (GPS) equipment that can provide latitude and longitude coordinates of a crash location, enter the latitude and longitude coordinates of the crash location in the appropriate boxes.
When reading the coordinates directly from a vehicle based or hand held GPS receiver, take care that the receiver is as close to the initial point of impact of the crash as possible before recording the location coordinates.
If you are not equipped with a GPS receiver, put dashes (--) in boxes 21 and 22.
NOTE: This form is designed for the GPS readouts in decimal degrees, not hours, minutes and seconds.
BOX 23 & 53 VEHICLE NUMBER
Enter a sequential number to each motor vehicle starting with number 1. List pedalcyclists and pedestrians after all motor vehicles. Motor vehicles are listed first, pedestrians second, bicyclists last. Enter a ―P‖ for the pedestrian. Enter ―B‖ for the pedalcyclists. Enter multiple pedestrians/pedalcyclists, as P1, P2, B1, B2, etc.,
on additional pages using one case number.
Pedestrians/pedalcyclists will be identified throughout the report in the corresponding position that they are assigned in these boxes. e.g., a pedestrian/pedalcyclist listed in the second position (box 53) would be further described or recognized in the boxes designated for vehicle 2 as depicted on the report overlay.
BOX 24 & 54 POLICY NUMBER
Enter the motor vehicle’s Insurance Policy number as it appears on the State of New Jersey Insurance Identification Card. If a New Jersey registered vehicle has no insurance, insert ―uninsured‖.
For out-of-state registered vehicles, insert the policy number, as it appears on their Insurance Identification Card. If no policy number is available, enter an asterisk (*) in Box 24 or Box 54 and explain in Box 135. 16
BOX 25 & 55 INSURANCE COMPANY CODE
Enter the Motor Vehicle’s Insurance Code, as it appears on the State of New Jersey Insurance Identification Card. If the code is missing, place an asterisk (*) in Box 25 or Box 55 and explain in Box 135.
This information is necessary to send an inquiry to the Insurance Company and verify coverage.
The links for New Jersey Insurance codes:
3-digit MVC code- www.state.nj.us/mvc/numeric.pdf
For out-of-state registered vehicles, put an asterisk (*) in the box and insert the name of the insurance company in Box 135.
The insurance company name may be written in Box 135, if required by departmental SOP.
PARKED - PED - PEDALCYCLIST - RESPONDING TO EMERGENCY - HIT & RUN
―X‖ the appropriate box AND circle the words, if applicable. This information is necessary to assure that the owner of a parked vehicle, a pedestrian or the victim of a hit and run does not have this crash charged to their record and insurance surcharges assessed.
Responding to an Emergency - This box is checked only for motor vehicles responding to an emergency and includes volunteer Fire/Ambulance personnel in their own vehicles (see note page 8).
Hit & Run - This box is checked for the ACTOR - not the VICTIM. Place a diagonal line in the driver/owner boxes with the words ―Hit & Run‖ to indicate that there is no information available.
BOXES 26 & 56 - DRIVER’S NAME
Enter the first name, middle initial and last name of the driver exactly as it appears on the license. Enter the same information for a pedalcyclist or pedestrian. If there is no middle initial, insert a dash (-). For example: If someone has an apostrophe in their name (O’Conner) the ―O‖ is part of the last name NOT the middle initial.
BOXES 27 & 57- NUMBER AND STREET
Enter the street address, exactly as it appears on the driver’s license. If change of address information is provided verbally, include it in Box 135. Enter the same information for a pedalcyclist or pedestrian. If there is an RD number and/or a P.O. Box number on the license, write it exactly as it appears, then include in brackets the name and number of the street where the driver actually resides or include this information in Box 135.
BOXES 28 & 58- CITY. STATE AND ZIP CODE
Enter the city, state and zip code exactly as indicated on the driver’s license. Enter the same information for a pedalcyclist or pedestrian. 17
BOXES 29 & 59-SEX
Enter the sex as indicated on the driver’s license: M = MALE F = FEMALE
BOXES 30 & 60- EYES
NJ EYE CODE CHART
1 = Black Enter the N.J. eye color code for the Driver.
2 = Brown
3 = Gray 4 = Blue Use the N.J. Eye Code Chart shown to the left. 5 = Hazel
6 = Green
7,8,9 = Other
BOXES 31 & 61-STATE
Enter the standard abbreviation for the state as indicated on the driver’s license.
BOXES 32 & 62- DRIVER’S LICENSE NUMBER
Enter the license number, exactly as it appears on the driver’s license. If the driver has no license, write ―none‖. If the driver has a permit, enter the permit number followed by ―permit‖.
BOXES 33 & 63- DATE OF BIRTH
Enter the date of birth of the person listed in Boxes 26 and 56 using the month, day, and year format (mm/dd/yy). Utilize preceding zeros, where applicable, e.g., 01,02, etc.
BOXES 34 & 64-EXPIRES
Enter the expiration date as indicated on the driver’s license using month and year format (mm/yy). Utilize proceeding zeros where applicable, e.g., 01, 02, etc.
BOXES 35 & 65-OWNER’S NAME
Enter the Vehicle Owner’s first name, middle initial and last name, exactly as it appears on the registration. If there is no middle initial, insert a dash (-).
If the driver is also the owner and the license and registration documents contain identical information, place an ―X‖ in the ―Same as Driver‖ box.
For a crash involving a combination vehicle (tractor-trailer/passenger car with trailer, etc.,
use boxes 35 and/or 65 through 45 and/or 75 to record information for the motorized unit.
Record trailer information in Box 135 (Narrative). 18
BOXES 36 & 66 NUMBER AND STREET
Enter the street address, exactly as it appears on the registration. If change of address information is provided include it in Box 135. If there is an RD number and/or a P.O. Box number on the registration, write it exactly as it appears then include, in brackets, the name and number of the street where the owner actually resides in Box 135. If you have checked the ―Same as Driver‖ box, then write the word SAME.
BOXES 37 & 67 – CITY, STATE AND ZIP CODE
Enter the city, state and Zip Code, exactly as it appears on the registration. If you have checked the ―Same as Driver‖ box, then write the word SAME.
BOXES 38 & 68 - MAKE
Enter the vehicle’s manufacture’s name, e.g., Ford, Chevy, BMW, etc.
BOXES 39 & 69 - MODEL
Enter the vehicle’s model as it appears on the registration.
Do not identify by the model’s style, e.g. 4-door, sedan, etc.
BOXES 40 & 70 – COLOR
Enter the vehicle’s color using the 2 digit code for the vehicle’s color as indicated on the NJTR-1 overlay.
BOXES 41 & 71-YEAR
Enter the vehicle’s year, as it appears on the registration.
BOXES 42 & 72 - PLATE NUMBER
Enter the vehicle’s license plate number, as it appears on the registration.
BOXES 43 & 73 – STATE
Enter the accepted abbreviation of the state, as it appears on the registration.
BOXES 44 & 74 - VIN NUMBER
Enter the entire Vehicle Identification Number (VIN), as it appears on the registration. Since 1968, most domestic passenger cars were assembled with a ―Vin Plate‖ that is visible through the windshield on the left side of the dash. The VIN may also be found on the nomenclature plate located on the driver’s door. This number must match the registration and insurance card. A traditional VIN is 17 characters. 19
BOXES 45 & 75-EXPIRES
Enter the expiration in month and year format (mm/yy) as it appears on the vehicle registration.
BOXES 46 & 76 - VEHICLE REMOVED TO
Check the corresponding block if the vehicle was driven, towed or left at the scene. Enter the name of the tow company if the vehicle was towed. Check the appropriate box to the right to indicate if the vehicle was impounded, disabled, or both. The authority to remove a disabled vehicle from the roadway, whether involved in a crash or not, is NJSA 39:4-136. If vehicle was driven away, enter a dash (-).
BOXES 47 & 77 - AUTHORITY TO REMOVE VEHICLE
Check the box for the authority that approved the vehicle’s removal.
BOXES 48 & 78 – ALCOHOL/DRUG TEST
This box indicates if alcohol or drug tests were conducted. Complete this section for all involved drivers and for pedestrians as applicable.
Test Given: Place an ―X‖ in the NO, YES or REFUSED box to show if a test was given. If you place an ―X‖ in the YES box, you must also place an ―X‖ in one of the Breath, Blood or Urine box and enter the results in the Results box. If the specimen was sent to a lab place an ―X‖ in the ―Pending‖ box.
Do not hold this crash report to await lab results. Once the results are received from the lab, submit a change report that identifies the test results.
BOXES 49 & 79 - HAZARDOUS MATERIAL
If Hazardous Materials cargos are present at the crash, indicate if the material remained on board or spilled by placing an ―X‖ in the ON BOARD or SPILL boxes. DO NOT check these boxes if only engine fluids are spilled.
If a placard is displayed on the vehicle signifying cargo is hazardous material, then information on that placard shall be used to fill in boxes 49 and/or 79. Identify the Hazardous Material by entering the 4-digit placard number from the placard displayed on the vehicle. The ―Diamond‖ box is used to place the one (1) digit number that is displayed at the bottom of the placard. If more than one placard is displayed enter additional placard information in Box 135.
Write out the name of the material along the placard number line if a number is not available. 20
BOXES 50 & 80 CARRIER NUMBER
Enter the USDOT Carrier number of the COMMERCIAL VEHICLE. All Commercial Vehicle Carriers that are involved in Interstate Transport must have a USDOT number. NOTE: the carrier and owner can be different entities. Be sure to check the accuracy of these entities for this entry. If additional owners and carriers are involved indicate the information in Box 135.
WARNING: The driver of the vehicle and the USDOT Number on the driver or passenger side of the vehicle may not be that of the carrier responsible for the vehicle/load.
It is important to correctly identify the right motor carrier USDOT number. You must enter the number of the MOTOR CARRIER THAT IS RESPONSIBLE FOR THE CARGO/VEHICLE.
The Motor Carrier is the person(s) who has care, custody, and control of the load/vehicle, and/or is directing the movement of the vehicle whether loaded or empty. Identifying the Motor Carrier will entail a driver interview and/or possibly the examination of multiple sources of information, which may include: markings on the vehicle (Name and USDOT #, vehicle registration, shipping papers, trip or term lease documents, and the driver’s log book (record of duty status). The driver interview is often the most important source of information. (To properly identify the responsible Motor Carrier, use the Motor Carrier Identification flowchart on page 65.)
Accurate information on this report will identify and remove unsafe commercial vehicles on New Jersey roadways and may be used in determining State and Local Federal transportation safety funding levels.
BOXES 51 & 81 – COMMERCIAL VEHICLE WEIGHT
Check the block if the commercial vehicle’s GVWR (gross vehicle weight rating)/GCWR (gross combined weight rating) is:
Weight is 10,000 lbs. (less than or equal to 10,000 lbs.)
Weight is 10,001 to 26,000 lbs. (equal to or greater than 10,001 lbs but less than 26,001 lbs.)
Weight is 26,001 lbs. (equal to or greater than 26,001 lbs.)
Commercial Vehicles: Though a vehicle displays commercial plates it does not necessarily mean that the vehicle will be considered a commercial vehicle for crash report purposes. For crash report purposes, a CMV (commercial motor vehicle) is defined as any one of the following:
A) A vehicle that has a GVWR/GCWR of 10,001 pounds or more
B) A vehicle that carries hazardous material and is required to display or displays a placard
C) A vehicle that carries 9 or more people, including the driver
D) Any other vehicle that requires a Commercial Driver’s License (CDL), e.g. Livery/Limo
BOXES 52 & 82 – CARRIER NAME
Enter the commercial vehicle Carrier Name for each vehicle that corresponds with the USDOT Carrier number in Boxes 50 and 80. Enter Carrier Address in Box 135, followed by the Driver License Class Code of the vehicle operator. (See definition of commercial vehicle as defined above.) 21
BOXES 83 THRU 95 (Persons Involved Data)
This section of the crash report records important information about all persons involved in the crash. You will note that this section is labeled A thru E down the left side, beginning in Box 83. These letters A thru E are sometimes mistaken as the entry for Box 83, THEY ARE NOT. Entries must begin in Box 83. If there is an entry other than dashes in box 8 & 9, make sure that there are entries in boxes 86, 89, 90 & 91.
You will note that there is room to enter only 5 involved persons (one per line). If more than five persons are involved, use supplementary report form NJTR-1 A for additional involved persons. If there are more than 5 additional persons you may extend the lines and enter the additional persons. A copy of the NJTR-lA can be found in this manual.
For large numbers of persons involved in a crash, as in multi-passenger vehicles, you may also use a multi occupant bus form available on the DOT Crash Records website: http://www.state.nj.us/transportation/refdata/accident/policeres.shtm
BOX 83-WHICH VEHICLE OCCUPIED
All passengers must be listed, even non-injured.
If a person was in vehicle 1, write 1 in row A under column 83.
Each additional person will be listed in Rows B-E under column 83.
For additional persons in the same \vehicle write 1in rows B-C under column 83. if there are no people in vehicle #1 start listing data about vehicle #2
For a third or fourth or fifth vehicle, use the number 3, 4, 5 in the column that identifies the corresponding person in that car.
A person in a wheelchair, including electronic mobility assist devices as defined in NJSA 39:1-1, is considered a pedestrian.
For multiple pedestrians or pedalcyclists involved in a crash they shall be entered as P1, P2, B1, B2, etc. in Box 83.
WHICH VEHICLE OCCUPIED
BOX 84- POSITION IN/ON VEHICLE
Use the diagram to show the position of each person inside or hanging onto the vehicle. A person sitting on someone’s lap has the same numbered position as that person.
If there are 4 people sitting in front seat, the 4th person takes the #2 position along with the regular #2 person.
If 4th person is in the rear, they take the #5 position along with the regular #5 person.
Passengers in a bus are #10. Additional passengers should be listed in the Bus Seating Charts, as well as in boxes 83 thru 95.
A passenger on a motorcycle is #4, except if the motorcycle has a sidecar and then the passenger would be # 3.
For Pedestrians and Bicyclist always use a dash (-)
POSITION IN/ON VEHICLE
02 - through 10 – Passengers
11 - Riding/Hanging on outside
11 11 11 11 1 2 3 4 5 6 7 8 9 10
PAGE ____OF_____ 23
136 CRASH DESCRIPTION
(REFER TO VEHICLE BY NUMBER)
A L 83 84 85 86 89 88 89 90 91 92 93 94 95
Note: you may extend the lines on this form in order to accommodate additional persons involved.
STATE OF NEW JERSEY
MOTOR VEHICLE DESCRIPTION
NJTR-1A (R 7/05)
OFFICER’S SIGNATURE______________________ BADGE NUMBER______________ 24
BOX 85- EJECTION FROM VEHICLE
This box is used to indicate if a DRIVER or PASSENGER was ejected from a vehicle. This does not apply to a pedestrian or pedalcyclist.
Partial Ejection - A portion of the person’s torso or head protruding out of the vehicle. It does not mean just arms sticking out of a window.
Trapped - If some type of mechanical force is used to free a person from the vehicle, such as a pry-bar or the Jaws of Life.
EJECTION FROM VEHICLE
01 Not Ejected
02 Partial Ejection
BOX 86- VICTIM’S PHYSICAL CONDITION
If an entry is made here, the crash is considered REPORTABLE. ―No Injury‖ receives a dash in this box. Entries must correspond with numbers in box 8 ―Total Killed‖ & box 9 ―Total Injured‖.
Killed - Victim is deceased. (Must check ―Fatal‖ box at the top of the report).
Incapacitated - Victim has a non-fatal injury. Cannot walk, drive or normally continue the activities that they could perform before the motor vehicle crash.
Moderate Injury - An evident injury, other than fatal and incapacitating. Injury is visible, such as a lump on head, abrasion, bleeding or lacerations.
Complaint of Pain - A reported or claims of injury that is not fatal, incapacitating or moderate. Injury is not visible to the investigating officer
VICTIM’S PHYSICAL CONDITION
03 Moderate Injury
04 Complaint of Pain
Enter the age of each involved person where Box 87 intersects with it corresponding row. Use preceding zeros for numbers 1 through 9, i.e.: 01, 02, 03.
If victims are under 1 year old write in the number of months followed by an ―M‖ for month, i.e. 02M, 11M. Write 1m for everything under one month of age.
Enter the sex of each involved person where Box 88 intersects with its corresponding row.
M=Male F=Female 25
BOX 89- LOCATION OF MOST SEVERE PHYSICAL INJURY
LOCATION OF MOST SEVERE INJURY
07 Shoulder/Upper Arm
08 Elbow/Lower Arm/Hand
10 Hip/Upper Leg
11 Knee/Lower Leg/Foot
12 Entire Body
Indicate the location of the most severe injury that the person sustained as a result of the crash where Box 89 intersects with its corresponding row. The investigating officer need only ascertain the injuries at the scene of the crash, not from a doctor’s diagnosis or hospital records. Example: If the driver had a severe head injury, a broken arm and contusions, you would list the most severe, which is the Head Injury 01.
NOTE: If there is a dash in Box 86, enter a dash (-) in boxes 89, 90 and 91.
BOX 90- TYPE OF MOST SEVERE PHYSICAL INJURY
Indicate the type of the most severe injury that the person sustained as a result of the crash. The investigating officer need only ascertain the injuries at the scene of the crash, not from a doctor’s diagnosis or hospital records.
01-Amputation - Severed parts
02-Concussion - Dazed condition as a result of a blow to the head
03-Internal - No visible injury but signs of anxiety, internal pain and thirst
04-Bleeding - Obvious discharge of blood
05-Contusion/Bruise/Abrasion - Discoloration of skin, or top layer of skin is scraped
06-Burn - Reddening, blistering or charring of skin over a portion of the body
07-Fracture/ Dislocation- Swelling or evidence of displaced bones
08-Complaint of Pain - No visible injury noted, but victim complains of pain
NOTE: If there is a dash in Box 86, enter a dash (-) in boxes 89, 90 and 91.
TYPE OF MOST SEVERE PHYSICAL INJURY
01 - Amputation
02 - Concussion
03 - Internal
04 - Bleeding
05 - Contusion/Bruise/Abrasion
06 - Burn
07 - Fracture/Dislocation
08 - Complaint of Pain _______ 26
BOX 91 REFUSED MEDICAL TREATMENT
Enter 01-Yes, if the individual sustained or claimed an injury but refused immediate medical treatment.
Enter 02-No, if the individual was treated and/or transported to a medical facility.
NOTE: If there is a dash in Box 86, enter a dash (-) in boxes 89, 90 and 91.
BOX 92 & 93 SAFETY EQUIPMENT AVAILABLE AND USED
01 - None Used
02 - Lap Belt only 03 – Harness only
04 - Lap Belt & Harness
05 - Child Restraint
06 – Helmet
07 - Reserved
08 – Airbag
09 - Airbag & Seat Belts
10- Safety Vests (Ped Only)
Box 92 identifies safety equipment AVAILABLE. Most late model cars will be coded in Box 92 AVAILABLE (i.e., ―09‖airbags and seat belts). Identify the safety equipment available where Box 92 intersects with its corresponding row.
Box 93 indicates safety equipment USED.
Indicate the safety equipment used where Box 93 intersects with its corresponding row.
If an airbag Does Not Deploy, it is not considered USED in Box 94
Complete Boxes 92 and 93 for every person involved in the crash, whether injured or not.
If a helmet is not DOT approved, explain in Box 135
Use dash (-) for pedestrians in these boxes as 01 is an invalid entry except where 10 is applicable.
BOX 94- Air Bag Deployment
Enter the corresponding number for the type of airbag deployed for the occupant.
BOX 95- HOSPITAL CODE
You use this box to enter the HOSPITAL CODE NUMBER of the hospital that the victim was taken to for treatment. The hospital codes are listed at the following website: http://nj.gov/health/ems/documents/hospital_infomation.pdf 27
SAMPLE ENTRIES FOR COLUMNS 83 THROUGH 95
Crash involving 2 vehicles and 5 people:
Line A shows the Driver of Vehicle #1(1), his position as the driver (1), that he is Dead (1), trapped in the vehicle (4), 29 years old (29), male (M), Chest Injury (05), Internal Injuries (3), Safety equipment available was airbag & seat belts (09), Safety equipment used was none (01), (hospital code-Overlook Hospital 7055).
Line B shows the Passenger of Vehicle #1 (1), his position in the front of the vehicle passenger side (3), moderate injury (3), not ejected (01), 9 years old (09), male (M), Head injury (01), Bleeding (4), Safety equipment available was airbag & seat belts (09), Safety equipment used was none (O1), Ambulance Run Number (hospital code-Overlook Hospital 7055).
Line C shows the Driver of Vehicle #2 (2), her position as the driver (1), that she has no injuries (-), not ejected (1), 62 years old (62) and female (F), no injuries (--), no injuries (-), Safety equipment available was airbag (08), Safety equipment used was none because airbag did not deploy (01), Ambulance Run Number is not applicable (-).
Line D shows the Passenger of Vehicle #2 (2), her position in the front of the vehicle passenger side (3), complaint of pain (4), not ejected (1), 42 years old (42), female (F), complain of neck pain (04), complaint of pain (8), safety equipment available was harness (03), safety equipment used was harness (03), (hospital code-Overlook Hospital 7055).
Line E shows the 2nd passenger of vehicle #2 (2), his position behind the driver in the back seat (4), no injuries (-), not ejected (1), 7 years old (7), male (M), no injuries (--), no injuries (-), safety equipment available was lap belt (02), Safety equipment used was lap belt (02). 83
Bill Beans 156 Truck Turn Lane, Cherry Hill, NJ