Local Report Number * Crash Severity Hit/Skip 1 - Solved Local Information

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1 Photos Taken OH- OH-P OH-3 County * Other PDO Under State Reportable Dollar Amount City * Village * Township * Private Property Reporting ncy NCIC * Reporting ncy Name * Number of Unit in error Units Animal City, Village, Township * Crash Date * Time of Crash Day of Week Degrees / Minutes / Seconds Latitude Longitude O / // O / // Roadway Division Divided Undivided Location Route Type Distance From Reference Reference Point Used - Intersection - Mile Post 3 - House Number Road Contour - Straight Level - Straight Grade 3 - Curve Level. Divided lane Direction of Travel Location Route Number Miles Feet Yards Manner of Crash Collision/Impact - Not Collision Between Two Motor Vehicles In Transport Traffic Crash Report Local Report Number * Crash Severity Hit/Skip - Solved Local Information N - Northbound S - Southbound Dir From Ref Crash Location 0 3 / - Curve Grade E E - Eastbound W - Westbound Loc Prefix O F Location Road Name Reference Route Type 0 - Not an intersection 0 - Four-way Intersection 03 - T-Intersection 0 - Y-Intersection 05 - Traffic Circle/Roundabout - Rear End 3 - Head-On - Rear-to-Rear C O P 0 0 Columbus PD 0 5 Columbus Lane Road Conditions 0 Number of Thru Lanes Backing 6 - Angle 7 - Sideswipe, Same Direction. O R Decimal Degrees Latitude Road Types or Milepost AV - Avenue CR - Circle AL - Alley CT - Court BL - Boulevard DR - Drive Longitude.. A V HE - Heights HW - Highway LA - Lane Location Road Type Reference Route Number Ref Prefix Reference Name (Road, Milepost, House #) 06 - Five-point, or more 07 - On Ramp 08 - Off Ramp 09 - Crossover 0 - Driveway/Alley Access MP - Milepost PK - Parkway PI - Pike PL - Place RD - Road SQ - Square Route Types IR - Interstate Route (inc. turnpike) US - US Route SR - State Route ST - Street TE - Terrace TL - Trail WA - Way CR - Numbered County Route TR - Numbered Township Route S T Road Summit Type - Railway Grade Crossing - Shared-Use Paths or Trails 0 - Dry 0 - Wet 03 - Snow 0 - Ice 8 - Sideswipe, Opposite Direction Weather Sand, Mud, Dirt, Oil, Gravel 06 - Water (Standing, Moving) 07 - Slush 08 - Debris * - Clear - Cloudy 3 - Fog, Smog, Smoke Intersection - Rain 5 - Sleet,Hail 6 - Snow Location of First Harmful Event - On Roadway 6 - On Shoulder 3 - In Median - On Roadside - Fatal - Injury 3 - PDO Rut, Holes, Bumps, Uneven Pavement * 0 - Other 7 - Sever Crosswinds 8 - Blowing Sand, Soil, Dirt, Snow 9 - Other/Unknown 5 - On Gore 6 - Outside Trafficway - Unsolved 0 5 F R I Reference * Condition Only Road Surface - Concrete - Blacktop, Bituminous Asphalt 3 - Brick/Block Work Zone Workers Present Law Enforcement Present (Officer/Vehicle) Law Enforcement Present (Vehicle Only) - Slag, Gravel, Stone 5 - Dirt 6 - Other Light Conditions Type of Work Zone - Lane Closure - Lane Shift/Crossover 3 - Work on Shoulder or Median - Daylight - Dawn 3 - Dusk - Dark - Lighted Roadway - Intermittent or Moving Work 5 - Other 5 - Dark - Roadway Not Lighted 6 - Dark - Unknown Roadway Lighting 7 - Glare* 8 - Other * Condition Only Location of Crash in Work Zone - Before the First Work Zone Warning Sign - Advance Warning Area 3 - Transition Area School Zone School Bus Yes, School Bus Directly Involved Yes, School Bus Indirectly Involved - Activity Area 5 - Termination Area Narrative Unit was traveling eastbound on E. Lane Ave. at Summit St. when Unit traveled through the T-Intersection and into the front yard of 07 Summit St. Unit then left the scene and traveled southbound on Summit St. before turning eastbound on E. 7th Ave. and being discovered in front of 3 E. 7th Ave. by the Reporting Officer. The Driver of Unit was not at scene. Diagram Witness stated that he observed Unit, while standing in front of 080 Summit St., in the front yard of 07 Summit St. Witness stated that he observed Unit back up before continuing southbound on Summit St. Witness stated that he observed the front license plate of Unit was left at scene. The Reporting Officer located Unit 's front license plate at the initial crash site. The Reporting Officer observed that Unit traveled into the front yard of 07 Summit St. and up some a slight embankment to the front of the address. The Reporting Officer observed that the change in elevation may have caused significant damage to the under carriage of Unit, as oil was spilled all over the front sidewalk of the address leading to the front porch, but that no damage occurred to any part of 07 Summit St. Pro Tow Towing impounded Unit to the Columbus Police Impound Lot as a Hit Skip Vehicle. Report Taken By Police ncy Supplement (Correction or Addition to an Existing Report Sent to ODPS Date Crash Reported Time Crash Reported Dispatch Time Arrival Time Time Cleared Other Investigation Time Total Minutes Officer's Name * Officer's Badge Number Checked By Scherger, Nathan 58 HAWKINS, JOHN P HSY700 OH (Rev 0/) of 5

2 Unit Number Owner Name: Last, First, Middle ( Same As Driver) Owner Phone Number - inc. area code ( Same As Driver) 0 Owner Address: City, State, Zip Unit ( Same As Driver) Local Report Number Damage Scale - None LP State License Plate Number Vehicle Identification Number # Occupants O H HFB7609 J M G G L Vehicle Year Vehicle Make Vehicle Model Vehicle Color Mazda Mazda 6 Proof of Insurance Shown Carrier Name, Insurance Company Policy Number Towed By Gray Pro Tow Towing - Minor 3 - Functional - Disabling Carrier Phone - include area code US DOT HM Placard ID No. HM Class Number Location Prior to Impact Special Function 0 Vehicle Weight GVWR/GCWR - Less Than Or Equal to 0k Lbs. - 0,00 to 6,000 Lbs 3 - More Than 6,000 Lbs. Hazardous Material Released 0 - Intersection - Marked Crosswalk 0 - Intersection - No Crosswalk 03 - Intersection - Other 0 - Midblock - Marked Crosswalk 05 - Travel Lane - Other Location 06 - Bicycle Lane 07 - Shoulder/Roadside 08 - Sidewalk 09 - Median/Crossing Island 0 - Driveway Access - Shared-Use Path or Trail - Non-Trafficway Area 99 - Other/Unknown 0 - None 0 - Taxi 03 - Rental Truck (Over 0k Lbs) 0 - Bus - School (Public or Private) 05 - Bus - Transit 06 - Bus - Charter 07 - Bus - Shuttle 08 - Bus - Other Pre-Crash Actions Straight Ahead 0 - Backing 03 - Changing Lanes 0 - Overtaking/Passing 05 - Making Right Turn 06 - Making Left Turn Type of Use - Personal - Commercial 3 - Government In Emergency Response 09 - Ambulance 0 - Fire - Highway/Maintenance - Military 3 - Police - Public Utility 5 - Other Government 6 - Construction Equip. Cargo Body Type 0 - No Cargo Body Type/Not Applicable Bus/Van (9-5 Seats, Inc Driver) 03 - Bus (6+ Seats, Inc Driver) 0 - Vehicle Towing Another Vehicle 05 - Logging 06 - Intermodal Container Chassis 07 - Cargo Van/Enclosed Box 08 - Grain, Chips, Gravel Unit Type 0 3 or Hit / Skip 07 - Making U-Turn 08 - Entering Traffic Lane 09 - Leaving Traffic Lane 0 - Parked - Slowing or Stopped in Traffic - Driverless Passenger Vehicles (less than 9 passengers) 0 - Sub-Compact 0 - Compact 03 - Mid Size 0 - Full Size 05 - Minivan 06 - Sport Utility Vehicle 07 - Pickup 08 - Van Motorized Bicycle - Snowmobile/ATV - Other Passenger Vehicle 7 - Farm Vehicle 8 - Farm Equipment 9 - Motorhome 0 - Golf Cart - Train - Other (Explain in Narrative) 3 - Negotiating a Curve - Other Action 09 - Pole 0 - Cargo Tank - Flat Bed - Dump 3 - Concrete Mixer - Auto Transporter 5 - Garbage/Refuse 99 - Other/Unknown Most Damaged Area 0 - None Center Front 03 - Right Front Impact Area 0 - Right Side 05 - Right Rear Rear Center 07 - Left Rear Trafficway Description - Two-Way, Not Divided - Two-Way, Not Divided, Continuous Left Turn Lane 3 - Two-Way, Divided, Unprotected(Painted or Grass > Ft.) Median - Two-Way, Divided, Positive Median Barrier 5 - One-Way Trafficway Hit / Skip Unit Med/Heavy Trucks or Combo Units > 0k lbs 3 - Single Unit Truck or Van axle, 6 tires - Single Unit Truck; 3+ axles 5 - Single Unit Truck / Trailer 6 - Truck/Tractor (Bobtail) 7 - Tractor/Semi-Trailer 8 - Tractor/Double 9 - Tractor/Triples 0 - Other Med/Heavy Vehicle Has HM Placard 08 - Left Side 09 - Left Front 0 - Top and Windows - Undercarriage - Load/Trailer 3 - Total(All Areas) - Other 5 - Entering or Crossing Specified Location 6 - Walking, Running, Jogging, Playing, Cycling 7 - Working 8 - Pushing Vehicle 9 - Approaching or Leaving Vehicle 0 - Standing Bus/Van/Limo (9 or More Including Driver) - Bus/Van (9-5 Seats, Inc Driver) - Bus (6+ Seats, Inc Driver) 3 - Animal with Rider - Animal with Buggy, Wagon, Surrey 5 - Bicycle/Pedacyclist 6 - Pedestrian/Skater 7 - Other Action 3 - Other Action - Non-Contact - Non-Collision 3 - Striking - Struck 5 - Striking/Struck Contributing Circumstances None 0 - Failure to Yield 03 - Ran Red Light 0 - Ran Stop Sign 05 - Exceeded Speed Limit 06 - Unsafe Speed 07 - Improper Turn 08 - Left of Center 09 - Followed Too Closely/ACDA 0 - Improper Lane Change /Passing/Off Road Sequence of Events First Harmful Event Most Harmful Event Collision with Person, Vehicle or Object Not Fixed - Pedestrian 5 - Pedalcycle 6 - Railway Vehicle (Train,Engine) 7 - Animal - Farm 8 - Animal - Deer 9 - Animal - Other 0 - Motor Vehicle in Transport - Improper Backing - Improper Start From Parked Position 3 - Stopped or Parked Illegally - Operating Vehicle in Negligent Manner 5 - Swerving to Avoid (Due to External Conditions) 6 - Wrong Side/Wrong Way 7 - Failure to Control 8 - Vision Obstruction 9 - Operating Defective Equipment 0 - Load Shifting/Falling/Spilling - Other Improper Action - Parked Motor Vehicle - Work Zone Maintenance Equipment 3 - Struck by Falling, Shifting Cargo or Anything Set in Motion by a Motor Vehicle - Other Movable Object Unit Speed Posted Speed Traffic Control 0 - No Controls Stop Sign Yield Sign 0 - Traffic Signal Stated 05 - Traffic Flashers Estimated 06 - School Zone HSY830 OHU (Rev 0/) Non-Collision Events 0 - Overturn/Rollover 0 - Fire/Explosion 03 - Immersion 0 - Jackknife 05 - Cargo/Equipment Loss or Shift Collision With Fixed Object 5 - Impact Attenuator/Crash Cushion 6 - Bridge Overhead Structure 7 - Bridge Pier or Abutment 8 - Bridge Parapet 9 - Bridge Rail 30 - Guardrail Face 3 - Guardrail End 3 - Portable Barrier 07 - Railroad Crossbucks 08 - Railroad Flashers 09 - Railroad Gates 0 - Construction Barricade - Person (Flagger, Officer) - Pavement Markings - None 3 - Improper Crossing - Darting 5 - Lying and/or Illegally in Roadway 6 - Failure to Yield Right of Way 7 - Not Visible (Dark Clothing) 8 - Inattentive 9 - Failure to Obey Traffic Signs /Signals/Officer 30 - Wrong Side of the Road 3 - Other Action 06 - Equipment Failure (Blown Tire, Brake Failure, etc) 07 - Separation of Units 08 - Ran Off Road Right 09 - Ran Off Road Left 3 - Crosswalk Lines - Walk/Don t Walk 5 - Other 6 - Not Reported 33 - Median Cable Barrier 3 - Median Guardrail Barrier 35 - Median Concrete Barrier 36 - Median Other Barrier 37 - Traffic Sign Post 38 - Overhead Sign Post 39 - Light/Luminaries Support 0 - Utility Pole Unit Direction From Vehicle Defects 0 - Cross Median - Cross Center Line Opposite Direction of Travel - Downhill Runaway 3 - Other Non-Collision - Other Post, Pole or Support - Culvert 3 - Curb - Ditch 5 - Embankment 6 - Fence 7 - Mailbox To 3 - North - South 3 - East - West 0 - Turn Signals 0 - Head Lamps 03 - Tail Lamps 0 - Brakes 05 - Steering 06 - Tire Blowout 07 - Worn or Slick tires 08 - Trailer Equipment Defective 09 - Motor Trouble 0 - Disabled From Prior Accident - Other Defects 8 - Tree 9 - Fire Hydrant 50 - Work Zone Maintenance Equipment 5 - Wall, Building, Tunnel 5 - Other Fixed Object 5 - Northeast 6 - Northwest 7 - Southeast 8 - Southwest of 5

3 0 / Non - / Occupant Local Report Number Injuries Injured Taken By EMS ncy Medical Facility Injured Taken To OL State Operator License Number OL Class No Valid OL M/C End. Condition Alcohol/Drug Suspected Safety Equipment Used 9 9 Alcohol Test Status DOT Compliant Seating Position 0 Air Bag Usage Ejection Trapped Alcohol Test Type Ạlcohol Test Value Drug Test Status Drug Test Type Offense Charged ( Local Code) Offense Description Citation Number Hands-Free Device Used Injuries Injured Taken By EMS ncy Medical Facility Injured Taken To Safety Equipment Used DOT Compliant OL State Operator License Number OL Class No Valid OL M/C End. Condition Alcohol/Drug Suspected Alcohol Test Status Alcohol Test Type Ạlcohol Test Value Drug Test Status Drug Test Type Offense Charged ( Local Code) Offense Description Citation Number Hands-Free Device Used Injuries - No Injury / None Reported - Possible 3 - Non-Incapacitating - Incapacitating 5 - Fatal Injured Taken By - Not Transported / Treated at Scene - EMS 3 - Police - Other Safety Equipment Used 0 - None Used - Vehicle Occupant 0 - Shoulder Belt Only Used 03 - Lap Belt Only Used 0 - Shoulder and Lap Belt Used Safety Equipment 05 - Child Restraint System-Forward Facing 06 - Child Restraint System- Rear Facing 07 - Booster Seat 08 - Used 09 - None Used 0 - Used - Protective Pads Used (Elbows,Knees, Etc) - Reflective Clothing 3 - Lighting - Other Seating Position 0 - Front - Left Side ( Driver) 0 - Front - Middle 03 - Front - Right Side 0 - Second - Left Side ( Passenger) 05 - Second - Middle 06 - Second - Right Side 07 - Third - Left Side ( Side Car) 08 - Third - Middle 09 - Third - Right Side 0 - Sleeper Section of Cab (Truck) - Passenger in Other Enclosed Cargo Area (Non-Trailing Unit Such as a Bus, Pick-up with Cap) - Passenger in Unenclosed Cargo Area 3 - Trailing Unit - Riding on Vehicle Exterior (Non-Trailing Unit) Other Air Bag Usage - Not Deployed - Deployed Front 3 - Deployed Side - Deployed Both Front/Side 5 - Not Applicable 9 - Deployment Unknown Ejection - Not Ejected - Totally Ejected 3 - Partially Ejected - Not Applicable Trapped - Not Trapped - Extricated by Mechanical Means 3 - Extricated by Non-Mechanical Means Operator License Class - Class A - Class B 3 - Class C - Regular Class (Ohio is D ) 5 - MC/Moped Only Condition - Apparently Normal - Physical Impairment 3 - Emotional (Depressed, Angry, Disturbed) - Illness 5 - Fell Asleep, Fainted, Fatigued 6 - Under The Influence of Medications, Drugs, Alcohol 7 - Other Alcohol/Drug Suspected - None - Yes - Alcohol Suspected 3 - Yes - HBD Not Impaired - Yes - Drugs Suspected 5 - Yes - Alcohol and Drugs Suspected Alcohol Test Status - None Given - Test Refused 3 - Test Given, Contaminated Sample/Unusable - Test Given, Results Known 5 - Test Given, Results Unknown Alcohol Test Type - None - Blood 3 - Urine - Breath 5 - Other Drug Test Status - None Given - Test Refused 3 - Test Given, Contaminated Sample/Unusable - Test Given, Results Known 5 - Test Given, Results Unknown Drug Test Type - None - Blood 3 - Urine - Other Casa, Charles - No Distraction Reported - Phone 3 - Texting/ ing - Electronic Communication Device 5 - Other Electronic Device (Navigation Device, Radio, DVD) Summit St Columbus, OH 30 (6) Other Inside the Vehicle 7 - External Distraction M Injuries Injured Taken By EMS ncy Medical Facility Injured Taken To Safety Equipment Used DOT Compliant Injuries Injured Taken By EMS ncy Medical Facility Injured Taken To Safety Equipment Used DOT Compliant HSY8306 OHM (Rev 0/) 3 of 5

4 OHIO TRAFFIC CRASH REPORT DIAGRAM / NARRATIVE CONTINUATION OH- LOCAL REPORT NUMBER IN COUNTY OF Franklin REPORTING AGENCY Columbus PD CRASH LOCATION E Lane AV - Columbus DATE OF CRASH M 03 D 3 Y 08 The Reporting Officer submitted the front license plate to the Columbus Police Impound Lot as evidence. No injuries were reported. As the Driver of Unit was not at scene, and the vehicle registers outside the City of Columbus, the Reporting Officer respectfully requests an AIU follow-up investigation. HSY 700 /07 OFFICER'S SIGNATURE BADGE NUMBER 58

5 OHIO TRAFFIC CRASH REPORT DIAGRAM / NARRATIVE CONTINUATION OH- LOCAL REPORT NUMBER IN COUNTY OF Franklin REPORTING AGENCY Columbus PD CRASH LOCATION E Lane AV - Columbus DATE OF CRASH M 03 D 3 Y 08 AIU Follow Up: There was insufficient evidence to identify driver # for criminal traffic charges. R. Moder #905 HSY 700 /07 OFFICER'S SIGNATURE BADGE NUMBER 58