TABLE OF CONTENTS DEFINITIONS 1

W Y O M I N G S 2 1 4 R E P O R T O N T R A F F I C C R A S H E S

TABLE OF CONTENTS DEFINITIONS 1 QUICK LOOK General Information 2 Economic Loss /County 3 Holiday Crash Statistics 4 Crash Count by County - Map 5 GENERAL CRASH INFORMATION Crash Counts by County & Month 6 Collision Type 21 to 214 7 PEOPLE INVOLVED INFORMATION Drivers Involved in, and by Age & Gender 8 Occupants with Seat Belt Usage by County 9-1 Pedestrian 11 Pedacyclists (Bicyclists) 12 THE ENVIRONMENT Road Surface & Road Condition by Crash Severity 13 Weather Conditions & Lighting Conditions by Crash Severity 14 VEHICLES Vehicle Types by Crash Severity 15 Contributing Circumstances by Crash Severity 16 WYOMING COMMUNITIES City/Town by Crash Severity 17-18 Manner of Collision by Intersection Type 19 ALCOHOL INVOLVED CRASHES Alcohol Involved 21 to 214 2 21 to 214 Alcohol Involved Drivers Age Group by Crash Severity 21-22 Alcohol Involved by County / City 23 Alcohol Involved by Vehicle Type, Estimated Speed, Age & Gender 24 Alcohol Involved by County / City 25 Alcohol Involved by Vehicle Type, Estimated Speed, Age & Gender 26 Alcohol Involved by County / City 27 Alcohol Involved by BAC Results, Crash Severity & Age Group 28-29

DRIVERS AGE 14-2 Young Driver with, and by Gender and Age 3 TRUCKS, SCHOOL BUSES & MOTORCYCLES Trucks 21 to 214 Med. & Heavy Trucks by Crash Severity and Highway System Type 31 School Buses 28 to 214 Number of School Bus and Injured Charts 32 School Bus Crash Severity by County and Collision Type by Crash Severity 33 Motorcycles 28 to 214 Number of Motorcycle and Injured Charts 34 Motorcycle Crash Severity by County and Collision Type by Crash Severity 35

DEFINITIONS REPORTABLE TRAFFIC CRASH A Reportable Traffic Crash is one which results in bodily injury or death of any person or a total property damage of $1 or more. CRASH SEVERITY Crash A traffic crash involving one or more persons who were killed. Crash A traffic crash involving one or more persons who were injured but there were no fatalities. Property Damage Only () A traffic crash involving property damage of $1 or more with no injuries or fatalities. INJURY STATUS Any injury resulting in death within 3 days after the traffic crash. Incapacitating Any injury, other than a fatal injury, which prevents the injured person from walking, driving or normally continuing any activities the person was capable of performing before the injury occurred. Non-Incapacitating Any injury, other than a fatal or incapacitating injury, which is evident to observers at the scene of the traffic crash Possible No evidence of an injury, but complaint of pain. 1

QUICK LOOK 214 Crash Counts TOTAL CRASHES FATAL CRASHES INJURY CRASHES CRASHES 14699 131 2818 1175 18K 16K 14K TOTAL CRASHES / YEAR 214 Involved Counts NUMBER OF VEHICLES NUMBER OF DRIVERS NUMBER OF PERSONS NUMBER OF PEDESTRIANS NUMBER OF PEDACYCLISTS 22966 21316 3891 111 74 214 / Counts INJURY CRASHES 2818 NUMBER INJURED FATAL CRASHES 3944 131 NUMBER KILLED 15 PEDESTRIAN CRASHES 1 PEDESTRIANS INJURED 16 PEDESTRIANS KILLED 5 BICYCLIST CRASHES 72 BICYCLISTS INJURED 69 BICYCLISTS KILLED 5 214 Location Counts URBAN CRASHES RURAL CRASHES 214 Alcohol Statistics 8484 6215 ALCOHOL RELATED CRASHES 883 ALCOHOL FATAL CRASHES 48 ALCOHOL FATALITIES 51 ALCOHOL INJURY CRASHES 327 ALCOHOL INJURIES 456 ALCOHOL CRASHES 58 214 Motorcycle Statistics MOTORCYCLE CRASHES 29 MOTORCYCLE FATALITIES 16 MOTORCYCLE INJURIES 258 12K 1K 8K 6K 4K 2K K 15894 16973 17424 1777 1558 14742 14813 1412 14588 14699 25 26 27 28 29 21 211 212 213 214 214 CRASHES / COUNTY ALBANY 112 BIG HORN 248 CAMPBELL 1223 CARBON CONVERSE 659 517 CROOK 249 FREMONT 868 GOSHEN 211 HOT SPRINGS 87 JOHNSON 352 LARAMIE 263 LINCOLN 269 NATRONA 2351 NIOBRARA 64 PARK PLATTE SHERIDAN 561 421 718 SUBLETTE 242 SWEETWATER 1332 TETON UINTA 545 379 WASHAKIE WESTON 12 118 4 8 12 16 2 24 2

214 WYOMING ECONOMIC LOSS/COUNTY COUNTY POPULATION ECONOMIC LOSS ALBANY 37,422 $1,52,19,732 BIG HORN 11,994 $359,48,82 CAMPBELL 15,748 $1,991,712,42 CARBON 48,176 $1,41,991,41 CONVERSE 14,313 $663,711,432 CROOK 7,184 $368,292,815 FREMONT 4,998 $1,338,265,76 GOSHEN 13,612 $263,663,637 HOT SPRINGS 4,847 $132,138,572 JOHNSON 8,628 $432,262,453 LARAMIE 95,89 $3,381,47,435 LINCOLN 18,364 $399,326,89 NATRONA 8,973 $3,326,537,633 NIOBRARA 2,541 $158,482,2 PARK 29,227 $778,844,466 PLATTE 8,765 $726,138,139 SHERIDAN 29,824 $873,564,167 SUBLETTE 1,41 $295,335,158 SWEETWATER 45,237 $1,94,94,427 TETON 22,268 $87,45,185 UINTA 21,66 $574,242,869 WASHAKIE 8,463 $152,99,391 WESTON 7,158 $178,991,688 TOTAL 582,658 $21,767,979,259 Population Source: U.S. Census Bureau 213 estimates - no 214 estimates available. Figures used to determine Economic Loss came from the US Department of Transportation Memorandun; have been updated from 28 to 212 for the "Treatment of the Economic Value of a Statistical Life in Departmental Analyses." WYDOT has adopted a slightly modified version of the Relative Disutility Factors by Status level (MAIS) found on page 5 of the attachment in this US DOT Memorandum. 3

21-214 HOLIDAY CRASH STATISTICS 214 213 212 211 21 New Years 36 98 13 85 17 18 148 17 131 17 84 168 2 33 133 2 48 84 189 26 163 39 84 112 1 18 93 1 29 Memorial Day 84 12 3 72 39 84 17 2 27 78 2 42 84 91 2 21 68 3 31 84 93 23 7 33 84 1 1 3 69 1 48 Independence Day 84 111 3 32 76 3 42 18 147 3 4 14 3 57 36 48 14 34 16 84 128 47 81 66 84 123 2 34 87 2 5 Labor Day 84 114 1 24 89 1 33 84 115 35 8 48 84 96 2 17 77 2 22 84 13 1 24 78 1 27 84 19 1 29 79 2 41 Thanksgiving 18 164 27 137 4 18 122 19 13 22 18 155 2 28 125 2 38 18 148 3 118 38 18 197 5 29 163 5 42 Christmas 18 253 35 218 46 36 21 5 16 8 18 164 1 21 142 1 26 84 81 16 65 25 84 8 1 1 69 1 13 ities Injuries Hours Hours ities Injuries Hours ities Injuries Hours ities Injuries Hours ities Injuries Hours ities Injuries Time Period 4

214 WYOMING FATAL CRASH MAP by County 5

GENERAL CRASH INFORMATION 214 Crash Counts by County ities Injuries ALBANY 7 7 199 269 896 112 BIG HORN 8 8 41 56 199 248 CAMPBELL 11 16 275 398 937 1223 CARBON 9 1 144 229 56 659 CONVERSE 5 7 87 116 425 517 CROOK 2 2 47 63 2 249 FREMONT 1 12 152 221 76 868 GOSHEN 2 2 29 39 18 211 HOT SPRINGS 2 2 14 21 71 87 JOHNSON 4 4 38 54 31 352 LARAMIE 17 21 484 67 1562 263 LINCOLN 3 3 53 78 213 269 NATRONA 11 13 427 565 1913 2351 NIOBRARA 3 5 15 24 46 64 PARK 3 3 11 144 457 561 PLATTE 6 7 83 122 332 421 SHERIDAN 2 2 121 155 595 718 SUBLETTE 4 4 29 38 29 242 SWEETWATER 13 13 285 385 134 1332 TETON 2 2 73 121 47 545 UINTA 3 3 78 113 298 379 WASHAKIE 2 2 19 26 99 12 WESTON 2 2 24 37 92 118 131 15 2818 3944 1175 14699 Crash Count by Month 1,44 1,377 1,93 943 1,53 1,76 1,15 1,91 1,113 1,131 1,667 1,565 JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER 6

21 TO 214 COLLISION TYPE CRASHES Harmful Event Category 21 211 212 213 214 Non-Collision 219 287 186 19 1928 9965 Moving Vehicle 7642 7795 7167 7795 7892 38291 Animal 2514 2422 2698 2277 2314 12225 Fixed Object 2396 259 2287 2614 2565 12371 Others 2 2 14742 14813 1412 14588 14699 72854 7

PEOPLE INVOLVED INFORMATION 214 TOTAL DRIVERS INVOLVED IN FATAL CRASHES DRIVER'S AGE DRIVER'S GENDER 14-16 17-2 21-24 25-29 3-39 4-49 5-59 6-69 7 + Female 3 4 5 3 12 5 1 4 3 49 Male 3 5 13 15 31 24 24 13 11 139 6 9 18 18 43 29 34 17 14 188 214 TOTAL DRIVERS INVOLVED IN INJURY CRASHES DRIVER'S AGE DRIVER'S GENDER 1-13 14-16 17-2 21-24 25-29 3-39 4-49 5-59 6-69 7 + UK Female 2 61 231 19 168 37 239 19 146 88 1 1623 Male 3 75 324 283 29 489 37 428 27 144 2676 Unknown 1 66 67 5 136 555 473 458 797 69 618 416 232 67 4366 Unknown gender & age are a result of hit and run crashes 214 TOTAL DRIVERS INVOLVED IN CRASHES DRIVER'S AGE DRIVER'S GENDER 1-13 14-16 17-2 21-24 25-29 3-39 4-49 5-59 6-69 7 + UK Female 1 217 766 672 721 147 782 82 52 318 4 585 Male 1 271 148 989 1172 1844 1563 1615 138 612 1 1163 Unknown 749 749 2 488 1814 1661 1893 2891 2345 2417 1558 93 763 16762 Unknown gender & age are a result of hit and run crashes 8

OCCUPANTS WITH SEAT BELT / USAGE BY COUNTY from STATE CRASH DATA Proper Use Misuse 212 Not Used Not Avail 1154 84% % 217 4 % 425 73% 1 2% 16% 147 25% % 82 59% % 52 5 4% 32 3% 1 1% 37% 72 69% % 1146 81% 1 % 27 4 % 53 74% 25 3% 19% 16 22% % 548 77% 1 % 156 3 % 212 75% 9 3% 22% 63 22% % 323 78% % 86 4 1% 134 69% 5 3% 21% 54 28% % 118 76% % 36 2 1% 51 88% 2 3% 23% 5 9% % 656 74% 1 % 223 5 1% 299 63% 12 3% 25% 166 35% % 141 64% % 79 1 % 57 77% 4 5% 36% 13 18% % 63 5% % 5 14 28 49% 1 2% 39% 28 49% 11% % 142 7% % 58 3 1% 91 81% 4 4% 29% 18 16% % 2594 89% 2 % 315 8 % 141 83% 62 5% 11% 146 12% % 168 72% % 59 5 2% 96 62% 6 4% 25% 52 34% % 2592 8% 3 % 644 3 % 1159 84% 43 3% 2% 172 13% % 36 68% % 17 % 25 71% 1 3% 32% 9 26% % 43 74% % 15 4 1% 139 58% 5 2% 26% 96 4% % Proper Use Misuse 213 214 Not Used Not Avail Proper Use Misuse Not Used Not Avail ALBANY 1368 85% 2 % 23 14% 2 % 1254 85% % 15% 1 482 8% 2 3% 1 17% 4 1% 413 79% 26 5% 224 72 14% 14 % BIG HORN 3% 96 59% 2 1% 58 36% 6 4% 142 67% 2 1% 66 31% 2 23 19% % 97 81% % 44 7% 4 6% 14 22% 1 1% CAMPBELL 2% 1295 83% % 259 17% 3 % 15 86% 4 % 14% 575 75% 33 4% 152 2% 2 % 577 74% 246 27 3% 179 23% 1 % CARBON % 588 75% 4 1% 191 24% 1 % 599 81% 1 % 19% 233 74% 11 4% 61 19% 8 3% 217 68% 4 1% 143 91 28% 8 % CONVERSE 3% 427 75% % 14 25% % 449 78% 1 % 21% 182 8% 5 2% 4 18% % 144 68% 4 123 2% 62 29% 2 % CROOK 1% 142 75% 2 1% 44 23% 1 1% 15 8% % 38 2% 64 74% % 21 24% 1 1% 8 51% 1 1% 76 48% % FREMONT % 644 74% % 228 26% 3 % 728 73% 3 % 26% 1 26 63% 16 4% 125 3% 9 2% 31 71% 15 262 3% 16 24% 5 % GOSHEN 1% 157 77% 1 % 45 22% % 17 77% % 5 23% 1 59 77% 5 6% 12 16% 1 1% 83 81% 4 4% 15 15% 1 % HOT SPRINGS 1% 66 75% % 22 25% % 47 59% 1 1% 31 39% 24 8% % 6 2% % 26 74% % 9 26% % JOHNSON % 26 74% 1 % 7 25% % 17 68% 2 1% 77 31% 72 64% 2 2% 37 33% 1 1% 72 64% 2 2% 38 34% 1 % LARAMIE 1% 344 9% 8 % 341 1% 3 % 2961 9% 5 % 1% 1 166 82% 51 4% 171 13% 8 1% 135 77% 56 322 4% 24 18% 12 % LINCOLN 1% 25 81% % 49 19% % 19 8% 3 1% 44 19% 129 83% 7 4% 19 12% 1 1% 13 82% 2 2% 17 14% 3 % NATRONA 2% 311 84% 3 % 56 16% 1 % 379 85% 5 % 15% 3 124 85% 71 5% 148 1% 5 % 1246 79% 64 551 4% 266 17% 4 % NIOBRARA % 53 76% % 14 2% 3 4% 35 58% % 25 42% 25 71% % 7 2% 3 9% 19 61% 1 3% 11 35% % PARK % 429 72% 3 1% 163 27% % 434 74% % 26% 138 54% 9 4% 19 43% % 162 62% 14 156 5% 86 33% 1 % % 9

& Proper Use Misuse 212 Not Used Not Avail 191 8% % 46 1 % 117 86% 8 6% 19% 11 8% % 475 71% 1 % 189 % 198 64% 6 2% 28% 16 34% % 81 6% % 54 % 28 74% 1 3% 4% 9 24% % 1399 81% 5 % 34 7 % 612 8% 15 2% 18% 142 18% % 567 8% % 14 3 % 32 58% 14 3% 2% 24 39% % 313 7% % 128 4 1% 129 65% 5 3% 29% 63 32% % 52 51% % 49 % 27 57% 3 6% 48% 17 36% % 65 58% % 46 1 1% 16 5% % 41% 16 5% % 13374 79% 5748 74% 19122 78% 14 3368 81 % 2% % 242 1,769 3% 23% % 256 5137 81 1% 21% % Proper Use Misuse 213 214 Not Used Not Avail Proper Use Misuse Not Used Not Avail PLATTE 241 82% 1 % 5 17% 2 1% 32 81% % 73 19% 1 12 89% 2 2% 1 9% 1 1% 164 61% 5 2% 99 37% 3 % SHERIDAN 1% 618 75% 2 % 198 24% 2 % 584 72% % 28% 219 74% 8 3% 67 23% 2 1% 212 79% 8 3% 227 45 17% 3 % SUBLETTE 1% 115 74% % 41 26% % 119 75% 1 1% 36 23% 2 33 72% 1 2% 12 26% % 67 83% 3 4% 1 12% 1 1% SWEETWATER 1% 148 83% 3 % 291 16% 4 % 1459 84% 2 % 16% 1 538 71% 36 5% 172 23% 13 2% 494 62% 281 24 3% 27 34% 15 % TETON 2% 43 71% 2 % 164 29% % 538 77% 3 % 23% 186 61% 9 3% 112 36% % 28 57% 17 162 5% 14 38% 1 % UINTA % 312 75% 1 % 14 25% 1 % 31 81% % 7 19% 1 168 8% 6 3% 36 17% % 152 76% 6 3% 39 2% 3 % WASHAKIE 2% 64 45% % 78 55% % 58 45% % 7 55% 36 71% 5 9 18% 1 2% 21 6% 2 6% 11 31% 1 % 1% WESTON 3% 55 64% 1 1% 28 33% 1 1% 64 58% 1 1% 46 41% 1 4% 1 4% 14 56% % 14 44% % 18 56% % % TOTAL 1519 36 3368 33 81% 42% 39% 38% 5864 298 1537 6 76% 4% 2% 1% COMBINED TOTAL 2883 8% 334 495 93 1% 19% % 15351 34 3323 14 82% % 18% % 5863 289 1914 8 72% 4% 23% % 21214 323 5237 94 79% 1% 19% % 1

214 PEDESTRIANS IN ALL CRASHES AGE / INJURY STATUS Incap Non-Incap Possible - 13 2 8 1 2 14-16 6 5 11 17-2 1 4 3 8 21-24 3 6 9 25-29 1 3 5 7 16 3-39 1 2 6 3 12 4-49 2 2 2 6 5-59 2 7 6 4 19 6-69 1 1 4 6 7 + 1 3 4 5 18 44 44 111 GENDER Female 52 Male 59 11

214 BICYCLIST IN ALL CRASHES AGE / INJURY STATUS Incap Non-Incap Possible - 13 4 1 3 17 14-16 7 1 8 17-2 5 4 9 21-24 1 3 4 25-29 3 3 3-39 1 4 2 7 4-49 1 1 2 2 6 5-59 1 2 5 4 12 6-69 1 1 2 1 5 7 + 1 1 2 Unknown 1 1 5 1 41 18 74 Others 1 GENDER Female 14 Male 59 "Others" in Gender refers to a hit and run bicyclist who left the crash scene before being identified 12

ENVIRONMENTAL 214 CRASHES WITH ROAD SURFACE TYPE Road Surface Asphalt 116 2126 738 955 Brick/Stone 1 1 Concrete 9 563 217 2589 Dirt 3 72 15 225 Gravel/Rock 5 12 214 321 Unknown 5 2264 2269 131 2818 1175 Unknown road surface crashes include animal crash forms where element is not included 14699 214 CRASHES ROAD CONDITIONS Road Conditions 1st Condition 2nd Condition 1st Condition 2nd Condition 1st Condition 2nd Condition 1st Condition 2nd Condition Dry 13 2 1927 13 7156 29 9186 44 Wet 6 2 19 27 77 77 93 16 Ice/Frost 11 6 448 88 2339 474 2798 568 Snow 6 6 178 217 1194 1,98 1378 1321 Mud/Dirt/Gravel 1 28 11 49 32 78 43 Slush 2 24 24 11 143 127 167 Oil/Fuel 1 1 2 Sand on Dry Pavement 4 3 3 2 7 5 Sand on Icy Road 1 2 7 11 18 13 26 Water Standing/Running 1 4 5 8 12 13 17 Other 2 11 4 13 4 Unknown 1 2 171 6 181 8 131 17 2818 397 1175 1895 14699 239 NOTE: Every crash can have two road condition choices 13

214 CRASHES WEATHER CONDITIONS Weather Conditions 1st Condition 2nd Condition 1st Condition 2nd Condition 1st Condition 2nd Condition 1st Condition 2nd Condition Clear 16 2167 8 8448 26 1721 34 Raining 1 82 7 293 19 376 26 Snowing 9 32 16 1677 42 1988 58 Fog 2 1 4 65 12 77 16 Blowing Dust/Sand/Dirt 1 2 2 5 5 7 8 Severe Wind Only 2 3 7 153 35 185 42 Blizzard 9 14 31 27 4 41 Sleet/Hail/Freezing Rain 7 8 4 23 47 31 Blowing Snow 2 3 41 58 27 289 313 35 Cloudy, Overcast 8 2 152 21 542 92 72 115 Smoke 3 3 Other 1 12 1 13 1 Unknown 1 15 1 21 3 226 4 131 6 2818 146 11749 574 14698 726 NOTE: Every crash can have two weather condition choices 214 CRASHES LIGHTING CONDITIONS Lighting Conditions Darkness Lighted 2 254 134 129 Darkness Unlighted 56 498 2776 333 Dawn 4 46 356 46 Daylight 64 1929 79 983 Dusk 4 85 31 399 Other 2 2 Unknown 1 6 182 189 131 2818 1175 14699 14

VEHICLES 214 VEHICLE TYPES Vehicle Type Number of Vehicles involved in: Vehicles Passenger 4 1624 5555 7219 Passenger Van 9 133 479 621 PU 58 116 4678 5896 School Bus 9 39 48 Other Bus 2 14 16 Transit Bus 3 9 12 Charter Bus 1 2 3 6 MC > 15cc 16 226 56 298 Off Road MC 3 3 Low Speed Vehicle 1 1 Other Vehicle 6 2 26 SUV 36 913 317 4119 Cargo Van 16 19 125 Motor Home 1 34 44 Light Truck (< 1K) 3 9 12 Medium Truck (>1K - <26K) 7 38 162 27 Heavy Truck (>26K) 22 349 1259 163 Farm Equipment 1 4 5 Construction Vehicle 6 25 31 MC <15 cc 1 4 5 Moped 2 2 Snowmobile 1 1 ATV 1 16 8 25 MPV 7 4 11 Unknown 8 2595 263 191 4542 18233 22966 15

Contributing Circumstances 214 VEHICLE WITH CONTRIBUTING CIRCUMSTANCES Number of Vehicles involved in: Vehicles Brakes 35 1 135 Cruise Control 2 19 21 Defroster 1 2 3 Exhaust System 1 1 Lights (Head, Signal, or Tail) 1 8 9 Mirrors 1 1 None Other 2 38 16 2 Oversized Load 3 9 12 Power Train 5 23 28 Rain/Snow/Ice on Windshield 3 28 31 Stalled Vehicle 2 9 11 Steering 14 39 53 Suspension 2 14 16 Tinted Windows 2 2 Tire 7 24 15 136 Trailer Brakes 2 18 2 Truck Coupling/Trailer Hitch/S 2 25 27 Unknown Vehicle Cargo Blocking View 5 5 Wheels 1 3 31 Windows/Windshield 4 3 7 Wipers 1 1 9 139 62 75 16

WYOMING COMMUNITIES 214 CITY/TOWN CRASHES WITH INJURIES AND FATALITIES City/Town # Persons Injured # Persons Killed AFTON 1 4 5 8 ALPINE 1 3 4 1 BAGGS 1 1 BASIN 1 1 BEAR RIVER 1 1 BIG PINEY 6 6 BUFFALO 1 51 61 11 BURLINGTON 2 2 BURNS 2 2 BYRON 3 3 CASPER 7 344 1594 1945 452 9 CHEYENNE 8 425 139 1742 577 1 CHUGWATER 3 6 9 3 CODY 1 33 169 23 39 1 COKEVILLE 1 5 6 2 COWLEY 2 2 DAYTON 2 2 DIAMONDVILLE 1 5 6 3 DOUGLAS 1 31 141 173 39 1 DUBOIS 1 12 13 1 EAST THERMOPOLIS 2 2 EVANSTON 18 56 74 24 EVANSVILLE 14 51 65 16 FRANNIE 1 1 GILLETTE 2 2 682 884 286 2 GLENDO 2 2 GLENROCK 1 23 24 1 GRANGER 1 1 GREEN RIVER 25 126 151 28 GREYBULL 3 26 29 3 GUERNSEY 1 1 HANNA 1 1 1 HARTVILLE 1 1 HUDSON 1 2 3 1 HULETT 1 3 4 1 JACKSON 1 32 238 271 39 1 KAYCEE 1 1 KEMMERER 2 24 26 2 LAGRANGE 1 1 LANDER 15 98 113 17 LARAMIE 16 58 614 14 LINGLE 4 4 LOST SPRINGS 1 1 LOVELL 8 2 28 12 LUSK 4 8 12 4 LYMAN 4 2 6 6 MARBLETON 1 1 MEETEETSE 1 1 MIDWEST 1 1 MILLS 17 7 87 23 MOORCROFT 3 13 16 4 MOUNTAIN VIEW 1 17 1 NEWCASTLE 5 26 31 7 PINE BLUFFS 1 8 9 2

City/Town # Persons Injured # Persons Killed PINEDALE 3 2 23 4 POWELL 14 56 7 14 RANCHESTER 4 4 RAWLINS 27 119 146 51 RIVERTON 1 57 236 294 69 1 ROCK RIVER 1 1 ROCK SPRINGS 3 12 423 546 155 3 SARATOGA 3 12 15 4 SHERIDAN 1 59 361 421 77 1 SHOSHONI 3 3 SINCLAIR 2 1 12 2 STAR VALLEY RANCH 1 1 1 SUNDANCE 3 2 23 5 THAYNE 2 2 THERMOPOLIS 5 25 3 5 TORRINGTON 1 14 66 81 16 1 UPTON 1 3 4 1 WAMSUTTER 4 6 1 5 WHEATLAND 9 43 52 13 WORLAND 11 53 64 14 WRIGHT 1 9 1 1 27 1645 6812 8484 2189 31 18

214 CITY/TOWN CRASHES INTERSECTION TYPE AND MANNER OF COLLISION Intersection Type Manner of Collision Five (5) Point or more Four (4) -Way Intersection Intersection as part of an Interchange L Intersection Not an Intersection Roundabout T Intersection Y Intersection Angle (Front to Side), Opposing Direction 5 317 8 4 175 15 4 618 Angle Direction not Specified 6 2 1 4 22 Angle Right (Front to Side, includes Broadside) 1 91 33 4 282 17 17 3 142 Angle Same Direction (Front to Side) 2 216 17 1 361 32 9 4 723 Head On (Front to Front) 1 83 2 1 19 31 1 228 Not a Collision w/2 Vehicles in Transport 1 27 2 1 31 19 Other 1 2 3 Rear End (Front to Rear) 8 783 94 819 4 282 12 22 Rear to Front (Normally Backing) 1 49 4 137 43 234 Rear to Rear (Normally Backing) 4 1 55 6 Rear to Side (Normally Backing) 12 282 11 35 Sideswipe Opposite Direction (Meeting) 17 2 66 15 1 Sideswipe Same Direction (Passing) 4 16 19 1 455 14 48 1 648 Unknown 5 97 1 13 22 259 183 11 2877 67 82 26 6497

ALCOHOL INVOLVED CRASHES 214 ALCOHOL INVOLVED TRAFFIC CRASHES Year All Alcohol % Alcoh Alcohol % Alcoh All Alcohol % Alcoh * * Alcohol % Alcoh All Alcohol % Alcoh ities ities ities Injuries Injuries Injuries 21 137 45 33% 153 48 31% 3183 397 12% 4492 562 13% 11422 517 5% 211 12 33 28% 135 36 27% 317 414 14% 4159 595 14% 11676 545 5% 212 18 42 39% 119 42 35% 283 395 14% 3891 532 14% 111 54 5% 213 75 24 32% 87 28 32% 2793 353 13% 3766 48 13% 1172 499 4% 214 131 48 37% 15 51 34% 2818 327 12% 3944 456 12% 1175 58 4% * Injuries include injuries from fatal crashes 14 Alcohol 2 12 1 8 6 4 2 #All #Alcohol 16 14 12 1 8 6 Alcohol ities #All ities #Alcoh ities 21 211 212 213 214 4 2 21 211 212 213 214

ALCOHOL INVOLVED CRASHES WITH AGE OF DRINKING DRIVERS 21 Drivers Involved in Age Groups Drivers 14-16 1 4 2 7 17-2 2 49 45 96 21-24 5 56 84 145 25-29 4 64 66 134 3-39 8 74 86 168 4-49 3 69 72 144 5-59 9 25 45 79 6-69 3 8 13 24 7-79 3 3 6 Unknown 2 5 7 35 354 421 81 211 Drivers Involved in Age Groups Drivers 14-16 1 6 7 17-2 2 39 45 86 21-24 5 7 89 164 25-29 2 74 9 166 3-39 4 85 91 18 4-49 6 58 71 135 5-59 1 32 56 89 6-69 9 14 23 7-79 1 3 4 8 Unknown 7 7 21 371 473 865 212 Drivers Involved in Age Groups Drivers 14-16 4 2 6 17-2 2 29 65 96 21-24 6 81 84 171 25-29 5 56 76 137 3-39 11 84 99 194 4-49 6 48 65 119 5-59 3 49 57 19 6-69 2 7 16 25 7-79 1 6 7 8 + 1 1 Unknown 4 4 36 358 475 869 21

ALCOHOL INVOLVED CRASHES WITH AGE OF DRINKING DRIVERS 213 Drivers Involved in Age Groups Drivers 14-16 2 1 3 17-2 2 31 4 73 21-24 1 62 12 165 25-29 6 55 84 145 3-39 6 92 16 24 4-49 4 45 91 14 5-59 5 48 58 111 6-69 1 13 23 7-79 1 3 4 8 8 + 1 1 2 Unknown 2 5 7 25 351 55 881 214 Drivers Involved in Age Groups Drivers 14-16 1 15 16 32 17-2 3 2 28 51 21-24 6 55 95 156 25-29 6 52 79 137 3-39 11 75 127 213 4-49 7 53 66 126 5-59 6 41 67 114 6-69 2 18 26 46 7-79 1 4 4 9 8 + 1 3 4 Unknown 5 5 43 334 516 893 22

ALCOHOL INVOLVED FATAL CRASHES 214 ALCOHOL INVOLVED FATAL CRASHES BY COUNTY County Number Number Injured Number Killed Albany 1 1 1 Big Horn 5 3 5 Campbell 6 2 7 Carbon 3 5 3 Converse 3 4 Crook 1 1 Fremont 3 1 3 Goshen 1 1 Hot Springs 1 2 1 Johnson 1 1 Laramie 3 4 Lincoln 1 1 Natrona 2 2 Niobrara 1 3 1 Park 3 3 3 Platte 1 1 Sheridan 1 1 Sublette 2 2 Sweetwater 9 9 48 2 51 City 214 ALCOHOL INVOLVED FATAL CRASHES BY CITY Number Number Injured Number Killed CASPER 2 2 CHEYENNE 1 1 CODY 1 1 DOUGLAS 1 1 GILLETTE 1 1 RIVERTON 1 1 1 ROCK SPRINGS 3 3 STAR VALLEY RANCH 1 1 TORRINGTON 1 1 12 1 12 23

214 ALCOHOL INVOLVED FATAL CRASHES VEHICLE TYPE Vehicle Type Number of Vehicles ATV 1 Heavy Truck > 26, 2 MC > 15 cc 3 Medium Truck 1 PU 24 Passenger 16 Passenger Van 1 SUV 13 61 214 ALCOHOL INVOLVED FATAL CRASHES ESTIMATED SPEED Estimated Speed - 13 3 14-16 1 25-29 1 3-5 5 5-65 21 65 + 2 Others 1 61 214 ALCOHOL INVOLVED FATAL CRASHES WITH AGE AND GENDER OF DRIVERS Age Groups Male Female Drivers 14-16 1 1 17-2 2 1 3 21-24 5 1 6 25-29 6 6 3-39 8 3 11 4-49 6 1 7 5-59 4 2 6 6-69 2 2 7-79 1 1 34 9 43 24

ALCOHOL INVOLVED INJURY CRASHES 214 ALCOHOL INVOLVED INJURY CRASHES BY COUNTY County Number Injured City 214 ALCOHOL INVOLVED INJURY CRASHES BY CITY Number of Number Injured BUFFALO 1 1 CASPER 37 52 CHEYENNE 5 74 CODY 3 3 DOUGLAS 8 1 DUBOIS 1 1 EVANSTON 1 2 EVANSVILLE 5 5 GILLETTE 21 3 GREEN RIVER 2 2 GREYBULL 1 1 JACKSON 1 1 LANDER 1 1 LARAMIE 16 21 MILLS 5 5 NEWCASTLE 1 2 POWELL 2 2 RAWLINS 7 18 RIVERTON 5 7 ROCK SPRINGS 2 22 SARATOGA 1 1 SHERIDAN 4 5 SINCLAIR 1 1 THERMOPOLIS 1 1 TORRINGTON 3 3 UPTON 1 1 WHEATLAND 2 2 WORLAND 1 1 22 275 25 Albany 2 26 Big Horn 1 1 Campbell 32 43 Carbon 12 23 Converse 1 12 Crook 7 7 Fremont 27 43 Goshen 4 4 Hot Springs 1 1 Johnson 3 3 Laramie 56 81 Lincoln 8 11 Natrona 52 68 Park 9 9 Platte 3 3 Sheridan 15 18 Sublette 7 8 Sweetwater 36 44 Teton 11 13 Uinta 7 1 Washakie 1 1 Weston 5 7 327 436

214 ALCOHOL INVOLVED INJURY CRASHES WITH VEHICLE TYPE Vehicle Type Number of Vehicles % Vehicles ATV 3.7% Cargo Van 3.7% Heavy Truck > 26, 16 3.5% Light Truck 1.2% MC > 15 cc 25 5.4% MPV 1.2% Moped 1.2% Other Vehicle 1.2% PU 148 32.2% Passenger 173 37.7% Passenger Van 7 1.5% SUV 78 17.% Snowmobile 1.2% Unknown 1.2% 459 1% 214 ALCOHOL INVOLVED INJURY CRASHES WITH ESTIMATED SPEED Estimated Speed Number of Vehicles - 2 117 2-3 7 3-5 14 5-65 67 65 + 48 Others 53 459 214 ALCOHOL INVOLVED INJURY CRASHES WITH AGE AND GENDER OF DRIVERS Age Groups Male Female Unknown Drivers 14-16 3 1 4 17-2 22 9 31 21-24 43 12 55 25-29 38 14 52 3-39 58 17 75 4-49 42 11 53 5-59 31 1 41 6-69 15 3 18 7-79 3 1 4 8 + 1 1 256 78 334 26

ALCOHOL INVOLVED CRASHES 214 BY CITY 214 BY COUNTY County Albany 23 Big Horn 3 Campbell 43 Carbon 18 Converse 18 Crook 8 Fremont 47 Goshen 6 Hot Springs 4 Johnson 7 Laramie 61 Lincoln 4 Natrona 96 Niobrara 2 Park 17 Platte 8 Sheridan 4 Sublette 11 Sweetwater 57 Teton 17 Uinta 4 Washakie 9 Weston 5 58 City BUFFALO 4 CASPER 8 CHEYENNE 55 CODY 8 DOUGLAS 12 DUBOIS 2 EVANSTON 1 EVANSVILLE 1 GILLETTE 35 GLENROCK 1 GREEN RIVER 11 GREYBULL 1 GUERNSEY 1 JACKSON 7 LANDER 11 LARAMIE 19 LINGLE 1 LOVELL 1 LUSK 1 MILLS 8 NEWCASTLE 3 POWELL 3 RANCHESTER 1 RAWLINS 13 RIVERTON 17 ROCK SPRINGS 35 SARATOGA 1 SHERIDAN 29 THERMOPOLIS 3 TORRINGTON 3 UPTON 1 WHEATLAND 3 WORLAND 7 WRIGHT 1 38 27

214 ALCOHOL INVOLVED CRASHES WITH AGE AND BAC RESULTS OF DRIVERS Age Groups BAC Results Drivers in Drivers in Drivers in - 13 14-16 17-2 21-24 25-29 3-39 4-49 Others is a result of no reported BAC result Others.15 -.2 1 Others 1 3 4 1 4 4.1 -.8 1 2 2.8 -.9 2 1.1 -.15 4 6.15 -.2 7 5.2 -.25 1 2.55 + 1 Others 1 16 23 3 31 4.1 -.8 1 3 12.8 -.9 1 1 3.1 -.15 1 17.15 -.2 1 2 13.2 -.25 4 6.25 -.3 1.3 -.35 1 1 Others 2 33 44 6 55 95.1 -.8 5 4.1 -.15 4 11.15 -.2 2 6 9.2 -.25 3 3 9.25 -.3 3 2 Others 1 31 44 6 52 79.1 -.8 4 6.8 -.9 2 6.1 -.15 7 16.15 -.2 8 17.2 -.25 1 5 8.25 -.3 2 2 5.4 -.45 1 1.55 + Others 8 46 68 11 75 127.1 -.8 3 3.8 -.9 1 1.1 -.15 1 5 13.15 -.2 1 3 1.2 -.25 3 4 5.25 -.3 2 4 1.3 -.35 1

Age Groups BAC Results Drivers in Drivers in Drivers in 5-59 6-69 7-79 8 + UK Others.35 -.4 1.55 + 1 Others 32 31 7 53 66.1 -.8 1 5.8 -.9 1 1.1 -.15 2 5 13.15 -.2 4 9.2 -.25 1 2 8.35 -.4 1 Others 3 27 31 6 41 67.1 -.8 1 1.8 -.9 2 1.1 -.15 3.15 -.2 1 2 6.2 -.25 2 1.25 -.3 1.55 + Others 1 11 13 2 18 26.1 -.15 1 1.2 -.25 1.25 -.3 1 Others 2 3 1 4 4.1 -.8 2.1 -.15 1 Others 1 1 3.55 + Others 5 5 Others 43 334 516 Others is a result of no reported BAC result

DRIVERS AGE 14-2 214 FATAL CRASHES INVOLVING DRIVERS BETWEEN AGES 14-2 GENDER Age Male Female 14 1 1 15 2 2 16 2 1 3 17 1 1 2 18 1 1 19 2 2 4 2 1 1 2 8 7 15 214 INJURY CRASHES INVOLVING DRIVERS BETWEEN AGES 14-2 GENDER Age Male Female 14 4 1 5 15 14 4 18 16 57 56 113 17 66 45 111 18 88 7 158 19 89 65 154 2 81 51 132 399 292 691 214 CRASHES INVOLVING DRIVERS BETWEEN AGES 14-2 GENDER Age Male Female 14 2 2 4 15 32 22 54 16 237 193 43 17 265 219 484 18 268 184 452 19 232 29 441 2 283 154 437 1319 983 232 3

TRUCKS TRUCK CRASHES MEDIUM TRUCK (>1K - <26K) & HEAVY TRUCK (> 26K) Year ities # Truck Killed Injuries # Truck Injured 21 19 27 7 257 356 121 857 1133 211 26 28 8 294 47 162 145 1365 212 25 26 7 258 375 137 971 1254 213 2 24 5 258 345 127 191 1369 214 28 39 5 314 467 172 1244 1586 118 144 32 1381 195 759 528 677 214 TRUCK CRASHES MEDIUM TRUCK (>1K - <26K) & HEAVY TRUCK (> 26K) BY ROADWAY Roadway Type Interstate 14 169 732 915 Primary 12 79 247 338 Secondary 1 17 36 54 City Street 1 11 91 13 County Road Rural 14 35 49 State Highway 2 6 8 M Route 18 75 93 BLM 1 1 Forest Service 1 1 Service Road 2 12 14 County Road Urban 2 8 1 28 314 1244 1586 31

SCHOOL BUS 214 64 School Bus 48 52 52 48 41 38 28 29 21 211 212 213 214 Number Injured in School Bus 43 25 2 7 1 1 7 28 29 21 211 212 213 214 32

214 SCHOOL BUS INVOLVED CRASHES COUNTY / CRASH SEVERITY County ALBANY 2 2 CAMPBELL 3 4 7 CARBON 2 2 FREMONT 1 1 2 JOHNSON 1 1 LARAMIE 6 6 LINCOLN 1 1 NATRONA 1 1 11 PARK 4 4 PLATTE 1 2 3 SWEETWATER 2 5 7 TETON 2 2 9 39 48 214 SCHOOL BUS INVOLVED CRASHES COLLISION TYPE / CRASH SEVERITY Collision Type Motor Vehicle in Transport on Roadway 7 28 35 Other NON-Fixed Object 1 1 2 Overturn/Rollover 1 1 Parked Motor Vehicle 9 9 Work Zone/Maintenance Equipment 1 1 9 39 48 33

MOTORCYCLES 214 Motorcycle 363 323 335 39 331 288 29 28 29 21 211 212 213 214 337 Number Injured in Motorcycle 314 312 32 281 27 258 28 29 21 211 212 213 214 34

214 MOTORCYCLE INVOLVED CRASHES COUNTY/CRASH SEVERITY County ALBANY 1 14 3 18 BIG HORN 1 2 3 CAMPBELL 24 4 28 CARBON 2 3 5 CONVERSE 6 6 CROOK 1 14 3 18 FREMONT 6 6 12 GOSHEN 1 1 HOT SPRINGS 1 1 2 JOHNSON 2 2 LARAMIE 5 34 5 44 LINCOLN 1 3 1 5 NATRONA 1 3 14 45 NIOBRARA 3 3 PARK 2 1 21 PLATTE 1 7 1 9 SHERIDAN 11 1 12 SUBLETTE 1 1 1 3 SWEETWATER 2 21 6 29 TETON 1 9 2 12 UINTA 3 3 WASHAKIE 3 3 WESTON 6 6 16 221 53 29 214 MOTORCYCLE INVOLVED CRASHES COLLISION TYPE/CRASH SEVERITY Collision Type Antelope 2 2 Concrete Traffic Barrier/Jersey Barrier 1 1 Deer 12 11 Delineator Post 1 5 1 7 Ditch 3 3 Earth Embankment/Berm 1 1 1 3 End of Drainage Pipe/Structure/Culvert 1 1 Fell/Jumped from a MV 2 2 Fence (including Post) 1 5 6 Guardrail Face 5 1 6 Motor Vehicle in Transport on Roadway 6 74 29 99 Other Domestic (Dog, Llama...) 2 2 Other Fixed Object 1 1 2 Other NON-Fixed Object 1 1 Other Non-Collision (MC Loss of Control 6 19 11 123 Parked Motor Vehicle 2 7 9 Pedacycle 1 1 Raised Median or Curb 5 2 7 Rock, Boulder, Rock Slide 2 2 Traffic Sign Support 1 1 Trees/Shrubbery 1 1 16 221 53 29 35

A P P E N D I X

Yes Date of Crash (yyyy/mm/dd) 2 No If NOT at Intersection mark if attached Badge # / / Combined Damage greater than or equal to $1, Yes No Occurred on Private Property County Yes Hit & Run Public/Private Property Damage Yes No City Crash occurred on: Highway/Street At/Related intersection: Highway/Street. No INVESTIGATOR'S TRAFFIC CRASH REPORT Investigating Agency 1 - City PD 2 - Sheriff 3 - BIA 4 - Forest Service 5 - Campus Police 6 - WHP 7 - Other Officer Name & Rank Time (24 hr) : Investigated at the Scene Feet or Miles Su Day of Week Mo Tu We Th Fr Sa Photo None Amount of Property Damage (if known) $ Photo/Video OF # Vehicle(s) GPS Latitude Police Notified: Arrived: CASE NO. Mail completed form within 1 days to: Wyoming Department of Transportation Crash Records 53 Bishop Boulevard Cheyenne, WY 829-334 Yes In City/Town No Yes No Direction INSTRUCTIONS TO ENSURE ACCURACY PRINT IN UPPER-CASE LETTERS USING A BLACK OR DARK BLUE PEN! PRINT NEATLY If 'Other' is selected in any field, describe in narrative If a vehicle is towed, describe towed vehicle in narrative SUPPLEMENTAL REPORTS If more than 2 vehicles are involved, complete form 'Supplemental Additional Vehicle/Driver Form' If more than 5 persons in a crash, complete form 'Supplemental Additional Vehicle Occupant Information' Trucks or Commercial Motor Vehicles complete form 'Supplemental Truck/CMV Information' If a non-motorist is involved, complete form 'Supplemental Non-Motorist' If a bus is involved and carrying passengers, complete form 'Supplemental Bus Information' If any drug tests are performed, complete 'Supplemental Drug Test Results' Previous report submitted Video Both 4 EMS Notified: Arrived:. GPS Longitude A B C D 4 5 6 7 8-2 2 2 2 Date: yyyy/mm/dd EMS Hospital Arrival Time : # non # Driver(s) # Person(s) Motorists # Injured # Killed.. Milepost Marker Highway Section # Intersection LRS # CAT. ID # DIR 1 / / : / / : / / : / / : Occurred on Divided Hwy No Yes Highway LRS # CAT. ID # DIR if yes Incr / Decr Incr Decr Unknown nearest street, highway, ramp, bridge, city, railroad crossing, etc. Division (WHP only) Time (24 hr) First MI Signature Highway Safety Use Only Rank Report Date (yyyy/mm/dd) 2 / / Proximity to Residence Rural PID NON-PID Highway District 1-Same Town 2-25 miles or less 3-25 miles Plus 4-Out of State Accurately Located Crash Type: G > $1, M - Missing Location Date Received: N < $1, I - Industrial Crash Report Number: Highway System P - Private D - Deliberate Last PR92 Revised 2/5/8

1 Page 2 Last Name Street Number Street Name Mailing Address (PO Box Number) Occupation Home Work Cell Phone Driver Phone - License Number Driver/Vehicle Information City Employer Emp Phone - - First Name Home Work Cell Phone - State (FIPS) Restrictions MI Gender State Zip Code SSN (fatals only) - - DOB (yyyy/mm/dd) / / - Age CDL Endorsement DL Type 1 - Not Licensed 5 - CDL 2 - Driver License 6 - CDL Permit 3 - Instruction Permit 7 - No License Required 4 - I2 Permit-intermediate 8 - Restricted License DL Class 1 - A 5 - Improper or 2 - B No Endorsement 3 - C 6 - Other 4 - M DL Status 1 - Clear 4 - Revoked 2 - Expired 5 - Suspended 3 - Canceled or Denied No. of Vehicle Occupants (1 to 5) Posted Speed Estimated Speed Last Name First Name MI Vehicle Owner same as driver 2 Street Number Make (ie, Chevrolet, Dodge, Toyota) Model (ie, Silverado, Dakota, Solara) Year Vehicle Identification Number Insurance Verified Vehicle Towed Extent of Damage Last Name Y-Yes N -No Y-Yes N-No Street Number Company Policy # By To Street Name 1 - None 2 - Functional 3 - Minor 4 - Disabling Street Name Mailing Address (PO Box Number) City City License Plate No. MV Damage >$1, First Name 1-Yes 2-No 99-Unk. State (FIPS) Direction of Travel Prior to Crash Expir. Date (mm/yy) 1 - North 5 - South 2 - Northeast 6 - Southwest 3 - East 7 - West 4 - Southeast 8 - Northwest - Color State Zip Code Initial Impact Most Damaged Point Area Non-Collision (Overturn/Rollover) 1-12 (Use 12 Point Clock Diagram) 13 Top (Roof) 14 Undercarriage 99 Unknown (Can't determine) DOB (yyyy/mm/dd) Occupation Employer Age Home Work Cell Phone Home Work Cell Phone SSN (fatals only) Driver Emp Phone - - Phone - - - - License Number State (FIPS) Restrictions CDL Endorsement MI State Gender Zip Code / / - DL Type 1 - Not Licensed 5 - CDL 2 - Driver License 6 - CDL Permit 3 - Instruction Permit 7 - No License Required 4 - I2 Permit-intermediate 8 - Restricted License DL Class 1 - A 5 - Improper or 2 - B No Endorsement 3 - C 6 - Other 4 - M DL Status 1 - Clear 4 - Revoked 2 - Expired 5 - Suspended 3 - Canceled or Denied No. of Vehicle Occupants (1 to 5) Posted Speed Estimated Speed Last Name First Name MI Vehicle Owner same as driver Street Number Make (ie, Chevrolet, Dodge, Toyota) Model (ie, Silverado, Dakota, Solara) Year Vehicle Identification Number Insurance Verified Vehicle Towed Extent of Damage Y-Yes N -No Y-Yes N -No Policy # By To Street Name Company 1 - None 2 - Functional 3 - Minor 4 - Disabling City License Plate No. MV Damage >$1, 1-Yes 2-No 99-Unk. State (FIPS) Direction of Travel Prior to Crash Expir. Date (mm/yy) - Color 1 - North 5 - South 2 - Northeast 6 - Southwest 3 - East 7 - West 4 - Southeast 8 - Northwest State Zip Code Initial Impact Most Damaged Point Area Non-Collision (Overturn/Rollover) 1-12 (Use 12 Point Clock Diagram) 13 Top (Roof) 14 Undercarriage 99 Unknown (Can't determine)

Page 3 Seat Position Air Bag Deployed 1-Driver 1-Not Applicable 2-Front Row Middle 2-Not Deployed 3-Front Row Right 3-Deployed Front 4-Passenger Front Row Left 4-Deployed Side (for foreign or postal vehicles where the driver is on the Right) 5-Deployed Combination 5-Second Row Left 6-Deployed Other 6-Second Row Middle 99-Deployment Unknown 7-Second Row Right 8-Third Row Left 9-Third Row Middle 1-Third Row Right Occupant Protection System 11-Fourth Row Left 12-Fourth Row Middle Operation 13-Fourth Row Right 1-Apparently Normal 14-Other Row (ie. Bus, Van) 2-Failure/Malfunction 15-Lying Down-Front Seat 3-Misuse 16-Lying Down-Other Seat 17-Motorcycle Passenger 4-Air Bag System Turned off 18-Sleeper Section of Cab or Rendered Inoperative 19-Other Enclosed Area 99-Unknown 2-Unenclosed Cargo Area 21-Trailing Unit 97-Riding on MV Exterior Safety Equipment Usage 98-Other (explain in narrative) 1-None Used 99-Unknown (explain in narrative) 2-Not Available Person Type 3-Shoulder & Lap belt 1 - Driver 4-Shoulder Belt Only 2 - Passenger 5-Lap Belt Only MV # 6-Passive Restraint Only 1 7-Restraint used-type Unk. If non-motorist, complete 2 8-Forward Facing Child supplemental form 9-Rear Facing Child Restraint 1-Booster Seat 11-Child Restraint-Type Unk. 12-Helmet Used 13-Other 99-Unknown MV # Driver # 1 1 Driver # 2 Person Type Seat Position Seat Belt Usage Vehicle Occupant Information EMS ID EMS Run # Ejection 1-Not Ejected 2-Partially Ejected 3-ly Ejected 4-Trapped & Extricated 5-Not Applicable 99-Unknown Seat Belt Operation Air Bag Deployed Ejection Status CASE NO. Status Description 1-1-Severe Lacerations 2-Incapacitating 2-Broken 3-Non-Incapacitating 3-Crushed 4-Possible 4-Unconsciousness 5-No 5-Internal Unknown 99-Unknown 6-Lumps 7-Abrasions 8-Bruises 9-Minor Lacerations 1-Limping Most Injured Area 11-Pain 12-Nausea 1-Head 13-Other (explain in narrative) 2-Face 14- No 3-Neck 99-Unknown 4-Thorax (Chest) 5-Abdomen/Pelvis Classification 6-Spine 1- (Not Documented) 7-Upper Extremity (Arm...) 2- (Autopsy) 8-Lower Extremity (Leg...) 3- (Medical Diagnosis) 9-No 4-Non- (Hospitalized 99-Unknown overnight or longer) 5-Non- (Treated & Released from Hospital) 6-First Aid Given at Scene 7-No Treatment 8-Refused Treatment 99-Unknown Inj. Transported by 1-Not Transported 2-EMS (Ground) 3-EMS (Air) 4-Law Enforcement 5-Other (Private MV) EMS ID EMS Run # 99-Unknown Area Description Classication Injured Transported by Medical Facility EMS ID EMS Run # Medical Facility Occupant Information Last Name First Name MI SSN (s Only) : - - Home Work Cell Phone Home Work Cell Phone and/ - - or - - Medical Facility Last Name First Name MI SSN (s Only) : - - DOB DOB / / / / Gender M, F, X Gender M, F, X Age Age Home Work Cell Phone Home Work Cell Phone and/ - - - - or Medical Facility Last First Name Name MI SSN (s Only) : - - Home Work Cell Phone Home Work Cell Phone and/ - - or - - Medical Facility Last Name First Name MI SSN (s Only) : - - Home Work Cell Phone Home Work Cell Phone and/ - - - - or Medical Facility Last First Name Name MI SSN (s Only) : - - Home Work Cell Phone Home Work Cell Phone and/ - - - - or Medical Facility DOB DOB DOB yyyy/mm/dd / / / yyyy/mm/dd / / yyyy/mm/dd / Gender M, F, X Gender M, F, X Gender M, F, X Age Age Age If more then 5 occupants add page three from Supplemental Additional Driver/Vehicle form

1 Page 4 1st event 2nd event Sequence choose up to 4: 3rd event Most Harmful Event 4th event choose 1 Non-Collision 1 - Overturn/Rollover 2 - Fire/Explosion 3 - Immersion 4 - Jacknife 5 - Cargo/Equipment Loss or Shift 6 - Equipment Failure 7 - Separation of Units 8 - Ran Off the Road Right 9 - Ran Off the Road Left 1 - Cross Median or Centerline 11 - Downhill Runaway 12 - Fell/Jumped from a MV 13 - Thrown or Falling Object 14 - Avoiding an Object on Road 15 - Avoiding an Animal on Road 16 - Carbon Monoxide (CO) Poisoning 17 - Injuries by being thrown against part of vehicle 18 - Other Non-Collision (MC Loss of Control) Collision w/ Person, MV, or Non-Fixed Object 19 - Pedestrian 2 - Pedacycle 21 - Railway Vehicle 22 - Motor Vehicle in Transport on Roadway 23 - Motor Vehicle in Transport on OTHER Roadway 24 - Parked Motor Vehicle 25 - Struck by Falling, Shifting Cargo or Anything Else Set in Motion by Motor Vehicle 26 - Other NON-Fixed Object 27 - Work Zone/Maintenance Equipment 28 - Work Zone Channeling Device 29 - Object Set in Motion by Another Vehicle Animals 3 - Horse 31 - Cow 32 - Pig 33 - Sheep 34 - Other Domestic (Dog, Llama,...) 35 - Elk 36 - Deer 37 - Moose 38 - Antelope 39 - Buffalo 4- Other Wild Collision w/ Fixed Object 41 - Guardrail End 42 - Guardrail Face 43 - Impact Attenuator/Crash Cushion 44 - Bridge Pier or Support 45 - Bridge Overhead Structure 46 - Bridge Rail 47 - Concrete Traffic Barrier/Jersey Barrier 48 - Other Traffic Barrier (Includes temporary) 49 - Utility Pole/Light Support 5 - Traffic Signal Support 51 - Traffic Sign Support 52 - Overhead Traffic Sign 53 - Sign Support Single Post 54 - Sign Support Multiple Post 55 - Other Traffic Sign Support 56 - Barricade 57 - Tree/Shrubbery 58 - Cut Slope 59 - Road Approach 6 - Rock, Boulder, Rock Slide 61 - End of Drainage Pipe/Structure/Culvert 62 - Building or Other Structure Wall 63 - Fence (Including Post) 64 - Raised Median or Curb 65 - Delineator Post 66 - Earth Embankment/Berm 67 - Ditch 68 - Snow Embankment 69 - Mail Box 7 - Tunnel 71 - Cattle Guard 72 - Other Fixed Object 73 - Cable Barrier Vehicle (1) Information Motor Vehicle Unit Type 1 - Motor Vehicle in Transport 2 - Parked Motor Vehicle 3 - Working Vehicle/Equipment HM Placard or Commercial Motor Vehicle 1 - Yes 2 - No if yes, complete CMV supplement Vehicle Owner 1 - Same as Driver 2 - Other 3 - Passenger 4 - Relative 5 - Rental Vehicle 6 - Commercial 7 - Occupant 8 - Vehicle Parked 9 - Federal Law Enforcement 1 - Federal Other Vehicle Type Non -Commercial Trailer Style Underride/Override 1 - No Underride or Override 2 - Underride-Compartment Intrusion 3 - Underride-No Compartment Intrusion 4 - Underride-Compartment Intrusion Unkown 5 - Override-Motor Vehicle in Transport 6 - Override-Other Motor Vehicle if Underride or Override Emergency Vehicle Use 1 - Yes 2 - No Emergency Equipment Activated 1 - Yes 2 - No Special Function of MV in Transport 1 - None 2 - Police 3 - Ambulance/EMS 4 - Fire Truck 5 - Military 6 - Snow Plow 7 - Tow Truck 11 - County Law Enforcement 12 - County Fire Department 13 - County Other 14 - City Law Enforcement 15 - City Fire Department 16 - City Other 17 - Government Other 18 - Ambulance/EMS 19 - WHP 2 - State Law Enforc Other 1 - Passenger 2 - Passenger Van 3 - PU 4 - School Bus 5 - Other Bus 6 - Transit Bus 7 - Charter Bus 8 - MC >15 cc 9 - Off Road MC 14 - SUV 15 - Cargo Van 16 - Motor Home 17 - Light Truck (1K or less) 18 - Medium Truck (>1K - <26K) 19 - Heavy Truck (>26K) 2 - Farm Equipment 21 - Construction Vehicle 22 - MC <15 cc 1 - Motorized Skateboard/Scter 23 - Moped 11 - Pedestrian Vehicle 12 - Low Speed Vehicle 24 - Snowmobile 25 - Segway 27 - MPV 13 - Other Vehicle 26 - ATV 1 - No Trailer 2 - Camping Trailer 3 - Mobile Home 4 - Utility Trailer 5 - Boat/Jet Ski Trailer 6 - Towed Vehicle Contributing 7 - Horse/Stock Trailer 8 - Motorcycle Trailer 9 - Multiple Trailers 1 - Other (ie. Bicycle) 8 - MV used as School Bus 9 - MV used as Other Bus 1 - Construction Equipment 11 - Farm Equipment 12 - Taxi 13 - Train Circumstance 1 - None 2 - Brakes 3 - Trailer Brakes 4 - Steering 5 - Power Train 6 - Suspension 7 - Tires 8 - Wheels 9 - Lights (Head, Signal or Tail) 1 - Windows/Windshield 11 - Rain/Snow/Ice on Windshield 12 - Tinted Windows 13 - Vehicle Cargo Blocking View 14 - Exhaust System 15 - Oversized Load 16 - Defroster 17 - Mirrors 18 - Wipers 19 - Truck Coupling/Trailer Hitch/Safety Chain 2 - Stalled Vehicle 21 - Cruise Control 1st choice 2nd choice 22 - Other Vehicle Maneuver/Action prior to crash 1 - Straight Ahead 2 - Backing 3 - Changing Lanes 4 - Overtaking/Passing 5 - Turning RIght 6 - Turning Left 7 - Make U-Turn 8 - Leaving a Traffic Lane/Parking 9 - Entering a Traffic Lane 1 - Slowing 11 - Negotiating a Curve 12 - Parked 13 - Stopped in Traffic 14 - Driverless Motor Vehicle 15 - Trafficway Maintenance 16 - Other Road Surface 1 - Concrete 2 - Asphalt 3 - Gravel/Rock 4 - Dirt 5 - Brick/Stone Horizontal Alignment Grade 1 - Level 2 - Hillcrest 3 - Uphill 4 - Downhill 5 - Sag (Bottom) 1 - Straight 3 - Curve Left 2 - Curve Right No. Lanes 1-6, 99 = Unknown (exclude turn lanes) Traffic Control Working Properly 1 - Yes 2 - No Traffic Control 1 - None 2 - Stop Sign 3 - Yield Sign 4 - Flashing Traffic Signal 5 - Do Not Enter Sign 6 - Traffic Signal 7 - Traffic Signal w/ Ped 8 - Traffic Signal w/ Ped & Audible Signals 9 - Person (Officer/Flagger, Xing Guard, etc) 1 - Pedestrian Crossing 11 - No Passing Zone 12 - Warning Signs 13 - Pavement Markings 14 - Traffic Barrels/Cones 15 - Temporary Jersey Barrier 16 - School Bus Flashing Stop Lamps 17 - School Zone Crossing 18 - RR Crossing Signal 19 - RR Crossing Signal & Gate 2 - RR Crossing Cross Buck Sign Only 21 - RR Crossing Cross Buck with Stop Sign 22 - RR Crossing Cross Buck with Yield Sign 23 - Other Trafficway Description 1 - Two-Way-Undivided 2 - Two-Way-Undivided w/ Continuous Left Turn Lane 3 - Two-Way-Divided, No Barrier 4 - Two-Way-Divided, With Barrier 5 - One Way Rumble Strips Present 1 - Yes 2 - No Rumble Strips Applicable 1 - Yes 2 - No Rumble Strips 1 - None 2 - Centerline Rumble Strips 3 - Median Shoulder Only 4 - Transverse Rumble Strips (Road Apprch) 5 - Both Shoulders 6 - Both Centerline and Outside Shoulder 7 - Outside Shoulders Only

2 Page 5 1st event 2nd event Sequence choose up to 4: 3rd event Most Harmful Event 4th event choose 1 Non-Collision 1 - Overturn/Rollover 2 - Fire/Explosion 3 - Immersion 4 - Jacknife 5 - Cargo/Equipment Loss or Shift 6 - Equipment Failure 7 - Separation of Units 8 - Ran Off the Road Right 9 - Ran Off the Road Left 1 - Cross Median or Centerline 11 - Downhill Runaway 12 - Fell/Jumped from a MV 13 - Thrown or Falling Object 14 - Avoiding an Object on Road 15 - Avoiding an Animal on Road 16 - Carbon Monoxide (CO) Poisoning 17 - Injuries by being thrown against part of vehicle 18 - Other Non-Collision (MC Loss of Control) Collision w/ Person, MV, or Non-Fixed Object 19 - Pedestrian 2 - Pedacycle 21 - Railway Vehicle 22 - Motor Vehicle in Transport on Roadway 23 - Motor Vehicle in Transport on OTHER Roadway 24 - Parked Motor Vehicle 25 - Struck by Falling, Shifting Cargo or Anything Else Set in Motion by Motor Vehicle 26 - Other NON-Fixed Object 27 - Work Zone/Maintenance Equipment 28 - Work Zone Channeling Device 29 - Object Set in Motion by Another Vehicle Animals 3 - Horse 31 - Cow 32 - Pig 33 - Sheep 34 - Other Domestic (Dog, Llama,...) 35 - Elk 36 - Deer 37 - Moose 38 - Antelope 39 - Buffalo 4- Other Wild Collision w/ Fixed Object 41 - Guardrail End 42 - Guardrail Face 43 - Impact Attenuator/Crash Cushion 44 - Bridge Pier or Support 45 - Bridge Overhead Structure 46 - Bridge Rail 47 - Concrete Traffic Barrier/Jersey Barrier 48 - Other Traffic Barrier (Includes temporary) 49 - Utility Pole/Light Support 5 - Traffic Signal Support 51 - Traffic Sign Support 52 - Overhead Traffic Sign 53 - Sign Support Single Post 54 - Sign Support Multiple Post 55 - Other Traffic Sign Support 56 - Barricade 57 - Tree/Shrubbery 58 - Cut Slope 59 - Road Approach 6 - Rock, Boulder, Rock Slide 61 - End of Drainage Pipe/Structure/Culvert 62 - Building or Other Structure Wall 63 - Fence (Including Post) 64 - Raised Median or Curb 65 - Delineator Post 66 - Earth Embankment/Berm 67 - Ditch 68 - Snow Embankment 69 - Mail Box 7 - Tunnel 71 - Cattle Guard 72 - Other Fixed Object 73 - Cable Barrier Vehicle (2) Information Motor Vehicle Unit Type 1 - Motor Vehicle in Transport 2 - Parked Motor Vehicle 3 - Working Vehicle/Equipment HM Placard or Commercial Motor Vehicle 1 - Yes 2 - No if yes, complete CMV supplement Vehicle Owner 1 - Same as Driver 2 - Other 3 - Passenger 4 - Relative 5 - Rental Vehicle 6 - Commercial 7 - Occupant 8 - Vehicle Parked 9 - Federal Law Enforcement 1 - Federal Other Vehicle Type Non -Commercial Trailer Style Underride/Override 1 - No Underride or Override 2 - Underride-Compartment Intrusion 3 - Underride-No Compartment Intrusion 4 - Underride-Compartment Intrusion Unkown 5 - Override-Motor Vehicle in Transport 6 - Override-Other Motor Vehicle if Underride or Override Emergency Vehicle Use 1 - Yes 2 - No Emergency Equipment Activated 1 - Yes 2 - No Special Function of MV in Transport 1 - None 2 - Police 3 - Ambulance/EMS 4 - Fire Truck 5 - Military 6 - Snow Plow 7 - Tow Truck Circumstance 1 - None 2 - Brakes 3 - Trailer Brakes 4 - Steering 5 - Power Train 6 - Suspension 7 - Tires 8 - Wheels 9 - Lights (Head, Signal or Tail) 1 - Windows/Windshield 11 - Rain/Snow/Ice on Windshield 12 - Tinted Windows 13 - Vehicle Cargo Blocking View 14 - Exhaust System 15 - Oversized Load 16 - Defroster 17 - Mirrors 18 - Wipers 19 - Truck Coupling/Trailer Hitch/Safety Chain 2 - Stalled Vehicle 21 - Cruise Control 11 - County Law Enforcement 12 - County Fire Department 13 - County Other 14 - City Law Enforcement 15 - City Fire Department 16 - City Other 17 - Government Other 18 - Ambulance/EMS 19 - WHP 2 - State Law Enforc Other 1 - Passenger 2 - Passenger Van 3 - PU 4 - School Bus 5 - Other Bus 6 - Transit Bus 7 - Charter Bus 8 - MC >15 cc 9 - Off Road MC 14 - SUV 15 - Cargo Van 16 - Motor Home 17 - Light Truck (1K or less) 18 - Medium Truck (>1K - <26K) 19 - Heavy Truck (>26K) 2 - Farm Equipment 21 - Construction Vehicle 22 - MC <15 cc 1 - Motorized Skateboard/Scter 23 - Moped 11 - Pedestrian Vehicle 12 - Low Speed Vehicle 24 - Snowmobile 25 - Segway 27 - MPV 13 - Other Vehicle 26 - ATV 1 - No Trailer 2 - Camping Trailer 3 - Mobile Home 4 - Utility Trailer 5 - Boat/Jet Ski Trailer 6 - Towed Vehicle Contributing 7 - Horse/Stock Trailer 8 - Motorcycle Trailer 9 - Multiple Trailers 1 - Other (ie. Bicycle) 8 - MV used as School Bus 9 - MV used as Other Bus 1 - Construction Equipment 11 - Farm Equipment 12 - Taxi 13 - Train 1st choice 2nd choice 22 - Other Vehicle Maneuver/Action prior to crash 1 - Straight Ahead 2 - Backing 3 - Changing Lanes 4 - Overtaking/Passing 5 - Turning RIght 6 - Turning Left 7 - Make U-Turn 8 - Leaving a Traffic Lane/Parking 9 - Entering a Traffic Lane 1 - Slowing 11 - Negotiating a Curve 12 - Parked 13 - Stopped in Traffic 14 - Driverless Motor Vehicle 15 - Trafficway Maintenance 16 - Other Road Surface 1 - Concrete 2 - Asphalt 3 - Gravel/Rock 4 - Dirt 5 - Brick/Stone Horizontal Alignment Grade 1 - Level 2 - Hillcrest 3 - Uphill 4 - Downhill 5 - Sag (Bottom) 1 - Straight 3 - Curve Left 2 - Curve Right No. Lanes 1-6, 99 = Unknown (exclude turn lanes) Traffic Control Working Properly 1 - Yes 2 - No Traffic Control 1 - None 2 - Stop Sign 3 - Yield Sign 4 - Flashing Traffic Signal 5 - Do Not Enter Sign 6 - Traffic Signal 7 - Traffic Signal w/ Ped 8 - Traffic Signal w/ Ped & Audible Signals 9 - Person (Officer/Flagger, Xing Guard, etc) 1 - Pedestrian Crossing 11 - No Passing Zone 12 - Warning Signs 13 - Pavement Markings 14 - Traffic Barrels/Cones 15 - Temporary Jersey Barrier 16 - School Bus Flashing Stop Lamps 17 - School Zone Crossing 18 - RR Crossing Signal 19 - RR Crossing Signal & Gate 2 - RR Crossing Cross Buck Sign Only 21 - RR Crossing Cross Buck with Stop Sign 22 - RR Crossing Cross Buck with Yield Sign 23 - Other Trafficway Description 1 - Two-Way-Undivided 2 - Two-Way-Undivided w/ Continuous Left Turn Lane 3 - Two-Way-Divided, No Barrier 4 - Two-Way-Divided, With Barrier 5 - One Way Rumble Strips Present 1 - Yes 2 - No Rumble Strips Applicable 1 - Yes 2 - No Rumble Strips 1 - None 2 - Centerline Rumble Strips 3 - Median Shoulder Only 4 - Transverse Rumble Strips (Road Apprch) 5 - Both Shoulders 6 - Both Centerline and Outside Shoulder 7 - Outside Shoulders Only

1 2 Page 6 Action (choose up to 4). 1st choice 2nd choice 1 - No Improper Driving 3rd choice 2 - Ran Off Road 3 - Failed to Yield ROW 4th choice 4 - Disregarded Traffic Signs 5 - Ran Red Light 6 - Disregarded Other Road Marking 7 - Speeding 8 - Drove too Fast for Conditions 9 - Improper Turn or No Signal 1 - Improper Backing 11 - Improper Passing 12 - Improper Parking 13 - Wrong Side/Wrong Way 14 - Following too Close 15 - Failed to Keep Proper Lane 16 - Erratic/Reckless/Careless/Aggressive 17 - Avoiding an Object on Road 18 - Avoiding Animal 19 - Avoiding Non-Motorist 2 - Avoiding MV 21 - Swerve Due to Wind/Slippery Surface 22 - Over Corrected/Over Steered 23 - Evading Law Enforcement 24 - Other Improper Action Suspect Alcohol Test Alcohol Type 1 - Yes 2 - No If Alcohol Test preformed other then Breath then form 92E will be required with results at a later date. Alcohol Test Result Action (choose up to 4). 1 - No Test Performed 2 - Test Refused 3 - Blood 4 - Serum 5 - Breath 6 - Urine 7 - Other 1st choice 1 - No Improper Driving 3rd choice 2 - Ran Off Road 3 - Failed to Yield ROW 4th choice 4 - Disregarded Traffic Signs 5 - Ran Red Light 6 - Disregarded Other Road Marking 7 - Speeding 8 - Drove too Fast for Conditions 9 - Improper Turn or No Signal 1 - Improper Backing 11 - Improper Passing 12 - Improper Parking 13 - Wrong Side/Wrong Way 14 - Following too Close 15 - Failed to Keep Proper Lane 16 - Erratic/Reckless/Careless/Aggressive 17 - Avoiding an Object on Road 18 - Avoiding Animal 19 - Avoiding Non-Motorist 2 - Avoiding MV 21 - Swerve Due to Wind/Slippery Surface 22 - Over Corrected/Over Steered 23 - Evading Law Enforcement 24 - Other Improper Action Suspect Alcohol Test Alcohol Type 1 - Yes 2 - No If Alcohol Test preformed other then Breath then form 92E will be required with results at a later date. Alcohol Test Result 2nd choice 1 - No Test Performed 2 - Test Refused 3 - Blood 4 - Serum 5 - Breath 6 - Urine 7 - Other Driver Information Condition 1st choice (choose up to 2) 2nd choice 1 - Apparently Normal 2 - Emotional (depressed, angry, disturbed...) 3 - ill (Sick) 4 - Fell Asleep, Fainted 5 - Fatigued 6 - Under Influence of Medication 7 - Physical Disability 8 - Suspected Drug Use 9 - Suspected Alcohol Use 1 - Other 11 - Driver Inattention Distraction (choose one) 1 - Not Distracted 2 - Electronic Communication Device (cell, pager..) 3 - Other Electronic Device (palm, TV, computer...) 4 - Other Distraction Inside MV (passenger, pet...) 5 - Other Distraction Outside MV Suspect Drugs 1 - Yes 2 - No If Drug Test preformed then form 92E will be required with results at a later date. Drug Test Type 1 - No Test Performed 2 - Test Refused 3 - Blood 4 - Serum 5 - Urine 6 - Other Condition 1st choice (choose up to 2) 2nd choice 1 - Apparently Normal 2 - Emotional (depressed, angry, disturbed...) 3 - ill (Sick) 4 - Fell Asleep, Fainted 5 - Fatigued 6 - Under Influence of Meds 7 - Physical Disability 8 - Suspected Drug Use 9 - Suspected Alcohol Use 1 - Other 11 - Driver Inattention Distraction (choose one) 1 - Not Distracted 2 - Electronic Communication Device (cell, pager..) 3 - Other Electronic Device (palm, TV, computer...) 4 - Other Distraction Inside MV (passenger, pet...) 5 - Other Distraction Outside MV Suspect Drugs 1 - Yes 2 - No If Drug Test preformed then form 92E will be required with results at a later date. Drug Test Type 1 - No Test Performed 2 - Test Refused 3 - Blood 4 - Serum 5 - Urine 6 - Other Citations Issued choose up to 5 1 - None 2 - DWUI 3 - Drinking - (i.e.,open container) 4 - Exceeding Speed Limit 5 - Speed too Fast 6 - Following too Close 7 - Wrong Side of Road 8 - Improper or No Signal 9 - Improper Lane Use 1 - Improper Turn 11 - Improper Passing 12 - Improper Starting Out 13 - Failed to Grant ROW to Ped 14 - Failed to Grant ROW to MV 15 - Disregard Officer 16 - Disregard Stop Light 17 - Disregard Stop Sign 18 - Disregard Other 19 - Improper Parking 2 - Reckless Driving 21 - Vehicular Homicide 22 - License Violation 23 - Improper Backing 24 - No Insurance 25 - Hit & Run 26 - Registration Violation 27 - Failure to Use Seat Belt 28 - Charges Pending 29 - Fed R & R Driver 3 - Fed R & R Vehicle 31 - Racing 32 - Careless 33 - Other (explain in narrative) DL Investigation Citations Issued choose up to 5 1st choice 2nd choice 3rd choice 4th choice 5th choice 1 - None 2 - DWUI 3 - Drinking - (i.e.,open container) 4 - Exceeding Speed Limit 5 - Speed too Fast 6 - Following too Close 7 - Wrong Side of Road 8 - Improper or No Signal 9 - Improper Lane Use 1 - Improper Turn 11 - Improper Passing 12 - Improper Starting Out 13 - Failed to Grant ROW to Ped 14 - Failed to Grant ROW to MV 15 - Disregard Officer 16 - Disregard Stop Light 17 - Disregard Stop Sign 18 - Disregard Other 19 - Improper Parking 2 - Reckless Driving 21 - Vehicular Homicide 22 - License Violation 23 - Improper Backing 24 - No Insurance 25 - Hit & Run 26 - Registration Violation 27 - Failure to Use Seat Belt 28 - Charges Pending 29 - Fed R & R Driver 3 - Fed R & R Vehicle 31 - Racing 32 - Careless 33 - Other (explain in narrative) DL Investigation 1 - Yes 2 - No 1st choice 2nd choice 3rd choice 4th choice 5th choice 1 - Yes 2 - No

Page 7 FIRST HARMFUL EVENT Non - Collision: 1 - Overturn/Rollover 2 - Fire/Explosion 3 - Immersion 4 - Jacknife 5 - Cargo/Equipment Loss or Shift 12 - Fell/Jumped from a motor vehicle 13 - Thrown or Falling Object 16 - Carbon Monoxide (CO) Poisoning 17 - Injuries by being thrown against part of the vehicle 18 - Other Non-Collision (Motorcycle Loss of Control) Collision w/ Person, MV, or Non-Fixed Object: 19 - Pedestrian 2 - Pedacycle 21 - Railway Vehicle 22 - Motor Vehicle in Transport on Roadway 23 - Motor Vehicle on OTHER Roadway 24 - Parked Motor Vehicle 26 - Other NON-Fixed Object 27 - Work Zone/Maintenance Equipment 28 - Work Zone Channeling Device 29 - Object Set in Motion by Another Vehicle Animals: 3 - Horse 31 - Cow 32 - Pig 33 - Sheep 34 - Other Domestic (Dog, Llama, etc) 35 - Elk 36 - Deer 37 - Moose 38 - Antelope 39 - Buffalo 4 - Other Wild (Bear, Coyote, Eagle) Collision w/ Fixed Object 41 - Guardrail End 42 - Guardrail Face 43 - Impact Attenuator/Crash Cushion 44 - Bridge Pier or Support 45 - Bridge Overhead Structure 46 - Bridge Rail 47 - Concrete Traffic Barrier/Jersey Barrier 48 - Other Traffic Barrier (Includes temporary) 49 - Utility Pole/Light Support 5 - Traffic Signal Support 51 - Traffic Sign Support 52 - Overhead Traffic Sign 53 - Sign Support Single Post 54 - Sign Support Multiple Post 55 - Other Traffic Sign Support 56 - Barricade 57 - Tree/Shrubbery 58 - Cut Slope 59 - Road Approach 6 - Rock, Boulder, Rock Slide 61 - End of Drainage Pipe/Structure/Culvert 62 - Building or Other Structure Wall 63 - Fence (Including Post) 64 - Raised Median or Curb 65 - Delineator Post 66 - Earth Embankment/Berm 67 - Ditch 68 - Snow Embankment 69 - Mail Box 7 - Tunnel 71 - Cattle Guard 72 - Fixed Object Other 73 - Cable Barrier 99 -Unknown Base Information Location of FHE Weather 1st choice Road 1st choice Lighting 1 - Clear 2 - Raining 2nd choice 1 - Dry 2 - Wet 2nd choice 3 - Snowing 4 - Fog 5 - Blowing Dust/Sand/Dirt 6 - Severe Wind Only 7 - Blizzard 3 - Ice/Frost 4 - Snow 5 - Mud/Dirt/Gravel 6 - Slush 7 - Oil/Fuel 8 - Sleet/Hail/Freezing Rain 8 - Sand on Dry Pavement 9 - Blowing Snow 9 - Sand on Icy Road School Bus 1 - Cloudy,Overcast 1 - Water standing/running Related 11 - Smoke 12 - Other 11 - Other 1 - On Roadway 2 - Off Roadway 3 - Shoulder 4 - Median 5 - On OTHER Roadway 6 - Outside of ROW 7 - Gore 8 - Separator 9 - In Parking Lane/Zone 1 - Tunnel 11 - Bridge 12 - Port of Entry 13 - Rest Area Road Circumstance choose up to 3 1 - None 3rd choice 2 - Road Surface Condition 3 - Debris, loose material on the surface 4 - Ruts, Holes, Bumps 5 - Work Zone/Construction Zone 6 - Worn or Polished Surface 7 - Obstruction in Roadway 8 - Traffic Control Device Missing 9 - Traffic Control Device Inoperative 1 - Traffic Control Device Obscured 11 - Shoulders (None, Low, Soft, High) 12 - Non- Highway Work 13 - Reduced Road Width 14 - Lane Markings Missing or Faded 15 - Obstructed by a Previous Crash 16 - Other Work Zone Related 1 - Yes 2 - No Work Zone Workers Present Work Zone Location 1 - Before the First Warning Sign 2 - Advance Warning Area 3 - Transition Area 4 - Activity Area 5 - Termination Area Type of Work Zone 1 - Lane Closure 2 - Lane Shift or Crossover 3 - Work on Shoulder/Median 4 - Intermittent or Moving Work 5 - Other Manner of Collision *see diagram right 1 - Rear End (Front to Rear) 2 - Head On (Front to Front) 3 - Angle Same Direction (Front to Side) 4 - Angle (Front-to-Side), Opposing Direction 5 - Angle Right (Front to Side, includes Broadside) 6 - Angle Direction not Specified 7 - Sideswipe Same Direction (Passing) 8 - Sideswipe Opposite Direction (Meeting) 9 - Rear to Side (Normally Backing) 1 - Rear to Rear (Normally Backing) 11 - Rear to Front (Normally Backing) 12 - Not a Collision w/2 Vehicles in Transport 13 - Other Direction of Force 1st choice 2nd choice 1 - Opposing (Opposite Direction within 15 degrees) 2 - Angle (force exceeds 15 degrees) 3 - Same (same direction within 15 degrees) 4 - Meeting (glancing collision from opposite direction) 5 - Passing (glancing collision from same direction) Environmental Circumstance choose up to 3 1 - Weather Conditions 3rd choice 2 - Visual Obstruction Buildings 3 - Visual Obstruction Other Vehicle 4 - Visual Obstruction Vegetation 5 - Visual Obstruction Hillcrest 6 - Visual Obstruction Embankment-Snow, Rock,etc 7 - Other Physical Obstruction 8 - Glare (Sun or Headlight) 9 - Animals in Roadway 1 - Other 11 - None Type of Intersection 1 - Not an Intersection 2 - Four (4) -Way Intersection 3 - T Intersection 4 - Y Intersection 5 - Five (5) Point or more 1 - Daylight 2 - Darkness Unlighted 3 - Darkness Lighted 4 - Dawn 5 - Dusk 6 - Other 1 - No 2 - Yes, Directly Involved 3 - Yes, Indirectly Involved 1st choice 2nd choice Relation to Junction Non-Interstate Interstate 1 - Non-Junction 12 - Thru Roadway 2 - Intersection 13 - Intersection 3 - Intersection Related 14 - Intersection Related 4 - Driveway Related 15 - Ramp 5 - Entrance/Exit Ramp 16 - Other Parts (Gore) 6 - Railway Grade Crossing Interchange 7 - Crossover Related 8 - Business Entrance 9 - Alley 1 - Other Non-Interchange (ie. Bike, Snowmobile Trail, School Xing) (describe in narrative) 6 - Intersection as part of an Interchange 7 - Roundabout Manner of Collision CLARIFICATION 1 - Rear End (Front-to-Rear) 2 - Head-on (Front-to-Front) 3 - Angle (Front-to-Side), Same Direction 4 - Angle (Front-to-Side), Opposing Direction 5 - Angle (Front-to-Side), Right Angle/Broadside

Page 8 Indicate North 1st First Name MI Last Name Street Number Street Name City: State: Zip Code Witnesses Home Work Cell Phone - 2nd Street Number and/ or - - First Name Street Name Home Work Cell Phone MI Last Name - City: State: Zip Code Home Work Cell Phone 3rd First Name and/ or - - - Home Work Cell Phone MI Last Name Street Number Street Name City: - State: Zip Code Home Work Cell Phone and/ or - - - Home Work Cell Phone -

W Y O M I N G D E P A R T M E N T OF T R A N S P O R T A T I O N H I G H W A Y S A F E T Y P R O G R A M 5 3 B I S H O P B L V D. C H E Y E N N E, W Y 8 2 9