State Number
Consecutive Number
Vehicle Number
Number of Vehicle Forms Submitted for MV In Transport
Number of Occupants
Crash Date (Day)
Crash Date (Month)
Crash Time (Hour)
Crash Time (Minute)
First Harmful Event
Manner of Collision
Unit Type
Hit and Run
Vehicle Registration State
Registered Vehicle Owner
Vehicle Make
Vehicle Model
Make Model Combined
Body Type
Vehicle Model Year
Vehicle Identification Number
VIN Character(1)
VIN Character(2)
VIN Character(3)
VIN Character(4)
VIN Character(5)
VIN Character(6)
VIN Character(7)
VIN Character(8)
VIN Character(9)
VIN Character(10)
VIN Character(11)
VIN Character(12)
Vehicle Trailing
Jackknife
MCID Issuing Authority
MCID Identification Number
Motor Carrier Identification Number
Gross Vehicle Weight Rating
Vehicle Configuration
Cargo Body Type
Hazardous Materials Involvement/Placard-HM1 -Involvement
Hazardous Materials Involvement/Placard-HM2 Placard
Hazardous Materials Involvement/Placard- HM3 Identification Number
Hazardous Materials Involvement/Placard-HM4 Class Number
Hazardous Materials Involvement/Placard-HM5 Released
Bus Use
Special Use
Emergency Use
Travel Speed
Underride/Override
Rollover Type
Location of Rollover
Areas of Impact - Initial Contact Point
Extent of Damage
Vehicle Removal
Most Harmful Event
Vehicle Related Factors (1)
Vehicle Related Factors (2)
Fire Occurrence
Driver Presence
Driver License State
Driver ZIP Code
Non-CDL License Status
Non-CDL License Type
Commercial MV License Status
Compliance with CDL Endorsements
License Compliance with Class of Vehicle
Compliance with License Restrictions
Driver Height
Driver Weight
Previous Recorded Crashes
Previous Recorded Suspensions and Revocations
Previous DWI Convictions
Previous Speeding Convictions
Previous Other Moving Violation Convictions
Date of First Crash, Suspension or Conviction (Month)
Date of First Crash, Suspension or Conviction (Year)
Date of Last Crash, Suspension or Conviction (Month)
Date of Last Crash, Suspension or Conviction (Year)
Speeding Related
Driver Related Factors (4 choices)
Trafficway Description
Total Lanes in Roadway
Speed Limit
Roadway Alignment
Roadway Grade
Roadway Surface Type
Roadway Surface Condition
Traffic Control Device
Traffic Control Device Functioning
Pre-Event Movement
Critical Event - Precrash (Event)
Attempted Avoidance Maneuver
Pre- Impact Stability
Pre- Impact Location
Crash Type
Trailer VIN (1)
Trailer VIN (2)
Trailer VIN (3)
Fatals in Vehicle
Driver Drinking