Truck and Bus Section Criteria

Please answer the following questions to determine whether or not this section needs to be completed:

1. Did the crash involve:

• A truck that has a gross vehicle weight rating (GVWR) of more than 10,000 pounds or a gross combination weight rating (GCWR) of more than 10,000 pounds used in public highways?
• Any vehicle with seating to transport nine (9) or more people, including the driver’s seat?
• Any vehicle displaying hazardous materials placard (regardless of weight)?

If No, then do not fill out this section.

If Yes,

2. Did this crash result in:

• A fatality, any person(s) killed in or outside of any vehicle (truck, bus, car, etc.) involved in the crash or who dies within 30 days of the crash as a result of an injury sustained in the crash?
• An injury: any person(s) injured as a result of the crash who immediately receives medical treatment away from the crash scene?
• A tow away: any motor vehicle (truck, bus, car, etc.) or trailing unit disabled as a result of the crash and transported from scene by a tow truck or other vehicle?

If No, then do not fill out this section.

If Yes to both 1 and 2, please complete this section.

NOTE: If a commercial vehicle involved in the crash is a leased vehicle being rented by another company, obtain that company’s name, DOT# and address, not the information for the leasing company.