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Traffic accident report form

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MP Traffic Accident

D A Form 3946. Military Police Traffic Accident Report, is prepared on all accidents reported to the Military Police. This form is one of the special tools needed to make sense out of the confusion at the accident scene.

General Instructions

Form 3946 is used to accomplish the following:

Record information concerning traffic accidents reported to and investigated by the Military Police.

Provide information to the commanders concerning accidents involving members of their commands.

Provide information concerning accidents to those involved in the accident, or their representatives.

Provide management information for analysis, review and development of accident prevention and safety programs.

The form is designed for one or two-car accidents. If three or more vehicles are involved, you must continue on additional forms.

There is one rule for numbering the vehicles involved in an accident:

Military vehicles are always designated Vehicle Number 1 if a military vehicle is involved. If there are no military vehicles involved, or if all the vehicles are military, then numbering is based on whatever is easier or makes sense to the person completing the form.

If continuation forms are used, the drivers and occupants should be listed on the same form as their respective vehicles.

Guidance on release of information is contained in AR 340-17. Coordination with the local SJA should be made prior to all releases of information from the forms.

Block-by-Block Instructions

The figures shown above, show a properly completed DA Form 3946 (front and back). In the following instructions, each block is shown separately and followed by a description of how to make the proper entry.

Insert the MPR number, CID ROI number (if applicable) and any other report number prescribed by local PM SOP. If these numbers are not known, leave this space blank.

Enter year, month, and day on which accident occurred. For example, 30 Apr 1977 would be entered, "77 04 30."

Enter time in hours and minutes at which the accident occurred. Use military time (such as 2350 hours). Time of accident means actual moment of the accident, not the time the accident was reported and not the time the investigation began.

Mark an "X" in the box to the left of the day of the week accident occurred.

Location

Indicate with an "X" whether the accident occurred on or off a military reservation.

Enter the route number and/or name of the highway or street, road, alley, etc. on which the accident occurred. Use official name rather than some nickname.

If accident occurred on a military reservation or in a city, enter the name of the reservation or city and state. If outside US, enter name of reservation, state/district, and name of country. If the accident occurred off a military reservation and outside a city, enter the word "outside," then the name of the nearest installation or city. Next, enter the word "in," and note the county, district, state and country (if not in US) in which the accident occurred. For example, "outside Anniston, AL, in Calhoun County, AL."

If accident occurred within an intersection, enter the name and/or route number of the intersecting highway, street, road, alley, etc. If the accident occurred at the intersection of a highway with an entrance or exit ramp, this ramp must be accurately identified by name and/or number to permit follow-up engineering and enforcement action. If the accident occurred at the intersection of a road and a railroad, identify the railroad crossing number. "Within an intersection," means that area within imaginary lines drawn from the edges of the intersecting roads on through the intersection.

If the accident did not occur in an intersection or on an entrance/exit ramp, enter the nearest intersecting street or landmark. Then enter in feet the distance between the center line of the nearest intersecting street and the location of the key event of the accident. Direction is the compass direction from the intersection or landmark to the location of the accident.

Enter the approximate miles from the nearest military installation or city (identified previously) if the accident did not occur within either. "City or Town" also refers to a military reservation, if that is what has been entered in the name and location block. If kilometers are used, strike out "Miles" and enter "Km." Again, the direction is from the installation or city to the scene of the accident.

Mark an "X" in the box or boxes that best describe the area in which the accident occurred. If none of those listed is appropriate, check "Other" and briefly describe in the space after it.

Type Accident

Mark (X) the box or boxes which best describe the incident. If a vehicle hit both an object and a pedestrian, mark only the box indicating the first impact. If "Other" is marked, explain in the space provided (for example, "Vehicle-Animal").

Enter the total number of vehicles involved in the accident. If more than two vehicles are involved, additional copies of DA Form 3946 must be used. Indicate the number of people killed and the number injured in the appropriate blocks. Disposition of killed and injured personnel will be explained in the "Description of Collision" block in Part B of the form. Mark an "X" in "Property Damage Only" block if there were no human fatalities or injuries. If any person claims an injury, it will be recorded as an injury even though the person does not appear to be injured.

Weather, Light, And Road Conditions

Mark an "X" in appropriate blocks for each vehicle. If necessary, more than one block may be checked, especially in the "Character," "Conditions." "Defects," and "Weather" blocks. If "Other" is marked in any column, explain in the "Description of Collision" block on the other side of the form, or on a continuation sheet. The blocks to be marked are to the left of the descriptions.

Traffic Control

Mark an "X" by any control devices affecting either vehicle. Explain "Other" devices in the "Description of Collision" block on the other side, or on a continuation sheet. If necessary, more than one block may be marked. Again, the blocks to be marked are to the left of the descriptions.

Vehicle Description

Enter the USA Registration Number if it is a military vehicle. Always make sure that numbers on the hood match the data plate in the vehicle. If it is a nongovernment vehicle, enter the license number and state, district or county.

Enter make of the vehicle (for example: passenger vehicles--"Dodge," "Chevrolet," "Volkswagen;" trucks--"Ford," "International;" motorcycles--"BMW," "Honda," etc.).

Enter the last two digits of the vehicle's model year, such as "57," "69," "73," etc.

Describe the model and style of the vehicle (for example: "Malibu, 2-door;" "Continental convertible," etc.). For common military vehicles, use "common" tonnage descriptions (for example: "¼ ton truck," "2½-ton truck," etc.).





Enter unit bumper markings if it is a tactical military vehicle. If the military vehicle is nontactical (commercial) enter the license plate number. If privately owned, enter decal number and color, if appropriate. Example: "AB430 (blue)."

Mark an "X" for privately owned or Government owned. If the registered owner is the driver, enter "NA."

If the owner is not the driver, enter owner's last name, first name, middle initial. If owner is military, also include rank and SSN (Social Security Number). If owner is a civilian, include SSN. If it is a Government-owned vehicle, enter "US Government."

Enter military address (unit or dispatching motor pool, station or location, state or district, and country if not US) if the owner is military; use current mailing address of owner if civilian. Be sure to include zip code on all US addresses.

Enter name of insurance company or agent. If a company, the city and state will normally be all the address needed. If a private agent is given, list the complete address of the agent. No effort will be made to ascertain the limits of insurance of any of the parties.

Driver Information

If there was no driver in the vehicle at the time of the accident, enter "No driver" in name block. If the driver is a service member, enter last name, first name, middle initial, rank, and his military address (unit, station, state, zip code). If the driver is a dependent, enter last name, first name, middle initial, dependency status and abbreviated unit of sponsor (such as "d/wife of CPT Harry B. Smith, 3/19 Arty"). A dependent's local mailing address should also be entered here (including zip code). For civilians, list last name, first name, and middle initial. Enter a married woman's name as: "Jones, Mary E.," not "Mrs. Dave Jones."

Enter SSN for all US personnel. If foreign, use military identification number or appropriate civilian identification number. If no number is available or known, enter "UNK."

Enter age in years.

Place an "X" in appropriate block, "Male" or "Female."

If the driver is military and driving a military vehicle, enter the driver's military license number and the station where issued (such as: "USA-383-70, Fort McClellan, AL"). In the case of military personnel driving military vehicles and having military licenses, enter "US Government" in the block for "State." For civilians, including dependents, enter the operator's license number and issuing state. If an international license, note "Inter" in the block for "State."

If limitations or restrictions are stated on license of driver, mark an "X" in "Yes" block and specify. Examples are "glasses," "Day-time only," etc. If a military driver is operating a vehicle for which he is not qualified as indicated on his license, this is not to be entered here but should be noted on an appropriate citation and in the "Description of Collision" block. If no limitations are noted on the driver's license, put an "X" in the "No" block.

Enter the operator's driving experience in years. For drivers with less than one year of experience, cross out the word "years," add "months," and make the appropriate entry. Unless it is clearly unreasonable, the driver's word should be accepted for this information.

The numbers referring to "codes" are red on the form. These red numbers refer to the red numbers at the bottom of the page. Enter only the appropriate letter or number.

Codes

Category

A. Army Officer-- commissioned or warrant Army officer on active duty. Included are reservists and national guard personnel on active duty for training (ADT) status.

B. Army Enlisted-- enlisted Army personnel on active duty. Included are reservists and national guard personnel on ADT status.

C. Other Service Officer-- US Navy, Marine, Air Force, and Coast Guard, commissioned and warrant officers. Included are reservists and national guard personnel on ADT status.

D. Other Service Enlisted-- US Navy, Marine, Air Force, and Coast Guard enlisted personnel. Included are reservists and national guard personnel on ADT status.

E. Civilian-- all US civilians, including DA civilian employees.

F. Dependent-- dependents of all US service personnel.

G. Other-- foreign nationals (both military and civilian) should be included here.

Injury Class

A. No Injury-- entered when there are no apparent or claimed injuries on the part of the individual concerned.

B. Dead at Scene-- entered when competent medical authority has pronounced individual dead at the scene.

C. Dead on Arrival-- individual pronounced dead upon arrival at hospital or medical facility.

D. Died in Hospital-- individual alive upon arrival, but died while in hospital or medical facility.

E. Incapacitating Injury-- any injury that prevents the injured person from walking, driving, or normally continuing other activities. Includes severe lacerations, broken or distorted limbs, unconsciousness, etc. This does not include momentary unconsciousness, broken fingers and toes, simple complaint of pain, etc.

F. Non-Incap (Evident) Injury-- any injury other than fatal or incapacitating. Includes broken fingers or toes, abrasions, etc. This does not include limping, complaint of pain, nausea, momentary unconsciousness, etc.

G. Possible Injury-- any injury reported by the police or claimed by the individual, such as momentary unconsciousness, claim of injuries not evident, limping, complaint of pain, nausea, hysteria, whiplash, etc.

H. Injury Unknown-- applies when it is not possible to objectively determine, at the time of the accident, whether there is no injury (Code A) or possible injury (Code G).

Shoulder/Lap Belts

A. Lap Belt Used-- make this determination based on what is observed at the scene and what is told to you. If told the belt or belts were in use and there is evidence to the contrary, further inquiry may be necessary, or "Unknown" code may have to be used.

B. Shoulder Harness Used-- use the same guidance as with lap belt.

C. Both Used-- enter if both lap and shoulder harness were in use at the time of the accident.

D. Not Used-- enter if neither lap belt nor shoulder harness were in use at the time of the accident, but were installed in this seat position.

E. Not Installed-- enter if neither lap belt nor shoulder harness are installed in this position in the vehicle.

F. Lap Belt Failed-- applies only when the belt was in use and failed at the time of the accident. Thus, if a belt was used at the time of the accident, but failed, the appropriate code would be "F," not "A." Belt failure may consist of torn webbing, seat belt anchorage assembly torn from vehicle structure, bolt sheared off, buckle broken, and so forth.

G. Shoulder Harness Failed-- same guidance as with lap belt failures.

H. Both Failed-- lap belt and shoulder harness were both in use and both failed.

U. Unknown-- evidence as to use of belts is nonexistent, contradictory, or inconclusive. Investigator has no way of knowing if belts were in use.

Source: www.globalsecurity.org

Category: Accident

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