NJTR-1 Form Field Manual

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NJTR-1 Form

Field Manual

Prepared by

Rutgers University

Police Technical Assistance Program

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Co-Sponsoring Agencies:

New Jersey Division of Highway Safety

New Jersey State Police

New Jersey Motor Vehicle Commission

NJTR-1 Form

Field Manual

Prepared by

Police Technical

ssistance Pro

ram

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NJTR-1 Form Training

Table of Contents

Table of Contents Page 3

Locate Crash Page 4

Driver Identification Page 14

Owner/Vehicle Identification Page 22

Alcohol/Drug Test Page 26

HAZMAT/Commercial Vehicle Information Page 26

Occupant, Pedalcyclist or Pedestrian Information Page 28

Roadway System Page 37

Vehicles Involved in Crash Page 42

Apparent Contributing Circumstances Page 47

Crash Diagram Page 54

Crash Description and Damage to Other Property Page 54

Enforcement Action Page 55

Investigator Identification and Case Status Page 55

Preliminary Instructions Page 57

NJTR-1 Protocol Page 65

Intersection Diagram Page 66

Ramp Crash Diagram Page 67

Box 83-Unumbered Sample Entries Page 68

NJTR-1 A Page 69

Bus Seating Arrangement Diagram Page 70

School Bus Seating Diagram Page 71

Crash Type Examples Page 72

Vehicle Type / Cargo Body Type Page 73

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Locate Crash

Box

Page __

of __

In box (Page _______ of _______) located at the top left corner of the report, write the number(s) to identify the

page number(s) on (Page ____) which are numbered consecutively on each additional page.

In (of _____), write the total number pages for the crash report.

Box

Reportable,

Non –

Reportable,

Change

Report

In the grouping of 3 boxes (Reportable, Non-Reportable, Change Report) located at the top center-right of the

report, place an “X” in one of these boxes.

Box selection advises the processing agency to send specific data elements to NJDOT. In the case of fatal

crashes, follow the State Police fatal accident protocol. (Refer to NJTR-1 Protocol on page 65)

Reportable Crash: A crash that results in injury or death of any person or damage to property of any one person

in excess of $500.

Box

Fatal

In box (Fatal) located in the top center-left of the report, place an “X” if the crash involves a fatality.

If a person is killed, verify that code "01 - Killed" is written where column (box) 86 (Victim's Physical Condition)

intersects with its corresponding row. Also, verify that a number written in box 8 (Total Killed) corresponds with

the number of persons killed as a result of the crash. Lastly, verify that the name/address/date and time of death

is recorded in the unnumbered box to the right of Box 95 known as column box (Names & Addresses of

Occupants – If Deceased, Date & Time of Death).

If the fatality occurs after the initial investigation report, submit a change report. Refer to the NJSA 39: 5-30 (d)

Fatal Protocol.

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Box

In box 1 (Case Number), write the “department” case number where the crash occurred.

Case number shall be written on all

additional pages and on any change reports that are sent to NJDOT.

Contract Law Enforcement (Mutual Aid): For your information and use in box 1 (Case Number), when

investigating a crash in another jurisdiction use a case number from the reporting agency.

Identify the investigator’s agency in box 135 (Crash Description).

DO NOT WRITE ANY OTHER INFORMATION IN THIS BOX.

Box

In box 2 (Police Department of), write the name and one of the type of police agency codes for the police

department that generated the case number:

01- Municipal Police

02 - State Police

03 - County Police

04 - Port Authority Police (new code)

99 - Other Police (new code)

Contract Law Enforcement (Mutual Aid): For your information and use in box 2 (Police Department of), when

investigating a crash in another jurisdiction use a case number from the reporting agency.

Box

In box 3 (Station/Precinct), write the station/precinct if applicable for your department, otherwise enter a dash

(-).

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Box

In box 4 (Date of Crash), write the date that the crash occurred in (mm-dd-yy) format.

Fill in all boxes i.e.: 10-02-64.

Box

In box 5 (Day of Week), circle the appropriate day of the week that the crash occurred.

The day of week must correspond with the date of crash in box 4 (Date of Crash).

Box

In box 6 (Time), write the time of the crash.

If the time is unknown, write the time that the crash was reported to your agency.

Use military time

(e.g., 0001 hours to 2400 hours).

Box

In box 7 (Municipality Code), write the 4-digit National Crime Information Center (NCIC) Municipality Code

where the crash occurred.

For your information and use in box 7 (Municipality Code), the Fatal Accident Record System (FARS) must rely

on location information in box 2 (Police Department of) and box 7 (Municipality Code) to locate point of impact.

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Box

In box 8 (Total Killed), write the number of persons killed as a result of the crash. Use a two-digit code i.e. 01,

02, 03.

If no one was killed as a result of this crash, enter dashes (--).

If a person is killed, they cannot

be accounted for in Box 9 (Total Injured).

In box 8 (Total Killed), if a number is written, verify that code "01-Killed" is written where column Box 86 (Victim's

Physical Condition) intersects with its corresponding row. Also, verify that an "X" is placed in box – Fatal

, located

in the top center-left of the report. Lastly, verify that the name/address/date and time of death is recorded in the

unnumbered box to the right of box 95 known as column box (Names & Addresses of Occupants – If Deceased,

Date & Time of Death).

Note: Notify the State Police within 24 hours of the fatal as per NJSA 39: 5-30 (d)

Box

In box 9 (Total Injured), write the number of persons injured as a result of the crash. Use a two-digit number,

i.e.: 01, 02, 03.

If no one was injured as a result of this crash, enter dashes (--).

If a person is injured, they cannot be accounted for in box 8 (Total Killed). Never write “01 - Killed” in column

(box) 86 (Victim’s Physical Condition) for an injury crash.

If you write an entry other than dashes in box 9 (Total Injured), then write entries in columns boxes 86 (Victim’s

Physical Condition), 89 (Location of Most Severe Physical Injury), 90 (Type of Most Severe Physical injury), 91

(Refused Medical Treatment).

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Boxes

10-22

Boxes 10 through 22 identify the location where the crash occurred known as the first “harmful” event.

It is “important” that boxes 10 through 22 be filled out accurately and completely.

Boxes 10 through 22 will explain the location in a uniform way which will allow for clearer comparability of motor

vehicle traffic crash statistics and data.

In reference to boxes 10 through 22 and throughout the report, it has taken advantage of new data collection

methodologies as well as supports existing manual methods.

For example, Geographic Information Systems (GIS) technology may be used by to pin-point the exact locations of

crashes in box 21 (Latitude) and box 22 (Longitude).

Note: The box for the street address has been omitted. All crash locations that occurred on a street or highway will

be identified using the nearest intersecting road method.

On line (box) 10 (Crash Occurred On: Road Name, Direction), parking lot crashes will be identified by a street

address.

Box

On line (box) 10 (Crash Occurred On: Road Name, Direction), write the road name where the crash occurred. If

the crash occurred on an Interstate, US, state, toll, county highway, or local route, write the route number in box 12

(Route Number) and also write the milepost in box 13 (Milepost).

Identify the highest road authority on line (box) 10 (Crash Occurred On). If there are two roadways of the same

hierarchy, list in numeric order first and second by roadway names in alphabetical order, e.g.: 1st Street and Alpine

Way.

On line (box) 10 (Crash Occurred On: Road Name, Direction), be as specific as possible for geo-coding purposes .

Using the road name

along with the information on line (box) 14 (Distance), box 15 (comprised of a grouping of 3

boxes; At Intersection with, Feet, Miles), box 16 (comprised of a grouping of 4 boxes; Direction N, S, E, W) and on

line (box) 17 (Cross Road Name) will result in an accurate location of the crash.

The name of a business or such phrases as “parking lot,” “in front of,” or “near” are not applicable, words/phrases

may be documented in box 135 (Crash Description).

On line (box) 10 (Crash Occurred On/Road Name/Direction), the direction of the road is identified to the right of

road name on line (box) 10 (Crash Occurred On/Road Name/Direction). The direction (N, S, E, W) is identified as

the nominal direction for divided roadways and one-way streets.

A north-south road may actually run east-west for a segment; however the direction should not change from the

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Box

(Cont)

nominal direction for reporting purposes. The nominal direction may be obtained from road signs, identified on

maps or straight-line diagrams.

Note: Ramps and jug handles are identified utilizing a different method. Refer to boxes 19 (Ramp) and line (box) 20

(Route/Name) to identify these locations.

box 11 (Speed Limit), write the speed limit for the road identified on the line (box) 10 (Crash Occurred On: Road

Name, Direction). Write the statutory NJSA 39:4-98 or posted speed limit and not the advisory speed limit. Advisory

speeds are the speed limit signs with a yellow background and black letters and are used as a warning for a

potential driving hazard ahead.

Boxes

12-13

For box 12 (Route Number), if the crash occurred on an Interstate, US, state, toll or county route, the route

number shall be written in this box.

The box (Suffix) is located between box 12 (Route Number) and box 13 (Milepost). Route Suffix Codes shall be

written and not direction codes N, S, E and W.

For box 13 (Milepost), State and interstate roadways shall have milepost numbers written in this box.

ROUTE SUFFIX CODES

A - Alternate

B -

Business

C - Freeway

M - Mercer Alignment (I-95 only)

P - Pennsylvania Extension

(NJ Turnpike Only)

S - Spur (County Routes Only)

T - Truck (Rt. 1 & 9 Only)

U - Upper (State Route 139 Only)

L -

Lower (State Route 139 Only)

W - Western Alignment (NJ Turnpike, Rt. 9, Rt. 173)

In box 13 (Milepost), the entry requires three digits to the left and two digits to the right.

Example: A crash occurred on the Spur of County Route 518 at milepost 1.1. Boxes 12 and 13 should look like this:

Route Suffix Codes shall be written and not direction codes N, S, E and W.

Straight-line diagrams may be utilized to obtain the milepost numbers.

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Boxes

14,

15,

16,

On line (box) 17 (Cross Road Name), distance from the nearest cross road may be determined by writing the

cross road name.

Write the distance to nearest cross road on line (box) 14 (Distance) and place an "X" in one of the boxes (Feet,

Miles) located in box 15 (At Intersection with, Feet, Miles), place an “X” for direction in box 16 (comprised of 4

boxes; Direction N, S, E, W) which is in closest proximity from the crash location to the intersecting or non-

intersecting cross road.

In box 15 (At Intersection with, Feet, Miles), place an “X” in the box (At Intersection with) if the crash occurred at

an intersection and write the cross road name on line (box) 17 (Cross Road Name).

NJSA 39: 1-1

- “Intersection” means the area embraced within the prolongation of the lateral curb lines or, if none,

the lateral boundary lines of two or more highways which join one another at an angle, whether or not one such

highway crosses another) (Refer to Intersection Diagram on page 66)

On line (box) 14 (Distance), write in the distance to the nearest cross road name for crashes that do not occur at

intersections. Distances shall be measured from the center of the intersection to the point of impact for the crash.

Indicate the units of measurement to the nearest intersection on line (box) 14 (Distance).

Note: The NJTR- 1 does not contain a space for a second intersecting street. The accuracy of identifying the name

of, distance to and direction to the nearest cross road name is essential; e.g., a crash between two vehicles

occurred on Route 22, 500 feet west of Rock Road.

Most engineering agencies use distance increments of 1/100 of a mile when determining locations for crashes.

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Box

In box 18 (Speed Limit), write the speed limit for the road identified on line (box) 17 (Cross Road Name).

Put the statutory (NJSA 39: 4-98) or posted speed limit and not the advisory speed limit in box 18 (Speed Limit).

Advisory speeds are the speed limit signs with a yellow background and black letters and are used as a warning for

a potential driving hazard ahead.

Boxes

19-20

For box 19 (Ramp), a ramp is defined as an "auxiliary roadway used for entering or leaving through-traffic lanes."

A jug handle is also considered a ramp.

In box 19 (Ramp), if the crash occurred on a ramp from one roadway (state, interstate, toll authority, county, or

local) to another, the crash is considered occurring on the ramp and will be investigated in the following order:

Box 10 Crash Occurred On/Road Name/Route #

Box 14 Distance "To" or "From" the secondary roadway

Box 19 Exits will be selected “To”, Entrances will be selected “From”.

Box 15 Select "Feet" or "Miles" (never select “At Intersection with” for a ramp)

Box 20 Exit, route, or secondary road name

Box 20 Code NB-Northbound SB-Southbound EB-Eastbound WB-Westbound

"The following is an example for coding a crash that occurred on a ramp leading from I-295 North to SH 73 South

approximately 200 feet from SH 73".

Reference Material: Ramp Crash Diagram on page 67.

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Boxes

19-20

(Cont)

When investigating a ramp crash, write the road name and route number for the primary roadway on line (box) 10

(Crash Occurred On: Road Name, Direction).

Place an "X” in either box (To) or box (From) located in (box) 19 (Ramp).

Write the route number and/or road name that the vehicle was traveling "to" or "from" on line (box) 20

(Route/Name).

Place an "X" in the appropriate box (NB, SB, EB, WB) that the vehicle was traveling to the right of line (box) 20

(Route/Name).

If any ramp or surface street has a road name, write the road name too.

Ramp entries are made by first determining the appropriate road hierarchy. Road hierarchy involves determining

which road is listed first on line (box) 10 (Crash Occurred On: Road Name, Direction).

The road hierarchy to the right is listed in descending order:

Interstate

State/Interstate Authority

State Highway

County

Municipal

U.S Government Property

State Park or Institution

County Authority, Park or Institution

Municipal Authority, Park or Institution

Private Property

On line (box) 10 (Crash Occurred On: Road Name, Direction), identify which road is primary in a ramp crash.

A ramp is an extension of the primary (main) roadway.

It is important to determine the primary and secondary roadway in order to write the appropriate name for the

primary road in box 10 (Crash Occurred On: Road Name, Direction) or the secondary roadway name on line (box)

20 (Route/Name).

The secondary roadway will always be written on line (box) 20 (Route/Name).

Once again in a ramp crash, on line (box) 20 (Route/Name), write the secondary roadway name.

Box 19 (Ramp) will be used to describe if the crash occurred on a ramp “to” or “from” the secondary roadway. In

some cases regarding ramps, orient location on the milepost number in proximity to the crash and from the milepost

takeoff point.

Line (box) 14 (Distance) identifies the location and distance of the crash on the ramp.

A distance will be identified “to” or “from” the secondary roadway written on line (box) 20 (Route/Name).

Reference Material: Ramp Crash Diagram on page 67.

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Boxes

19-20

(Cont)

Ramp crash investigation:

Box 10. Write the name or route number of the primary roadway, including direction of travel.

Box 11. Write Speed Limit of the primary roadway listed on line (box) 10 (Crash Occurred On: Road Name,

Direction).

Box 12. Enter the route number of the Roadway listed on line (box) 10 (Crash Occurred On: Road Name,

Direction) and the suffix if applicable.

Box 20. Write the secondary roadway and the direction to which the ramp connects.

Box 19. If the collision occurred on a ramp leading to the roadway listed on line (box) 20 (Route/Name), place

an “X” in the “To” box in box 19 (Ramp).

If the collision occurred on a ramp leading from the roadway listed in on line (box) 20 (Route/Name),

place an “X” in the “From” box in box 19 (Ramp).

Box 14. Write the distance of the collision relative to or from the roadway listed on line (box) 20 (Route/Name).

For line (box) 10 (Crash Occurred On: Road Name, Direction), the lower numbered highway on the same hierarchy

will be the primary highway.

If the crash did not occur on a ramp, enter a dash (-) on line (box) 20 (Route/Name).

Reference Material: Ramp Crash Diagram on page 67.

Boxes

21-22

For box 21 (Latitude) and box 22 (Longitude), write in the latitude and longitude coordinates of the crash location

in the appropriate boxes if your department has deployed a Global Positioning System (GPS).

If GPS receiver is available, take the GPS coordinates at the crash point of impact.

If you are not equipped with a GPS receiver, enter dashes (--) in box 21 (Latitude) and box 22 (Longitude).

Note: This form is designed for the GPS readouts in decimal degrees, not hours, minutes and seconds.

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Driver Identification

Box

and/or

In box 23 and/or 53 (Vehicle Number), write a sequential two-digit code/number for each motor vehicle starting

with number "01."

Identify in the following order: Motor vehicles; pedalcyclist; pedestrians.

Write the code for pedalcyclist starting with "B1" and "P1” for the pedestrian.

Write code for multiple pedalcyclists/pedestrians as B2, B3, P2, P3, etc., on additional pages using one case

number.

In box 23 and/or box 53 (Vehicle Number), pedalcyclists/pedestrians

will be identified throughout the report with the corresponding

position that they are assigned in these boxes e.g., a

pedalcyclists/pedestrians listed in the second position box 53

(Vehicle Number) would be further described or recognized in the

boxes designated for vehicle #2 as depicted on the report overlay.

Box

and/or

In box 24 and/or box 54 (Policy Number), write the motor vehicle’s insurance policy number as it appears on

the State of New Jersey Insurance Identification Card.

If a New Jersey registered vehicle has no insurance, write “uninsured”.

For out-of-state registered vehicles, write the policy number, as it appears on the Insurance Identification Card.

If a policy number is not available, place an asterisk (*) in box 24 and/or box 54 (Policy Number) and explain in

box 135 (Crash Description).

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Box

and/or

In box 25 and/or box 55 (Insurance Code), write the motor vehicle's insurance code, as it appears on the State

of New Jersey Insurance Identification Card.

If the insurance code is missing, place an asterisk (*) in box 25 and/or box 55 (Insurance Code) and explain in

box 135 (Crash Description).

Insurance codes are necessary to send an inquiry to the Insurance Company and verify coverage.

Insurance card information is necessary to send an inquiry to the insurance company and to verify coverage.

The links for New Jersey Insurance codes:

5 digit code www.nj.gov/dobi/data/inscomp.htm

3 digit code www.state.nj.us/mvc/numeric.pdf

For out-of-state registered vehicles

, place an asterisk (*) in box 25 and/or box 55 (Insurance Code) and write the

name of the insurance company in box 135 (Crash Description).

Box

Park, Ped,

Pedalcyclist,

Resp. to

Emergency,

Hit & Run

In box (Parked, Ped, Pedalcyclist, Resp to Emergency, Hit & Run) grouped beneath box 24 (Policy Number)

and box 25 (Insurance Code) as well as box 54 (Policy Number) and box 55 (Insurance Code), respectively, place

an "X" to ensure that first responders (Resp to Emergency), owner of a parked vehicle, a pedalcyclist, a

pedestrian, or the victim of a hit and run

does not have this crash charged to their driver record and insurance

surcharges assessed.

Circle the box (Resp to Emergency) when applicable.

In box (Responding to an Emergency)

, place an "X" and circle this box only for motor vehicles responding to an

emergency which includes volunteer Fire/Ambulance personnel in their personal vehicles.

If Responding to Emergency is selected in the Driver Identification section, you shall write in code "04 -

Responding to Emergency" in boxes 110 and/or 111 (Vehicle Use).

In box (Hit & Run)

, place an "X" in this box for the "actor" never for the "victim."

Draw a diagonal line starting from box 23 through 47 or box 53 through 77 and write in the phrase “Hit & Run” on

line (box) 26 and/or 56 to indicate that the driver/owner information is not available.

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Box

and/or

In box 26 and/or box 56 (Driver's Name), write the first name, middle initial and last name of the driver as it

appears on the license.

Write the same information for a pedalcyclist or pedestrian.

If there is no middle initial, enter a dash (-).

If driver/operator has an apostrophe in their surname (O’Conner), the “O” is part of the last name “NOT” the

middle initial.

Boxes

and/or

In box 27 and/or box 57 (Number and Street), write the street address as it appears on the driver’s license.

Change of address

may be used if identified on the driver’s license.

If change of address is identified as the result of interview, explain in box 135 (Crash Description).

Write the number and street for a pedalcyclist or pedestrian as it appears on the driver's license or as the result of

interview.

For your information and use in box 27 and/or box 57 (Number and Street), if there is an Rural District (RD) or

Rural Route (RR) number and/or a Post Office (PO) Box Number, interview for the street address, write in

brackets { } the actual name of the road adjacent to the RD, RR or PO Box Number.

Explain in box 135 (Crash Description).

Box

and/or

In box 28 and/or box 58 (City, State, Zip), write the city, state and zip code, as it appears on the driver’s license.

Write the city, state and zip for a pedalcyclist or pedestrian as it appears on the driver's license or as the result of

interview.

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Box

and/or

In box 29 and/or box 59 (Sex), write “M” or “F” for the sex as it appears on the driver's license:

M = MALE F = FEMALE

Box

and/or

In box 30 and/or box 60 (Eyes), write the N.J. eye

color two-digit code for the driver as it appears on the

driver's license.

Use the N.J. Eye Code Chart.

Box

and/or

In box 31 and/or box 61 (State), write the standard abbreviation for the state as it appears on the driver's

license.

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Box

and/or

In box 32 and/or box 62 (Drivers License Number), write the number as it appears on the driver's license.

If the driver is unlicensed, write “NONE” in box 32 and/or 62 (Drivers License Number). Explain in box 135 (Crash

Description).

If the driver has a permit, write the permit number followed by the word “PERMIT" in box 32 and/or 62 (Drivers

License Number). Explain in box 135 (Crash Description).

Box

and/or

In box 33 and/or box 63 (DOB), write the date of birth using month, day and year (mm/dd/yy) format of the

person listed in box 26 and/or box 56 (Driver's Name).

Use a two-digit code for month, date and year e.g., the date of birth for September 14, 1970 is 09/14/70.

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Box

and/or

In box 34 and/or box 64 (Expires), write the expiration date as it appears on the operator's driver's license using

the month and year (mm/yy) format.

Use a two-digit code for month and year i.e., the expiration date for March 1996 is 03/96.

Sample License

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Features of a New Driver

License

Reading the Long Numbers

Middle Initial Codes

61 = A 71 = J 82 = S

62 = B 72 = K 83 = T

63 = C 73 = L 84 = U

64 = D 74 = M 85 = V

65 = E 75 = N 86 = W

66 = F 76 = O 87 = X

67 = G 77 = P 88 = Y

68 = H 78 = Q 89 = Z

69 = O 79 = R 00 = No Middle

Initial

01-60, 70, 80, and 81 are invalid codes

Month of Birth Code

The male month of birth code is normal

01 January 05 May 09 September

02 February 06 June 10 October

03 March 07 July 11 November

04 April 08 August 12 December

Fifty (50) is added to the month of birth for females

51 January 55 May 59 September

52 February 56 June 60 October

53 March 57 July 61 November

54 April 58 August 62 December

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Eye Color Codes

1= Black

2= Brown

3= Gray

4= Blue

5= Hazel

6= Green

7, 8, 9, and 0 are tie breakers

Reading a Transaction Number

Other Security Features

• Under 21 licenses have a profile photo (Digital licenses will

have a head on photo but the orientation of the license will

be vertical)

• The plate number should be ½ on the picture

• All licenses expire at the end of the month regardless of

when in the month they ere issued

• All writing is in capital letters

• All dates on license use a 4 digit year

• The eye color is always a contraction (BRN, BLK, GRY, BLU,

HAZ, GRN)

The New Jersey Digital License

• Being issued now at some MVC agencies

• Old style ceased being issued 07-01-2004

• The last of the old style will be valid until 2008

• No more non photo licenses will be issued

• All codes are the same as the old license

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Owner/Vehicle Identification

Box

and/or

In box 35 and/or box 65 (Owner's Name), write the vehicle owner’s first name, middle initial and last name as it

appears on the registration.

If there is no middle initial, enter a dash (-).

If the driver is also the owner, and the license and registration documents contain identical information, place an

“X” in the “Same As Driver” box located in box 35 and/or box 65 (Owner's Name).

Box

and/or

For your information and use in box 36 and/or box 66 (Number and Street), write the number and street as it

appears on the registration. If there is an Rural District (RD) or Rural Route (RR) number and/or a Post Office

(PO) Box Number, interview for the street address, write in brackets { } the actual name of the road adjacent to

the RD, RR or PO Box Number.

Explain in box 135 (Crash Description).

If you have selected the “Same as Driver” located in box 35 and/or box 65 (Owner's Name), then write “SAME" in

box 36 and/or box 66 (Number and Street).

Box

and/or

In box 37 and/or box 67 (City, State, Zip), write the city, state and zip code as it appears on the registration.

If you have selected the “Same as Driver” box located in box 35 and/or box 65 (Owner's Name), then write

“SAME” in box 37 and/or box 67 (City, State, Zip).

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Box

and/or

In box 38 and/or box 68 (Make), write the vehicle manufacturer’s name for make e.g., Ford, Chevy, BMW etc.

Box

and/or

In box 39 and/or 69 (Model), write the vehicle’s model as it appears on the registration e.g., Escort, Corvette,

525i, etc.

Do not

identify by the model's style e.g., 4-door, sedan, etc.

Box

and/or

In box 40 and/or box 70 (Color), write vehicle’s color spelled out completely e.g., red, blue, etc., although color

appears as an abbreviation (RD, BL, etc.) on the registration.

Box

and/or

In box 41 and/or box 71 (Year), write the vehicle’s year in (yyyy) format as it appears on the registration.

No abbreviations.

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Box

and/or

In box 42 and/or box 72 (Plate Number), write the vehicle’s license plate number in as it appears on the

registration, include temporary registration.

Do not

write unconfirmed or partial registration information in this box.

Explain unconfirmed, partial, or temporary registration in box 135 (Crash Description).

Box

and/or

In box 43 and/or box 73 (State), write the standard abbreviation for state as it appears on the registration.

Box

and/or

In box 44 and/or box 74 (VIN), write the entire

vehicle identification number (VIN) as it appears on the

registration. A traditional VIN is 17 characters.

Since 1968, most domestic passenger cars were assembled with a Vin Plate

that is visible through the windshield

on the left side of the dash. The VIN may also be found on the nomenclature plate located on the driver’s door.

This number must match the registration and insurance card.

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Box

and/or

In box 45 and/or box 75 (Expires), write the expiration in month and year (mm/yyyy) format as it appears on the

registration.

Use a two-digit code for month and a four-digit code for year.

The code for March 2005 is 03/2005.

Box

and/or

In box 46 and/or box 76 (Vehicle Removed To), place an “X” in one of the boxes (Driven, Left at Scene, Towed)

located if the vehicle was driven, left at the scene or towed. Write the name of the tow company if the vehicle

was towed in box 46 and/or 76.

If vehicle was driven away, place an "X" in the box (Driven) and enter a dash (-) in box 46 and/or box 76 (Vehicle

Removed To) in the space provided.

Place an “X” in one or both of the boxes (Impound, Disabled) to the right in boxes 46 and/or 76 (Vehicle Removed

To) if the vehicle was impounded or disabled. The authority to remove a disabled vehicle from the roadway,

whether involved in a crash or not, is NJSA 39: 4-136.

Box

and/or

In box 47 and/or box 77 (Authority), place an “X” in the appropriate box (Owner, Driver, Police) located in box

47 and/or box 77 (Authority) for the authority that approved a vehicle’s removal .

V1.00-112805

Registration Sample

Drug/Alcohol Test

Box

and/or

Box 48 and box 78 (Alcohol/Drug Test) identify if alcohol or drug tests were conducted. Complete this

section for all drivers, pedalcyclists and pedestrians.

Box (Given): Place an “X” in one of the grouping of boxes (No,Yes, Refused) if test is given.

Box (Type): If you placed an “X” in box (Yes) in box (Given), then place an “X” in one of Type

grouping of

boxes (Breath, Blood, Urine).

Box (Results): Write the results on line box ( __ %) or place an “X” in box (Pending).

If the specimen was sent to a lab, place an "X" in box (Pending).

Do not hold this report to await lab results. Once the results are received from the lab, submit a

"change" report that identifies the test results.

HAZMAT/Commercial Vehicle Information

Box

and/or

Box 49 and box 79 (Hazardous Material) identify HAZMAT cargo.

In boxes (On Board, Spill) located in box 49 and box 79 (Hazardous Material), place an "X" to identify if

hazardous materials (HAZMAT) are present at the crash. This refers to hazardous cargo only.

Do not

place an "X" in one of the boxes (On Board, Spill) if only engine fluids are spilled. This is done for

NJDEP reporting purposes to clarify hazardous cargo.

V1.00-112805

Box

and/or

(Cont)

For your information and use in box 49 and/or box 79 (Hazardous Material), placards are required on any

vehicle that carries more than 1,000 pounds of Hazardous Material.

Refer to Federal Motor Carrier Safety Administration website at:

http://www.fmcsa.dot.gov/safety-security/hazmat/complyhmregs.htm#hm

In box (Diamond) located in the center of box 49 and/or 79 (Hazardous Material) identify the one (1) digit

number that is displayed at the bottom of the placard.

On line (box) (Name or Placard Number) identify the hazardous material by writing the 4-digit code in box

49/79 (Hazardous Material) from the placard displayed on the vehicle.

In box 49 and/or box 79 (Hazardous Material), write the name of the HAZMAT along the placard number line if

a number is not available.

If more than one placard is displayed, explain additional placard information in box 135 (Crash Description).

Box

and/or

In box 50 and box 80 (Carrier Number), write the USDOT Carrier number of the commercial vehicle. All

commercial vehicle carriers that are involved in interstate transport must have a USDOT number. NOTE: The

carrier and owner can be different entities and must be verified.

If additional owners and carriers are involved, write the carrier number and name in box 135 (Crash

Description).

For your information and use in box 50 and/or box 80 (Carrier Number), the majority of the USDOT numbers

may be found on the driver’s side of the vehicle and it is important to correctly identify the motor carrier USDOT

number even in cases where the numbers are not located anyplace on the vehicle. The USDOT number may

also be found on the passenger side of the vehicle. Look for a number preceded by the letters: USDOT.

You shall write the number of the MOTOR CARRIER THAT IS RESPONSIBLE FOR THE CARGO.

For your information and for use in box 50 and/or box 80 (Carrier Number), an interview with the driver will

determine the following:

a) Leased or rented vehicle?

b) Motor carrier responsible for the cargo?.

c) Who is directing & controlling the movement of the vehicle?

d) Motor carrier’s principal place of business?

Correct identification will reveal the motor carrier’s USDOT safety status.

V1.00-112805

Box

and/or

In box 51 and/or box 81 (Commercial Vehicle Weight), place an "X" in one the appropriate boxes ( ≤ 10,000

lbs, 10,001 to 26,000 lbs, ≥

26,001 lbs) to identify the commercial vehicle’s Gross Vehicle Weight Rating

(GRWR):

Box ( ≤ 10,000 lbs) - Weight is less than or equal to 10,000 lbs.

Box (10,001 to 26,000 lbs) - Weight is equal to or greater than 10,001 lbs but less than 26,000 lbs.

Box ( ≥ 26,001 lbs) - Weight is equal to or greater than 26,001 lbs.

For your information and for use in box 51 and/or box 81 (Commercial Vehicle Weight), although a vehicle

displays commercial plates, it does not necessarily mean that the vehicle will be considered a commercial

vehicle for crash report purposes. A Commercial Motor Vehicle (CMV) is defined as any one of the following:

A) A vehicle that has a GVWR of 10,001 pounds or more.

B) A vehicle that carries hazardous material (HAZMAT) and is required to display or displays a placard.

C) A vehicle that carries 16 or more people, including the driver.

D) Any other vehicle that requires a Commercial Drivers License (CDL) e.g., livery/limo.

Box

and/or

In box 52 and/or box 82 (Carrier name), write the commercial vehicle carrier name for each vehicle that

corresponds with the USDOT Carrier number in box 50 and/or box 80 (Carrier Number).

Occupant, Pedalcyclist or Pedestrian Information

Boxes

83-95

The “Persons Involved Data” table is a matrix in the crash report that records important information about all

persons involved in the crash.

This table is labeled by rows and columns; rows A through E down the left side, beginning in column (box) 83;

columns (boxes) 83 through 95 across the top.

Entries must begin in column (box) 83 using the appropriate codes listed for columns (boxes) 83, 84, 85, 86,

89, 90, 91, 92 and 93. Column box 87 (Sex) and column box 88 (Age) shall be written by investigator.

V1.00-112805

Boxes

83-95

(Cont)

For your information and use in the "Persons Involved Data" table, if a code is written in box 8 (Total Killed)

and/or box 9 (Total Injured), you shall write entries in the following column (boxes) to correspond with those

entries in box 8 and/or 9:

- Column (box) 86 (Victim’s Physical Condition),

- Column (box) 89 (Location of Most Severe Physical Injury),

- Column (box) 90 (Type of Most Severe Physical Injury) and

- Column (box) 91 (Refused Medical Treatment).

The "Persons Involved Data" table only allows room to write in five (5) persons (one per row).

If more than 5 persons are involved, use supplementary report form NJTR-1A for an additional 5 persons.

For more than 5 additional persons extend the lines on the NJTR-1A and write the information for the additional

persons.

Reference Material: Sample Entries Box 83 – Unnumbered on page 68.

Reference Material: Form NJTR-1A page 69.

Box

Under column (box) 83 (Which Vehicle Occupied), all passengers

shall be accounted for including the non-injured.

If a person was in vehicle #1, write "01" in row A under column (box) 83.

For additional persons in vehicle #1, write "01" in rows B through E

under column (box) 83.

If vehicle #1 has no persons, start listing data about vehicle #2. For

vehicles #3, #4, #5, write "03," "04" and "05" in the appropriate row.

For your information and for use in column (box) 83 (Which Vehicle

Occupied), A person in a wheelchair, including electric or battery

operated mobility devices are defined in NJSA 39: 1-1 as a

pedestrian.

Write the code for a pedalcyclist starting with "B1" and "P1” for a

pedestrian.

Write code for multiple pedalcyclists and pedestrians as B2, B3, P2, P3,

etc., in column (box) 83 in the appropriate row.

V1.00-112805

Box

In column (box) 84 (Position In/On-Vehicle), use the diagram for each person inside or hanging onto the

vehicle.

A person sitting on someone’s lap has the same numbered position as that person.

If there are 4 persons in a vehicle sitting in front seat, the 4th person is listed in the #2 position as an additional

#2 person adjacent to the appropriate row, which will reveal that the person was the fourth person sitting in the

front seat.

In column (box) 84 (Position In/On-Vehicle), if the 4th person in the vehicle is sitting in the rear seat, they are in

the #5 position along with the 5

person in the rear seat.

A passenger on a motorcycle is in the #4 position, except if the motorcycle has a sidecar and then the

motorcycle passenger would be in the #3 position.

A person “Riding/Hanging on the Outside” of a vehicle would be in the #11 position.

For Pedalcyclists and Pedestrians, always enter a dash (-)

In column (box) 84 (Position In/On-Vehicle), passengers in a bus are in the located in #10 position. Additional

passengers should be listed in a “Bus Seating Arrangement” diagram and attached to the report. The "Persons

Involved Data" table and "Bus Seating Arrangement" are required to complete the investigation.

All passengers must be accounted for in the “Persons Involved Data” table [columns (boxes) 83 through 95].

Reference Material: Bus Seating Arrangement on page 70.

Reference Material: School Bus Seating Diagram on page 71.

Box

Column (box) 85 (Ejection From Vehicle) write the code to identify if a driver or passenger was ejected from

a vehicle e.g., car, motorcycle, etc.

V1.00-112805

Box 85

(Cont)

Column (box) 85 (Ejection From Vehicle) does not apply to a pedalcyclist.

Partial Ejection: When a portion of the person’s torso or head protrudes from the vehicle. Note: A passenger

with his or her arms protruding out of a window is not a partial ejection.

Trapped: When mechanical force is used to free a person from the vehicle, such as a pry-bar or the Jaws of

Life.

Box

For your information and use in column (box) 86 (Victim's Physical Condition), if there is an injury then the

crash is "reportable."

In column (box) 86 (Victim's Physical Condition), write the code to identify the level of severity of an injury.

If there is no injury

, enter a dash (-) in box 86 (Victim's Physical Condition). A dash (-) is also required in box 8

(Total Killed) and box 9 (Total Injured).

If there is a dash (-) in column (box) 86 (Victim’s Physical Condition), enter a dash (-) in column (box) 89

(Location of Most Severe Physical Injury), column (box) 90 (Type of Most Severe Physical Injury) and column

(box) 91 (Refused Medical Treatment).

For your information and use in column (box) 86 (Victim's Physical Condition), KILLED IS NOT INJURED

If a person is killed, write code "01-Killed" where column (box) 86 (Victim's Physical Condition) intersects with

its corresponding row.

Verify that an "X" is placed in the box (Fatal) located at the top center-left of the report. Also, verify that a

number written in box 8 (Total Killed) corresponds with the number of persons killed as a result of the crash.

Lastly, verify that the name/address/date and time of death is recorded in the unnumbered box to the right of

Box 95 known as column box (Names & Addresses of Occupants – If Deceased, Date & Time of Death).

Reference Material: NJTR-1 Protocol on page 65.

V1.00-112805

Box

Where column (box) 87 (Age) intersects with its corresponding row, write the age of each person. Use a two-

digit code/number, e.g., 01, 02, 03, etc.

If victims are under 1 year old, write the two-digit number of the month followed by an “M” for month, e.g., 01M

through 11M.

Write 01M for all infants below the age of 2 months.

11M includes all days and weeks up to one year.

Reference Material: NJTR -1A on page 69.

Box

Where column (box) 88 (Sex) intersects with its corresponding row, write the sex of each person.

M=Male F=Female

Reference Material: NJTR -1A on page 69.

V1.00-112805

Box

In column (box) 89 (Location of Most Severe

Physical Injury), write the code to identify the

location

on the body of the most severe physical injury

from the crash.

The investigator must

ascertain the injuries at the

scene of the crash, not from a doctor’s diagnosis or

hospital records.

Example: If the driver had a severe head injury, a

broken arm and body contusions, the head injury is

identified as the most severe

, which is code "01 -

Head Injury."

Note: If there is a dash (-) in column (box) 86

(Victim’s Physical Condition), enter a dash (-) in

column (box) 89 (Location of Most Severe Physical

Injury), column (box) 90 (Type of Most Severe

Physical Injury) and column (box) 91 (Refused

Medical Treatment).

Reference Material: NJTR -1A on page 69.

V1.00-112805

Box

Where column (box) 90 (Type of Most Severe Physical Injury) intersects with is corresponding row, write

the code to describe the type of the most severe physical injury that the person sustained as a result of the

crash.

The investigator must

ascertain the injuries at the scene of the crash, not from a doctor’s diagnosis or hospital

records.

Note: If there is a dash (-) in column (box) 86 (Victim’s Physical Condition), enter a dash (-) in column (box) 89

(Location of Most Severe Physical Injury), column (box) 90 (Type of Most Severe Physical Injury) and column

(box) 91 (Refused Medical Treatment).

Reference Material: NJTR -1A on page 69.

Box

Where column (box) 91 (Refused Medical Treatment) intersects with its corresponding row, write the code to

identify if immediate medical treatment was refused.

Write code “01-Yes” if the person sustained or claimed an injury but refused immediate medical treatment.

V1.00-112805

Box

(Cont)

Write code “02-No” if the person was treated and/or transported to a medical facility.

Enter a dash (-) if the person claimed no injuries

Note: If there is a dash (-) in column (box) 86 (Victim’s Physical Condition), enter a dash (-) in column (box) 89

(Location of Most Severe Physical Injury), column (box) 90 (Type of Most Severe Physical Injury) and column

(box) 91 (Refused Medical Treatment).

Reference Material: NJTR -1A on page 69.

Boxes

and

Where column (box) 92 (Safety Equipment Available and Used) and

where column (box) 93 (Safety Equipment Available and Used)

intersect with their corresponding rows, write the code(s) in both

columns (boxes) for each person in the crash, whether injured or

not.

Where column (box) 92 (Safety Equipment Available and Used)

intersects with its corresponding row, write the code to identify the

safety equipment AVAILABLE

Most late model cars will be coded in column (box) 92 as available

(e.g. “09-Airbags and Seat Belts”).

Where column (box) 93 (Safety Equipment Available and Used)

intersects with its corresponding row, write the code to identify the

safety equipment USED

Although equipment may be available in some cases it might not

have deployed or have been used (e.g. “09-Airbags and Seat

Belts”).

For your information and for use in column (boxes) 92 and 93, if an

airbag does not deploy

, it is not considered used in column (box) 94

(Airbag Deployment).

If helmet is not NJDOT approved, explain in box 135 (Crash

Description).

Enter a dash (-) in column (box) 92 (Safety Equipment Available and

Used) and column (box) 93 (Safety Equipment Available and Used)

for pedestrians. Where code "10-Safety Vests" is applicable, "01-

None Used" is an invalid entry in these boxes.

Reference Material: NJTR -1A on page 69.

V1.00-112805

Box

Where column (box) 94 (Airbag Deployment) intersects with its corresponding row, write the code for the

airbag type deployed for each person

01 - Front

02 - Side

07 - Other

08 – Multiple

Reference Material: NJTR -1A on page 69.

Box

In column (box) 95 (Hospital Code) intersects with its corresponding row, write the HOSPITAL CODE

NUMBER where the person is taken for treatment.

The hospital codes are listed on the NJ Department of Health and Senior Services webpage at

http://www.state.nj.us/health/ems/jems.pdf

Reference Material: NJTR -1A on page 69.

Box

Un-

Numbered

In the unnumbered column (box) (Names & Addresses of Occupants – If Deceased, Date & Time of

Death) to the right of column (box) 95 (Hospital Code Number) where it intersects with its corresponding row,

write the names and addresses for all drivers, passengers, pedalcyclists and pedestrians.

It is permissible to abbreviate names and addresses of occupants by writing "0(zero)1-Vehicle," "B1-

Pedalcyclist" "P1-Pedestrian," and "O1-Other."

Verify that an "X" is placed in the box (Fatal) located at the top center-left of the report. Also, verify that a

number written in box 8 (Total Killed) corresponds with the number of persons killed as a result of the crash.

Lastly, verify, that code "01-Killed" is written in column (box) 86 (Victim's Physical Condition).

Reference Material: Sample Entries For Columns 83 through 95 page 68.

Reference Material: NJTR -1A on page 69.

V1.00-112805

Roadway System

Box

In box 96 (Road Divided By), write the code for

the physical separation dividing the roadway .

“01 - Barrier Median” - Any physical separation

that precludes the vehicle from

traversing the median (i.e. guide rail, jersey

barrier, wooded areas).

“02 - Curbed Median” - Any median that divides

traffic lanes that has a sloped or vertically curbed

edging along or around the median.

“03 - Grass Median” - Any traversable grass

median.

“04 - Painted Median” - Any separation between

live lanes that is painted with double yellow lines

and cross-hatching. Painted center lines on the

roadway alone are not considered medians, “05-

None” in column (box) 96 (Road Divided By).

“05 – None” - If no physical separation is present,

or if the crash occurs in an intersection.

Box

In box 97 (Temporary Traffic Control Zone) identify if work was being conducted in

proximity to the crash. Explain all relevant information in box 135 (Crash Description).

A Construction Zone is defined as a roadway construction zone that displays signs

warning of a construction zone longer than one day. The construction zone begins at the

first construction sign and ends at the last sign as per MUTCD Part VI .

A Maintenance Zone is defined as any short-term work zone set up for one day or less.

A Utility Zone is either a construction or maintenance zone established by any public or

private utility.

An Incident Zone is an area of a highway where temporary traffic controls are imposed by

authorized officials in response to a road user incident, natural disaster, or special event.

V1.00-112805

Box

(Cont)

V1.00-112805

Box

In box 99 (Road System), write the code to identify

the road system.

US Routes are identified as "02 - State Highway.”

The road system code must correlate with the entry

on line (box) 10 (Crash Occurred On/Road Name).

If codes "01 - Interstate," "02 – State Highway," or

"03 – State/Interstate Authority" are used, write the

milepost number in box 13 (Milepost).

School parking lots and driveways as well as any

land owned and maintained by a governing body are

to be “coded.” Example: an elementary school will

be coded "08 – Municipal Authority Park or

Institution," a county college will be coded "06 –

County Authority, Park or Institution" and a State

college will be coded "04 – State Park or Institution."

Note: Toll roads, Palisades Interstate Parkway,

Interstate Bridges Commissions are coded as “03 –

State/Interstate Authority" (code change).

For your information and use in box 98 (Light Condition), write the code for the light

condition at the time of the crash, which may be different from the time you conduct your

investigation.

Continuous lighting means that a roadway is fully lit along its length.

Spot lighting indicates a roadway where there is alternating dark spots and lighted areas

along the roadway.

When street lights are inoperable, write code “04 - Dark, Street Lights Off” in box 98 (Light

Condition).

LIGHT CONDITION

01 Daylight

02 Dawn

03 Dusk

04 Dark (street lights off)

05 Dark (no street lights)

06 Dark (street lights on, continuous)

07 Dark (street lights on, spot)

V1.00-112805

Box

100

In box 100 (Road Character), write the code

that best describes the roadway at the

location of the first event.

Road character data is used to determine

sight distance from an engineering point of

view and should describe the alignment of the

road.

Box

101

Box 101 (Road Surface Type) refers to the

physical makeup of the road at the location of

the crash. Examples include:

Concrete

- Portland cement concrete

Blacktop

- Bituminous concrete (asphalt),

including chip road sealing (oil and stone) and

macadam

Other

- Must be explained in box 135 (Crash

Description); i.e.: cobblestones, wood (bridge

decks), steel construction plates, etc.

V1.00-112805

Box

102

Box

103

In box 102 (Road Surface Condition), write the

code to identify the road surface at the time and

location of the crash.

Include foreign substances such as vehicle fluids

that were present prior to the crash and explain

as "other foreign substances" in box 135 (Crash

Description).

Oil includes all petroleum products.

Only choose one code .

In box 103 (Environmental Condition),

write the code for the weather condition at

the time

of the crash.

Only choose one code.

Additional comments should be explained

in box 135 (Crash Description).

V1.00-112805

Vehicles Involved In Crash

Box

104

Box

105

In box 104 (Total Number of Motor Vehicles Involved in Crash), write the two-digit

code/number for the total number of motor vehicles involved in the crash.

The total vehicles involved in the crash shall correspond with the number of owners in box 35

and/or box 65 (Owner’s Name) that are identified in the NJTR-1.

Pedalcyclists or pedestrians are not accounted for (identified) in box 104 (Total Vehicles

Involved in Crash).

In box 105 (Crash Type), write the code that most

accurately describes the crash type.

This box describes the first event of the crash.

Encroachment is a situation where a vehicles’ lane of

travel is entered by another vehicle

Reference Material: NJTR 1 Overlay, Page 2 “Crash

Type Examples on page 72.

V1.00-112805

Boxes

106

and

107

Boxes

108

and

109

Box 106 and box 107 (Oversize/Overweight Permit) is for

commercial vehicles and only to be used in commercial vehicle

crashes.

All other types of vehicles enter a dash (-).

Write code "01 - Yes" if oversize/overweight permit issued by

NJDOT.

In box 108 and/or box 109 (Vehicle Type) identify each vehicle involved by type.

Codes “01-19 Passenger Vehicles” - A GVWR less than or equal to 10,001 pounds or seats less

than 9 passengers (GCWR=Gross Combination Weight Rating)

Code “03 – Cargo Van” - Step Van, Full-size van. Example: FedEx

Code “04 - Sport Utility” - utility vehicles. Examples: Ford Explorer, Chevy Blazer, GMC Envoy,

Dodge Durango

Code “05 – Pickup”- Includes open, rack body and pickup trucks

Code “06 - Recreation Vehicle” - Vehicles used for recreational purposes only, e.g. travel trailers

(Winnebago, Fleetwood, etc.)

Code “07 - All Terrain Vehicle” (ATV’s) with either 3, 4, 6 or more tires

Code “08 – Motorcycle” - All motor-operated vehicles of the

bicycle/tricycle type, except MOPED, ATVs

Code “11 – Moped” - Pedal bicycle with helper motor (under 50cc)

V1.00-112805

Box

108

and

109

(Cont)

V1.00-112805

Boxes

110

and

111

Boxes

112

and

113

In box 110 and/or box 111 (Vehicle Use), write the code for each vehicle involved.

If "04 - Responding to an Emergency" is selected, refer to Title 11

(For an accident* occurring

as a result of operation of any motor vehicle in response to an emergency if the operator at the

time of the accident* was responding to the call to duty as a paid or volunteer member of any

police or fire department, first aid squad, or any law enforcement agency).

* Statutor

Lan

In box 112 and/or box 113 (Special Function Vehicles), write the code to describe the special

function or how the vehicle was being used at the time of the crash, otherwise enter a dash (-).

V1.00-112805

Boxes

114

and

115

Reference Material: Vehicle Type – Cargo Body Type 0n page 73.

Boxes

116

and

117

In box 114 and/or box 115 (Cargo Body Type - Commercial Vehicle Only), write the code for

cargo body type for commercial vehicles, otherwise enter a dash (-).

Box 116 and box 117 (Direction of Travel of Vehicle) identifies the direction of travel recorded as

the nominal direction posted on road signs or identified on maps or straight-line diagram for the road

where the crash occurred.

Use a two-digit code i.e., "01-N," "02-E," "03-S," "04-W."

DO NOT USE THE ABREVIATIONS (N., S., E., and W.)

NOTE: Use only one choice, e.g.: Using the two-digit code for northeast is “01” and not 0102.

For your information and use in box 116 and box 117 (Direction of Travel of Vehicle), even though a

north-south road may actually run east-west for a segment, the direction shall not change for reporting.

If a vehicle is traveling in the wrong direction, write the actual direction of travel of the errant vehicle

(e.g., northbound in a southbound lane).

When a vehicle is backing on a roadway its direction of travel is the same as the nominal direction.

The direction the vehicle while in motion and not the direction it was moving is the nominal direction.

When a vehicle is parked, identify the direction that the front of the vehicle was facing prior to the

crash.

V1.00-112805

Apparent Contributing Circumstances

Boxes

118 a&b

and

119 a&b

Any code marked with an asterisk (*) under Apparent Contributing Circumstances and any

selection using “other” must be further explained in box 135.

In box 118a&b and box 119a&b (Apparent Contributing Circumstances), the investigator will

determine the most prominent factor(s) contributing to the crash, even if a summons is not issued.

Select up to two codes for contributing circumstances (Human/Driver Actions, Vehicle Factors,

Road/Environmental Factors and Pedestrian Factors) for each driver, but only one code is required

as a minimum.

For your information and use in box 118a&b and box 119a&b (Apparent Contributing

Circumstances), although it may seem that alcohol involvement would be included and contributed

to the crash, other factors such as speed, failure to yield, road deficiencies, or other improper driving

actions will be

the proximate (actual) cause of the crash in box 118a&b and box 119a&b (Apparent

Contributing Circumstances).

In box 118a&b and box 119a&b (Apparent Contributing Circumstances), a determination of the

apparent contributing circumstances shall be made as a result of the crash investigation.

Statistical data gathered from this part of the report is used to study the cause and effect of crashes.

For example, if a vehicle was involved in a crash and the road or environmental conditions listed in

box 102 (Road Surface Condition) and box 103 (Environmental Condition) were icy and/or snow

covered, write code “01 - Unsafe Speed,” even if a summons is not issued.

Do not code “25 - None” for all vehicles. There is “always” an apparent contributing circumstance for

one or both of the vehicles in a multi-vehicle crash.

V1.00-112805

Boxes

120

and

121

Boxes

122

and

123

Box 120 and box 121 (Apparent Physical Status), write

the code to identify the apparent physical status of each

driver/operator, pedalcyclist, pedestrian immediately

before

the crash.

If apparent physical status is unknown, write code "00."

Code "06 - Physical Handicaps" may include:

• Severe Vision or Hearing Impairments

• Deafness or Blindness

• Leg/Foot/Arm or Hand Amputation

When illicit "03 – Drug Use" or prescription drugs "04 -

Medication" or combinations of alcohol and drugs "05 -

Alcohol and Drug Use" are identified, describe by name or

type of drug/medication use in box 135 (Crash Description).

Any code marked with an asterisk (*) under

Apparent Physical Status

and any selection using

“other” must be further explained in box 135.

In box 122 and box 123 (Cell Phone in Use) write the code to identify if each driver/operator,

pedalcyclist and/or pedestrian was using a cell phone at the time of the crash.

Write code “01 - Handheld" or code “02 - Hands Free" to identify cell phone use.

Enter a dash (-) in box 122 and/or box 123 (Cell Phone in Use) if cell phone use is not applicable.

V1.00-112805

Boxes

124

and

125

For your information and use in box 124 and box 125 (Pre-Crash Action), pedalcycles are

considered vehicles.

If a vehicle, pedacycle and/or pedestrian contributed to the crash and did not

have contact with

a motor vehicle, explain the Pre-Crash Action in box 135 (Crash Description), including Driver

Identification Section and Owner/Vehicle Identification Section and enter a dash (-) in box 26

and/or box 56 (Driver's Name).

Box 124 and box 125 (Pre-Crash Action) are used for vehicle, pedacyclists and/or pedestrians

that made

contact during the crash sequence.

In reference to box 124 and box 125 (Pre-Crash Action), if a pedestrian was an apparent

contributing circumstance in the pre-crash action, write the pedestrian name and information

starting in the space provided for a drivers name which is located in box 26 and/or box 56

(Driver's Name).

For a pedestrian, you shall not

write their driver’s license number in box 32 and/or box 62

(Driver's License Number).

A motorized wheelchair is not as regulated as a motor vehicle, and shall be reported as a

pedestrian

In box 124 and box 125 (Pre-Crash Action):

Code “12 - Merging/Entering Traffic Lane” - crashes associated when two lanes merge into one

(e.g., acceleration or deceleration merges). This does not include "05 - Starting From Parking.”

Code “14 - Driverless/Moving”: e.g., a vehicle rolls out of a parking space, when a driver is

ejected or exits and the vehicle continues in motion.

Codes “43- Crossing at ‘Marked’ Crosswalk” - at Intersection, “44 – Crossing at ‘Unmarked’

Crosswalk” - at Intersection, “45 – Crossing at ‘Marked’ Crosswalk” - at Mid-Block. Definitions

for crosswalks are found in NJSA 39: 1-1.

Any selection marked with an asterisk (*) under Pre-Crash Action and any selection

using “other” must be further explained in box 135.

V1.00-112805

Boxes

124

and

125

(Cont)

Boxes

126

and

127

In box 126 and/or box 127 (Traffic Controls), write one code for each vehicle in the crash.

A particular traffic control device may be regulating the flow of traffic and be in proximity to the

point of impact and not exactly at the point of impact.

A vehicle identified as first in line is controlled by the traffic control device. All others are

controlled by the lane markings, etc.

Vehicle/Pedalcyclist Action (01-29)

01 Going Straight Ahead

02 Making Right Turn (not turn on red)

03 Making Left Turn

04 Making U Turn

05 Starting From Parking

06 Starting In Traffic

07 Slowing or Stopping

08 Stopped In Traffic

09 Parking

10 Parked

11 Changing Lanes

12 Merging/Entering Traffic Lane

13 Backing

14 Driverless/Moving

15 Passing

16 Negotiating Curve

17 Driving on Shoulder

18 Right Turn on Red Signal

29 Other Veh/Cyclist Action*

Pedestrian Action (31-49)

31 Pedestrian Off Road

32 Walking To/From School

33 Walking/Jogging On Road W/Traffic

34 Walking/Jogging On Road Against

Traffic

35 Playing In Road

36 Standing/Lying/Kneeling In Road

37 Getting On Or Off Vehicle

38 Pushing Or Working On Vehicle)

39 Other Working In Roadway

40 Approaching Or Leaving School Bus

41Coming From Behind Parked Vehicle

42 (reserved)

At Intersection

43 Crossing At “Marked” Crosswalk

44 Crossing At “Unmarked” Crosswalk

At Mid-Block

V1.00-112805

Boxes

128 a-d

and

129 a-d

In boxes 128a-d and 129a-d (Sequence of Events), write the code(s) to identify the beginning of

a crash and all subsequent actions.

Determine the sequence of events by answering the question “What did the vehicle come

in contact with?”

These details will describe what happened.

Example 1: If Vehicle 1 runs off the road, hits a parked car

(vehicle 2) and then a utility pole, the report should be filled out as

follows:

Vehicle 1 Vehicle 2

128a - 05 129a - 26

128b - 28 129b - (-)

128c - 52 129c - (-)

128d - (-) 129d - (-)

Example 2:

If Vehicle 1 hits Vehicle 2 coming in the opposite

direction, then hits a curb, then hits a tree. Vehicle 2 is hit by

vehicle 1, hits pedalcyclist, and then hits a traffic sign support, the

report should be filled out as follows:

Vehicle 1 Vehicle 2

128a - 26 129a - 26

128b - 56 129b - 21

128c - 60 129c - 50

128d - (-) 129d - (-)

If code “19 - Other non-collision” is used or “39 - Other Non-Fixed Object” or “69-Other Fixed

Object”, explain in box 135.

See next Page for box codes for 128a-d and 129a-d.

V1.00-112805

Boxes

128 a-d

and

129 a-d

(Cont)

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Boxes

130 - 133

In boxes 130-133 (Vehicle Impact Area), write the code to identify the point where the

contact first began between two vehicles, a vehicle and trees, a vehicle and a pedestrian,

etc.

13 - Roof

14 - Undercarriage

15 - Overturned

17 - None Visible

Use the Clockpoint Diagram to identify the area of initial impact and principal damage

(area that was most damaged).

Box 130-133 Example: Vehicle #1 was struck in the rear by Vehicle #2. Vehicle #1

sustained no damage. Vehicle #2 sustained damage to the front of the vehicle.

Refer to NJTR-1 Overlay, pg. 2.

V1.00-112805

Crash Diagram

Box

134

In box 134 (Crash Diagram), identify North by placing an arrow in the circle at the upper left corner of box

diagram.

Draw each vehicle and number accordingly to correspond with box 23 and/or box 53 (Vehicle Number).

Identify the roadway boundaries, crossings, pavement markings, traffic controls, view obstructions and

intersections related to the crash.

If any vehicles were moved prior to your arrival, draw a "representative" diagram based on your investigation

and explain in box 135 that the vehicles were moved prior to your arrival.

In box 134 (Crash Diagram), identify the pre-crash, crash and post crash positions of the vehicles in the

diagram, if possible.

This can be accomplished on one diagram by depicting the vehicles along their path or on separate diagrams,

depending on the investigator’s preference.

Use form NJTR-1B (supplemental page ) in lieu of box 134 (Crash Diagram) on form NJTR-1 or in case of

serious injury or fatalities, or if applicable.

Write “See NJTR-1B” in box 134 (Crash Diagram) of the NJTR-1, if applicable.

Crash Description and Damage To Other Property

Box

135

In box 135 (Crash Description), describe these 3 basic elements at a minimum:

First

An outline of the physical facts involved in the crash.

Second

A summary of the accounts from all operators, pedestrians and witnesses.

Third

An objective evaluation statement by the investigator concerning his/her conclusions.

Also, explain any entries that require asterisk (*) information identified throughout the form. Include pedestrian

or pedalcyclist clothing worn at the time of the crash. Note: List any photos taken. Use form NJTR-1A

(supplemental page) if applicable.

ALL REPORTS

REQUIRE A

DIAGRAM.

Electronic versions

are acceptable.

V1.00-112805

Box

136

In box 136 (Damage To Other Property), write the code(s) for all other property damage that occurred as a

result of the crash not including the vehicles involved (i.e., "59 - Fence," "62 - Fire Hydrant," "58 -

Embankment," etc.).

Write the property owner’s name and address, along with the description of the property that was damaged.

Use codes from boxes 128a-d and 129a-d (Sequence of Events) where applicable.

Enforcement Action

Box

Oper

In the box (Operator) located to the left of box 137 and 139 (Charge), write the code to identify the

driver/operator by chronological number correlated with box 26 and/or box 56 (Driver's Name).

The driver in box 26 (Driver's Name) is known as Operator “01” and in box 56 (Driver's Name) the driver is

known as Operator “02.”

Pedalcyclists and pedestrians are also associated with box 26 and/or box 56 (Driver's Name).

Boxes

137

and/or

139

In box 137 and/or 139 (Charge), write only the most serious

charge.

When there are multiple charges

against a person, place an “X” in the box (Multiple Charges) located in box

137 and/or 139 (Charge) and write additional charges in box 135 (Crash Description).

Boxes

138

and/or

140

In box 138 and/or box 140 (Summons Number), write the summons number for the charge written in box 137

and/or box 139 (Charge).

When there are multiple summonses

issued, write the summons numbers and multiple charges in box 135

(Crash Description).

Investigator Identification and Case Status

Box

141

In box 141 (Officer's Signature), the investigator is required

to electronically or manually write (sign) his/her

name or the report is not valid.

Box

142

In box 142 (Badge Number), the investigator is required

to write his/her badge number.

V1.00-112805

Box

143

In box 143 (Reviewed By), the supervisor who reviews the report must

check it for completeness, accuracy

and proper content; then electronically or manually write (sign) their initials along with their badge number to

the right of their initials.

After the report has been reviewed it should be forwarded to the police department's Custodian of Records.

All reportable crashes are to be submitted to NJDOT as required by statute or regulation.

Refer to the NJDOT webpage for the current mailing address, protocols and other relevant information.

http://www.state.nj.us/transportation/refdata/accident/policeres.shtm

Reference Material: NJTR-1 Protocol on page 65.

Box

144

In box 144 (Case Status), place an “X” in either of the boxes (Pending, Complete) located in box 144 (Case

Status) based on the department's standard/standing operating procedures.

All reports must be completed.

A report that is pending

shall be updated to complete status by submitting a change report. Several updates

may be required before complete status.

V1.00-112805

Police Guide for Preparing

Reports of

Motor Vehicle Crashes

V1.00-112805

“Every law enforcement officer who investigates a vehicle accident* of which report must be made as

required in this Title, or who otherwise prepares a written report as a result of an accident* or thereafter by

interviewing the participants or witnesses, shall forward a written report of the accident* to the division, on

forms furnished by it, within five days after this investigation of the accident*.”

The investigation and reporting of motor vehicle crashes is a necessary duty of a police officer. Reports are

intended to help reduce the number of crashes, deaths

and injuries through the collection of data elements

and study how they occur. You play a vital role in the collection of this data and it is imperative that you

understand each piece of information that you enter.

We gratefully acknowledge the following individuals for making this manual a reality.

NJDOT, Bureau of Safety Programs – STRCC Chairman, William Beans

New Jersey State Police; Committee Chairmen – Sergeant First Class Robert Parlow

NJDOT, Information Technology; NJTR1 Designer – Thomas Kennedy

Voorhees Township Police Department; NJTR-1 Manual Designer-

Lieutenant Mark J. Wilson

New Jersey State Police – Sergeant Scott Wishart

Washington Township Police Department, Gloucester County – Sergeant Steven Branco

Washington Township Police Department, Bergen County – Chief William Cicchetti

Bergenfield Police Department – Chief Thomas Lucas

Colts Neck Police Department – Sergeant Richard Maxwell

New Jersey Division of Highway Traffic Safety – Al Tindall

New Jersey Motor Vehicle Commission – Marcy Klein, Patricia Jones

New Jersey State Police, FARS Unit – Lisa Glodowski, Sandra Jenkins

New Jersey State Office of Information Technology – Joseph Decker, Debbie Johnson

New Jersey Motor Vehicle Commission – Stanley Cierniak

University of Rutgers, Police Training – Kennard Wondrack, Raymond Chintall

Federal Highway Administration – Karen Yunk

NJDOT, Bureau of Safety Programs – Kevin Conover, Lisa Kaye, Penny Jones

* Statutory Language

V1.00-112805

History of Crash Reporting

Historically, most traffic crash reports were intended, and used, primarily as simple “Who, What,

Where, When and maybe Why” chronicles. In this age of ever decreasing resources, and ever

increasing needs, the ability to provide timely, accurate data to Highway Safety Officials becomes

increasingly urgent, because it allows traffic safety officials to “do more with less”.

Each traffic Crash Report is a memorialization of a “reportable” crash. The circumstances are

rarely ideal as the officer must perform triage in attending to injured persons, minimize the impact

and risk to surrounding traffic and then survey and analyze the crash scene.

Pursuant to the requirements of N.J.S.A. 39:4-131, an officer investigating a motor vehicle crash

must submit to Motor Vehicle Commission a completed crash report within five (5) days. The

reports are submitted by all law enforcement agencies in the State for any “reportable” motor

vehicle traffic crash resulting in injury to or death of any person, or damage to property of any one

person in excess of $500.00. As a result, approximately 320,000 (2003) crash reports are produced

annually.

The Division of Highway Traffic Safety (DHTS) and the New Jersey Department of Transportation

are responsible for allocating funds from the National Highway Traffic Safety Administration

(NHTSA) and the Federal Highway Administration (FHWA) for the purpose of creating programs

aimed at improving the safety of New Jersey roadways. Traffic crash analysis affects these and

other agencies, as the crash report is the only source of their information. As such, crash reporting

information is critical in the decision-making process of numerous agencies.

Some of them are:

Division of Highway Traffic Safety

Motor Vehicles Commission

Division of State Police

Department of Transportation

Department of the Treasury

Department of Insurance

Department of Education

Department of Human Services

Office of Emergency Management Services

County and Municipal Traffic Engineers

County and Municipal Traffic Officers

V1.00-112805

Preliminary Instruction Guide

On July 16, 1997, The National Safety Council’s Board of Directors passed a motion to eliminate

the word ACCIDENT and replace it with the word CRASH. The reason for the motion was to

change people’s way of thinking about crashes. An accident is defined as “An unexpected or

undesired event, chance or fortune” while a crash is “to cause a vehicle or aircraft to have a

collision, to be involved in a crash.” This reinforces the philosophy that crashes don’t just happen;

they have causes and can be prevented.

Although Title 39 has not yet changed to reflect this new trend in terminology the changes have

been made in this manual.

The most recent NJTR-l went into effect on January 1, 2006. The report was renumbered through

input from officers to assist you in the completion of the form. Some changes throughout the new

report should be noted:

The report was changed from 124 blocks to 144 blocks.

Important points

• All 144 boxes on the Crash Report must be completed, even if you only enter a dash.

• Be very specific when entering the location of the crash. This information must be completed in

order to pinpoint the exact location of the crash for geo-code processing.

• All reportable crash reports, including fatals, must be forwarded to the New Jersey Department

of Transportation through the New Jersey Motor Vehicle Commission.

• Use a dash (-) to indicate non-applicable information in all blocks.

• Use double zeros (00) to indicate the required information is unknown in blocks 96 -133.

• 99 “Other” is no longer shown in each category. Write in “99” in the boxes where no choices

for “Other” apply and you will explain in the narrative.

• If a box calls for a two digit numeric answer be sure to fill in both digits, i.e. 01,02,03

• List and number occupied vehicles first, then unoccupied vehicles, then bicyclists and

pedestrians on the report

• When entering intersecting municipal street names, enter the numeric streets first and then the

alpha streets in alphabetical order.

• A pedalcycle is considered a vehicle for purposes of crash reporting, except when coding

ejection from vehicle (box 85). A pedalcyclist is not coded as being ejected from the cycle if

involved in a crash.

• A person sitting behind the wheel of a parked vehicle should not have their information listed in

the operator boxes (26-34, 56-64) but listed that information in the narrative (box 135)

• If a vehicle or a pedestrian caused the crash and DID NOT

have any contact with a motor

vehicle, explain the pedestrian information box 135 and enter a dash (-) in boxes 26 and/or 56.

• Write the pedestrian’s identification in boxes 26 and 56. Do not

list the driver’s license number

in boxes 32 and 62 for pedestrians.

V1.00-112805

1. Motor vehicle and traffic laws regarding taking of crash reports

A. Requirements for drivers

1. N.J.S.A.39: 4-130 requires that any driver of a vehicle or street car involved in an accident

which results in injury or death of any person or damage to property of any one person in

excess of $500 shall by the quickest means of communication notify the local police

department or nearest office of the county police or state police of the accident.

2. The driver is further required to forward a written report of such accident within 10 days to

Motor Vehicle Services on forms furnished by it.

3. A written report of an accident shall not be required by this section if a law enforcement

officer submits a written report to Motor Vehicle Services pursuant to N.J.S.A.39: 4- 131.

B. Requirement for police officers

1. N.J.S.A.39: 4-131 requires the following:

a. That Motor Vehicle Services shall prepare and supply to police departments

forms for accident* reports. These forms will contain detailed information about the

motor vehicle accident*, including the cause, the conditions then existing, and the

persons and vehicles involved.

b. Every law enforcement officer who investigates a vehicle accident* of which

report must be made or who otherwise prepares a written report as a result of an

accident* shall forward a written report of the accident* to Motor Vehicle Services,

on the forms furnished by it, within 5 days after his or her investigation of the

accident*

c. The written report required to be forwarded by law enforcement officers and the

information contained therein shall not be privileged or held confidential. Every

citizen of this state shall have the right, during business hours and under

supervision, to inspect and copy such reports and shall also have the right to

purchase copies of the reports at the fee established by law.

2. Private property crashes are to be reported in the same manner as crashes occurring on

public roadways. This includes crashes in parking lots, on private streets, and on any other

location in the State.

C. Completing Accident* Report Form NJTR-1

I. The State of New Jersey Police Accident* Report Form NJTR-l is to be completed by the

police officer for all investigations of motor vehicle crashes.

2. Form NJTR-1 A Motor Vehicle Accident* Description is to be completed if more than five

people were involved in the crash or if additional space is needed for the description.

3. Form NJTR-l B Motor Vehicle Accident* Diagram, or other diagrams, shall be used in all

crash cases involving serious injury or a fatality in lieu of block 134 on form NJTR-l. When

using an NJTR-1B or other diagram write: SEE ATTACHED DIAGRAM” in block 135.

• Statutory Language

V1.00-112805

D. NJTR-1A Motor Vehicle Accident* Description

1. Use this form if more room is needed for the Accident* Description Box 135 and/or if there

were more than five passengers in the vehicle(s).

E. Additional Report Pages

1. In many instances, the police officer conducting a crash investigation will find that it is

necessary to submit more than one NJTR-1 form, to correctly report the investigation.

2. The need for an additional NJTR-1 report page would occur when the crash involved three

or more cars, three or more pedestrians or pedalcyclists, or five or more vehicle occupants.

This is necessary because an NJTR- 1 has space for only two vehicles and five occupants.

Pedestrians and pedalcyclists are identified in the “Driver” parts of the NJTR-1 by listing

name and address but not by including their driver’s license.

3. When an additional form page is needed, the minimum entries required for the additional

report are boxes 1 through 7, as outlined in the sections with the bold black lines.

a. For example, if an additional report page is submitted because there were more than

two vehicles, pedestrians, or pedalcyclists in the crash, the additional report pages

need only reflect items 1 through 7 and all other items relating to the additional

vehicles, pedestrians, or pedalcyclists covered in boxes 106-133.

A. Change Reports

1) Whenever it is necessary to make a change in information set out on a report which

has already been submitted to Department of Transportation, a new report must be

submitted showing the changes, with the change box checked at the top of the report

form. One example would be a hit-and-run crash in which a report is submitted before

the offender is identified. An additional report would be required to show the

offender’s identity and other pertinent new information developed and not previously

reported. Another instance where a “Change Report” is required is when an injured

party from a motor vehicle crash dies from their injuries after the initial crash report is

submitted. Note that the NJSP & NJMVC are notified via the NLETS teletype and the

NJDOT is to be notified via fax as per NJTR1 protocol information sheet.

2) The bold black lines (blocks 1-7) are always the minimum number of mandatory

fields for additional NJTR-1s in the change report along with the names of Driver 1

and Driver 2 on the original report should be carefully printed in boxes 26 and 56,

“Driver’s Name”, of the Change Report.

3) When submitting a change report only submit the information that needs to be

changed or added. Do not fill in all of the blocks if there is no change in the original

report.

B. Fatal Crashes

1. All fatal motor vehicle crashes shall be reported to the New Jersey State Police via

N.L.E.T.S. within 24 hours of occurrence. It is requested of all municipal police

departments that they follow the standard format for reporting fatal motor vehicle

crashes as it appears on their N.L.E.T.S. (NCIC) terminals. Refer to the NJTR-1

Protocol in the appendix.

V1.00-112805

2. In addition, a photocopy of the initial investigation report shall be submitted, in a

special envelope, to the MVC Fatal Accident Review Board within 72 hours (N.J.

Statute 39:5-30). This should NOT be one of the two copies marked as “State Copy”.

3. Upon completion of the investigation, a photocopy of the completed report shall be

mailed to:

Division of State Police

Fatal Accident Investigation Unit

PO Box 7068

West Trenton, New Jersey 08628-7068

II. Recommended Procedures for the Handling of Motor Vehicle Crashes Not Investigated at the Scene.

1. The Department of Transportation has submitted the following recommended

procedure for a late report of a motor vehicle crash that is not investigated at the

scene.

a. Police personnel should make an entry in their watch log indicating the

date and time the reporting individual reported the motor vehicle crash to

the police department.

b. The department should then provide the reporting individual with an

SR1 form (Motor Vehicle Accident Report)

c.The reporting individual shall complete the form for reportable crashes. It

is suggested that the reporting individual provide a copy to the police

department for its files but follow your departmental procedures in this

matter.

d. The reporting individual shall mail a copy of the report to the agency

indicated on the SR1 form.

e. Police personnel should emphasize to the reporting individual that they

should indicate in box 20 on the report that the police did not investigate the

crash.

V1.00-112805

To help you understand what an insurance company considers an “At-fault” crash, we have

provided you with an excerpt from the New Jersey Department of Insurance, dated 8/18/97.

Department of Insurance

Title 11

11:3-34.3 Definition of “At Fault Accident*”

“At-fault accident” is any accident involving a driver insured under the policy which resulted in a payment by

the insurer of at least $500.00, and for which the driver is at least proportionately responsible based on the

number of vehicles involved.

A driver is [considered] proportionately responsible if 50 percent responsible for an accident* involving two

drivers; if 33 1/3 percent responsible for an accident* involving three drivers, etc.

An at-fault accident* SHALL NOT INCLUDE

the following:

1) Involvement in an accident* in which the motor vehicle owned or operated by the insured or other driver

insured under the policy was lawfully parked.

2) Involvement in an accident* in which the motor vehicle was struck by a hit and run driver, if such

accident* was reported to the proper authorities within 24 hours.

3) Involvement in an accident* in connection with which neither the named insured nor any other driver

insured under the policy was convicted of a moving traffic violation and the owner or operator of another

vehicle involved in such accident* was so convicted.

4) For physical damage losses other than collision.

5) For an accident* in which the motor vehicle was struck in the rear by another vehicle and a driver

insured under the policy has not been convicted of a moving violation in connection with the accident*.

6) For an accident* occurring as a result of operation of any motor vehicle in response to an emergency if

the operator at the time of the accident* was responding to the call to duty as a paid or volunteer member

of any police or fire department, first aid squad, or any law enforcement agency.

* Statutory Language

V1.00-112805

NJTR-1 PROTOCOL

Non- Fatal Crash Reporting

A non-Fatal reportable crash (NJTR-1) needs only to be mailed to NJDOT (See address below) within 5

days in accordance with State Statue Title 39. None to Motor Vehicle Commission or State Police.

Fatal Crash Reporting

1. Police Dept & medical examiner do preliminary crash investigation.

2. Local Police Send NLETS Teletype Message (Incident report) to State Police Fatal Unit within 24 hours

on all Fatal crashes-

3. Mail a copy of NJTR-1 only to, Motor Vehicle Commission, Fatal Accident Review Board and to

NJDOT within 72 hours (whether complete or not):

A. NJTR-1 State copy Motor Vehicle Commission Phone 609-292-8018

Fatal Unit Fax 609-341-3373

225 East State Street

PO Box 173

Trenton NJ 08666

B. NJTR-1 State copy New Jersey Department of Transportation

1035 Parkway Avenue, CN 600

Trenton NJ 08625

Atten: Bureau of Safety Programs – Crash Records Unit

Phone 609-530-3474 Fax 609-530-3496

NOTES:

I. If crash appears prosecutable and there is concern about filling in Contributing Circumstances

(Blks 28 & 29) the form can be submitted without filling in blks 28 & 29

II. Once the investigation is complete then submit NJTR-1 change report with copy of Investigation

report to Motor Vehicle Commission, NJDOT and State Police.

C. Photo Copy NJSP – Division Headquarters State Police Fatal Unit

FAI Unit Phone 609-882-2000 Ext 2240

PO Box 7068 Fax 609-883-0237

West Trenton 08628

State Police do their investigation A. State Police send report to DMV & Prosecutors.

B. Fatal Accident Review Board determines if administrative action is

warranted.

V1.00-112805

Definition of an Intersection as per Title-39:1-1

“Intersection” means the area embraced within the prolongation of the lateral curb lines or, if none, the lateral

boundary lines of two or more highways that join one another at an angle, whether or not one such highway crosses

another. The square in the center of the drawing below is an example of the area deemed to be an intersection. Any

crash that occurs outside of the square of the intersection will have blocks 10 thru 22 (if applicable) completed at the

top of the NJTR-1.

V1.00-112805

SAMPLE ENTRIES FOR COLUMNS 83 THROUGH 95

Crash involving 2 vehicles and 5 people:

Line A shows the Driver of Vehicle #1(1), his position as the driver (1), that he is Dead (1), trapped

in the vehicle (4), 29 years old (29), male (M), Chest Injury (05), Internal Injuries (3), Safety

equipment available was airbag & seat belts (09), Safety equipment used was none (01), (hospital

code-Overlook Hospital 7055).

Line B shows the Passenger of Vehicle #1 (1), his position in the front of the vehicle passenger

side (3), moderate injury (3), not ejected (01), 9 years old (09), male (M), Head injury (01),

Bleeding (4), Safety equipment available was airbag & seat belts (09), Safety equipment used was

none (O1), Ambulance Run Number (hospital code-Overlook Hospital 7055).

Line C shows the Driver of Vehicle #2 (2), her position as the driver (1), that she has no injuries (-

), not ejected (1), 62 years old (62) and female (F), no injuries (--), no injuries (-), Safety

equipment available was airbag (08), Safety equipment used was none because airbag did not

deploy (01), Ambulance Run Number is not applicable (-).

Line D shows the Passenger of Vehicle #2 (2), her position in the front of the vehicle passenger

side (3), complaint of pain (4), not ejected (1), 42 years old (42), female (F), complain of neck pain

(04), complaint of pain (8), safety equipment available was harness (03), safety equipment used

was harness (03), (hospital code-Overlook Hospital 7055).

Line E shows the 2nd passenger of vehicle #2 (2), his position behind the driver in the back seat

(4), no injuries (-), not ejected (1), 7 years old (7), male (M), no injuries (--), no injuries (-), safety

equipment available was lap belt (02), Safety equipment used was lap belt (02).

83 84 85 86 87 88 89 90 91 92 93 94 95

A 1 1 2 1 2 9 M 0 5 3 2 0 9 0 1 01 70

Bill Beans 156

Truck Turn Lane,

Cherry Hill, NJ

01/24/05 0723

B 1 3 3 3 0 9 F 0 1 4 2 0 9 0 1 01 70

Tom Beans

C 2 1 - - 6 2 F - - - 1 0 8 0 1 01 - -

D 2 3 4 3 4 2 F 0 4 8 2 0 3 0 3 01 70

Elaine Wrigley

E 2 4 - - 0 7 M - - - 1 0 2 0 2 01 - -

NOTE: For a fatality, you must also list the name, address, date and time of the death in

the box next to Box 95.

Page ________ of ________

New Jersey Police Crash Investigation Report

Motor Vehicle Crash Description

Police Dept: ________________________ Code: _______

Station: ___________________________ Case No: _______________

Names & Addresses of Occupants - If Deceased, Date & Time of Death92919089888786858483

93 9594

(Refer to vehicle by number)

Veh

Occ

Pos

In/On

Eject

Phys

Cond

Age

Type

Inj

Loc

Inj

Sex

Ref

Med

Equip

Avail

Hosp

Code

Bag

Depl

Equip

Used

135 Crash Description

NJTR-1A (rev. 07/2005)

Officer's Signature Badge Number

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1. Same Direction (Rear-end)- Two vehicles moving one behind the other and collide, regardless of what movements either vehicle was in the process of making. This would iinclude a

collision in which the leading vehicle spun out and became turned 180 degrees around such that the resulting same direction collision had it strike front end to front end with the following

vehicle.

2. Same Direction (Sideswipe)- Two vehicles moving alongside each other and collide, with at least one of the vehicles being struck on the side. This type would include a collision

resulting from one of the vehicles making an improper turn such as a left from the right lane or vice-versa or turning right from the appropriate outside lane and striking a vehicle passing on

the right shoulder.

3. Right Angle- Two vehicles approaching from non-opposing angular directions collide, typically resulting as one vehicle failed to either stop or yield right of way from a Stop or Yield sign,

ran a red light, or was not cleared from the intersection upon the onset of the conflicting movement's green signal.

4. Opposite Direction (Head-on/Angular)- Two vehicles approaching opposite directions and intending to continue in opposite directions collide in a frontal or angular manner as a result

of one or both vehicles crossing the painted or unpainted centerline or divided median of the roadway. This includes a collision resulting from one vehicle traveling the wrong way down a

divided highway.

5. Opposite Direction (Sideswipe)- Two vehicles approaching opposite directions and intending to continue in opposite directions collide in a sideswiping manner as a result of one or both

vehicles crossing the painted or unpainted centerline or divided median of the roadway. This also includes a collision resulting from one vehicle traveling the wrong way down a divided

highway.

6. Parked Vehicle- A crash involving a vehicle in transport striking a parked vehicle within the roadway or in a parking lot.

7. Left Turn/U Turn- Two vehicles approaching from opposite directions collide as a result of at least one vehicle attempting to make a left or U turn in front of the opposing vehicle.

8. Backing- This type of crash, previously labeled as "Other" type, is defined as any multi-vehicle collision when at least one vehicle was in the act of backing.

9. Encroachment- Previously labeled as "Other" type crash, but frequently mislabeled as an angle crash due to the approach directions of one of the turning vehicles and a stopped,

starting or slowing vehicle on an adjacent approach, this crash defines the collision of two adjacent approach vehicles whose paths are unintended to come in conflict, but collide as a result

of one or both vehicles over- or under-turning.

10. Overturned- A crash in which a vehicle overturns on or off the roadway without first having been involved in some other type single or multiple vehicle crash. This includes motorcycle

crashes in which the operator loses control of and drops bike, but had not initially struck another motor vehicle, fixed or non-fixed object, animal, pedacyclist or pedestrian.

11. Fixed Object- A crash in which the primary collision involved a single vehicle and a fixed object.

12. Animal- A crash involving a vehicle striking any animal, including a deer. However, a deer crash could also be so-named for specific identification of this more common type animal

crash within the appropriate box on the Police Crash Report form.

13. Pedestrian- A crash involving a vehicle and pedestrian in which the collision between the two is the first event and also took place within the road proper. This type includes a vehicle

colliding with someone walking their bicycle in the roadway.

14. Pedalcycle- A crash involving a vehicle and a bicycle that is in the act of being ridden or stopped in the roadway, but currently mounted by the cyclist.

15. Non-fixed object- Excluding the single motor vehicle type crashes defined in numbers 10-14 above, this type implies any crash initially involving a single vehicle and object not

considered a fixed or permanent condition of the highway like ruts, bumps, sink- or potholes or other miscellaneous stationary or airborne road debris such as garbage, tree limbs, fallen-off

parts of other vehicles, broken and scattered signs/posts, etc.

16. Railcar-vehicle- Any crash involving a vehicle and a train, trolley, light transit or other type railcar that occurred within a roadway right-of-way or at an at-grade inter section.

99. Other- This category encompasses all other categories of single and multi-vehicle crashes that are not defined above. These include, but are not limited to, all other non-collision events

such as immersion, cargo loss, separation of units, fire/explosion, and run-off road incidents (whereby damage is caused to the vehicle, but nothing else was physically struck during or

following the act of leaving the highway ).

00. Unknown

Same Direction (Rear End)

Struck Parked Vehicle

Pedestrian Pedalcyclist

Non-Fixed Object Railcar-vehicle

Left Turn / U Turn

Crash Type Diagrams

Overturn

Opp Direction (Side Swipe)

Same Direction (Side Swipe)

Backing

Right Angle

Opp Direction (Head On, Angular)

Fixed Object Animal

Encroachment

Over

Under

Vehicle

Type

Cargo

Body

Type

Cergo Van

Single Unit

Me)

Tractor

Semi

Trailer

Flatbed

Cargo

Tank

Intermodal

Chassis