The Minnesota Accident Report form, officially known as Minnesota Motor Vehicle Accident Report PS 32001 - 08, plays a crucial role in enhancing road safety. It is a mandatory document for drivers involved in crashes that result in property damage of $1,000 or more, or in cases of injury or death, requiring submission to Driver and Vehicle Services within 10 days. Failing to submit this form is considered a misdemeanor, highlighting the importance of accurately and promptly reporting the incident.
To ensure you're contributing to the safety of Minnesota's roads and adhering to state requirements, click the button below to learn more about how to fill out and submit the Minnesota Accident Report form.
In Minnesota, the aftermath of a motor vehicle accident can be as challenging as the event itself, especially when it comes to navigating legal requirements. The Minnesota Motor Vehicle Accident Report form, identified by its code PS 32001 - 08, serves a critical purpose in this process. It's designed not just for record-keeping but also for improving road safety by collecting data on traffic accidents. This form must be completed by every driver involved in a crash that results in $1,000 or more in property damage or any injury or death. The report must then be submitted to the Driver and Vehicle Services within ten days of the incident. Neglecting to fill out this form is considered a misdemeanor, highlighting the state's seriousness about gathering accurate accident data. The form itself requests detailed information, including personal details of the drivers involved, descriptions of the vehicles, the accident's circumstances, and insurance information. Importantly, it also asks for a narrative of how the accident happened and a diagram if possible, which helps in understanding the dynamics of the crash. It specifies that this information aids in building safer roads and outlines the legalities of data privacy concerning the report, reassuring drivers that the details provided cannot be used against them in civil or criminal matters, thus emphasizing both the importance of compliance for public safety and the protection of individual rights.
MINNESOTA MOTOR VEHICLE ACCIDENT REPORT
PS 32001 - 08
The information on this report is used to help build safer roads.
Every driver in a crash involving $1,000 or more in property damage, or injury or death, MUST COMPLETE this form and send it to Driver and Vehicle Services within 10 days.
Failure to provide this information is a misdemeanor under Minnesota Statute 169.09, subdivision 7. See reverse side for address and for data privacy information.
A
B
C
DRIVER’S TRAFFIC ACCIDENT REPORT
E-form available at www.mndriveinfo.org
DO NOT DETACH
DATE OF
MONTH
DAY
YEAR
DAY OF WEEK
TIME
TOTAL # OF
COUNTY
NAME OF CITY OR TOWNSHIP
T
ACCIDENT
AM
VEHICLES
CITY
I
PM
INVOLVED
TWP
M
ACCIDENT OCCURRED
LOCATION OF ACCIDENT:
E
(Choose only one box below
and proceed to the right)
ON:
AT:
-
AT INTERSECTION
(Street Name or Road Number)
P
DISTANCE
DIRECTION
L
MILES
N
NOT AT INTERSECTION
FEET
S
W FROM:
(Number)
IN PARKING LOT
DESCRIBE LOCATION:
D DRIVER’S FULL NAME
ADDRESS
STATE
ZIP CODE
INJURY
R
CODE*
Y
V
DRIVER’S LICENSE NUMBER
CLASS
STATE OF ISSUE
DATE OF BIRTH
SEX
VE
E R
H
OWNER’S FULL NAME
LICENSE PLATE NUMBER
PARTS OF VEHICLE DAMAGED
ESTIMATE COST TO REPAIR
$
TYPE (CAR, PICKUP, VAN, SUV, MOTORCYCLE, TRUCK, ETC.)
MAKE
MODEL
COLOR
# OF OCCUPANTS
IGIVE FULL LIABILITY INSURANCE INFORMATION OR IT WILL BE ASSUMED YOU DID NOT HAVE INSURANCE
SPLEASE NAME OF INSURANCE COMPANY (NOT AGENCY)
U
COPY
Automobile Insurance
FROM
POLICY NUMBER
Policy Period: from
to
POLICY
Name of Policy Holder
Address
Your Signature X
D
OTHER
FULL NAME
O
DRIVER
OTHER FULL NAME
HE
OWNER
IF MORE THAN TWO VEHICLES - FILL IN SECTION “C” ON SEPARATE FORM AND ATTACH
*SEE CODES ON REVERSE SIDE*
ENTER NUMBER FOR CORRECT RESPONSE IN EACH BOX BELOW
TYPE ACCIDENT
COLLISION WITH A(N)
COLLISION WITH FIXED OBJECT
NON-COLLISION
1- MOTOR VEHICLE
8- DEER
21- CONSTRUCTION EQUIPMENT
29- HYDRANT
37- EMBANKMENT/DITCH/CURB
51- OVERTURN/ROLLOVER
2- PARKED MOTOR VEHICLE
9- OTHER ANIMAL
22- TRAFFIC SIGNAL
30- TREE/SHRUBBERY
38- BUILDING/WALL
52- SUBMERSION
3- ROADWAY EQUIPMENT - SNOWPLOW
23- RR CROSSING DEVICE
31- BRIDGE PIERS
39- ROCK OUTCROPS
53- FIRE/EXPLOSION
4- ROADWAY EQUIPMENT - OTHER
12- COLLISION WITH OTHER
24- LIGHT POLE
32- MEDIAN SAFETY BARRIER
40- PARKING METER
54- JACKKNIFE
5- TRAIN
TYPE OF NON-FIXED OBJECT
25- UTILITY POLE
33- CRASH CUSHION
41- OTHER FIXED OBJECT
55- LOSS/SPILLAGE NON-HAZ MAT
6- PEDALCYCLE, BIKE, ETC.
13- OTHER COLLISION TYPE
26- SIGN STRUCTURE
34- GUARDRAIL
42- UNKNOWN FIXED OBJECT
56- LOSS/SPILLAGE HAZ MAT
7- PEDESTRIAN
27- MAILBOXES
35- FENCE (NON-MEDIAN BARRIER)
64- NON-COLLISION OF OTHER TYPE
28- OTHER POLES
36- CULVERT/HEADWALL
65- NON-COLLISION OF UNKNOWN TYPE
WORK ZONE (CIRCLE CORRECT RESPONSE)
SPEED LIMIT ENTER POSTED SPEED LIMIT ( NOT YOUR TRAVEL SPEED)
YES
NO
DID THE CRASH OCCUR IN A WORK ZONE?
IF YES, WERE WORKERS PRESENT?
WEATHER / ATMOSPHERE
5- SLEET/HAIL/FREEZING RAIN
8- SEVERE CROSSWINDS
1- CLEAR
3- RAIN
6- FOG/SMOG/SMOKE
90- OTHER
ROAD SURFACE
2- CLOUDY
4- SNOW
7- BLOWING SAND/DUST/SNOW
1- DRY
3- SNOW
5- ICE PACKED SNOW
7- MUDDY
9- OILY
2- WET
4-SLUSH
6- WATER (STANDING/MOVING)
8- DEBRIS
LIGHT CONDITION
1- DAY LIGHT
4- DARK (STREET LIGHTS ON)
7- DARK (UNKNOWN LIGHTING)
TRAFFIC CONTROL DEVICE
2- BEFORE SUNRISE (DAWN)
5- DARK (STREET LIGHTS OFF)
1- TRAFFIC SIGNAL
7- SCHOOL BUS STOP ARM
13- RR OVERHEAD FLASHERS
3- AFTER SUNSET (DUSK)
6- DARK (NO STREET LIGHTS)
2- OVERHEAD FLASHERS
8- SCHOOL ZONE SIGN
14- RR OVERHEAD FLASHERS/GATE
3- STOP SIGN - ALL APPROACHES
9- NO PASSING ZONE
15- RR SIGN ONLY
4- STOP SIGN - NOT ALL APPROACHES
10- RR CROSSING GATE
(NO LIGHTS, GATES OR STOP SIGN)
MANNER OF COLLISION
4- RAN OFF ROAD - LEFT SIDE
8- HEAD ON
5- YIELD SIGN
11- RR CROSSING -FLASHING LIGHTS
1- REAR END
5- RIGHT ANGLE (”T-BONE”)
9- SIDE SWIPE - OPPOSING DIRECTION
6- OFFICER/FLAG PERSON/SCHOOL PATROL
12- RR CROSSING - STOP SIGN
2- SIDESWIPE - SAME DIRECTION
6- RIGHT TURN
98- NOT APPLICABLE
3- LEFT TURN
7- RAN OFF ROAD - RIGHT SIDE
MY
VEHICLE
ACTIONS / MANEUVERS PRIOR TO ACCIDENT
BY VEHICLE
PARKED VEHICLES
1- GOING STRAIGHT AHEAD
21- PARKED LEGALLY
FOLLOWING ROADWAY
22- PARKED ILLEGALLY
2- WRONG WAY INTO
23- VEHICLE STOPPED
OPPOSING TRAFFIC
OFF ROADWAY
3- RIGHT TURN ON RED
4- LEFT TURN ON RED
5- MAKING RIGHT TURN
6- MAKING LEFT TURN
7- MAKING U-TURN
8- STARTING FROM PARKED POSITION
9- STARTING IN TRAFFIC
10- SLOWING IN TRAFFIC
11- STOPPED IN TRAFFIC
12- ENTERING PARKED POSITION
13- AVOID UNIT/OBJECT IN ROAD
14- CHANGING LANES
15- OVERTAKING/PASSING
16- MERGING
17- BACKING
18- STALLED ON ROADWAY
DIRECTION OF TRAVEL PRIOR TO ACCIDENT
BY PEDESTRIAN
BY BICYCLIST
1- NORTHBOUND
31- CROSSING WITH SIGNAL
40- WALKING/RUNNING IN ROAD
51- RIDING WITH TRAFFIC
2- NORTH EASTBOUND
32- CROSSING AGAINST SIGNAL
AGAINST TRAFFIC
52- RIDING AGAINST TRAFFIC
3- EASTBOUND
33- DARTING INTO TRAFFIC
41- STANDING/LYING IN ROAD
53- MAKING RIGHT TURN
4- SOUTH EASTBOUND
34- OTHER IMPROPER CROSSING
42- EMERGING FROM BEHIND
54- MAKING LEFT TURN
5- SOUTHBOUND
35- CROSSING IN A MARKED CROSSWALK
PARKED VEHICLE
55- MAKING U-TURN
6- SOUTH WESTBOUND
36- CROSSING (NO SIGNAL OR CROSSWALK)
43- CHILD GETTING ON/OFF SCHOOL BUS
56- RIDING ACROSS ROAD
7- WESTBOUND
37- FAIL TO YIELD RIGHT OF WAY TO TRAFFIC
44- PERSON GETTING ON/OFF VEHICLE
57- SLOWING/STOPPING/STARTING
8- NORTH WESTBOUND
38- INATTENTION/DISTRACTION
45- PUSHING/WORKING ON VEHICLE
8
1
2
39- WALKING/RUNNING IN ROAD WITH TRAFFIC
46- WORKING IN ROADWAY
W
7
3
47- PLAYING IN ROADWAY
6
4
48- NOT IN ROADWAY
5
CONTINUE
WAS THERE A POLICE
IF YES, WHAT DEPARTMENT (NAME OF CITY, COUNTY OR STATE PATROL)
OFFICER AT THE
REPORT ON
SCENE?
OTHER SIDE
As required by Minnesota Data Privacy Act you are hereby informed that the information requested on this form is collected pursuant to statute to provide statistical data on traffic accidents. The time and place of the accident, names of parties involved and insurance information may be disclosed to any person involved in the accident or to others persons as specified by law. This written report cannot be used against you as evidence in any civil or criminal matter and your version of how the accident happened is confidential.
SEAT
TYPE
USE
AIR BAG
EJECT
OCCUPANT SEAT POSITION CODES
SAFETY EQUIPMENT TYPE
RESTRAINT DEVICE USED
SAFETY EQUIPMENT USED
EJECTION CODES
INJURY CODES
CODES
1- DRIVER
1- TRAPPED, EXTRICATED
K- KILLED
(INCLUDE MOTORCYCLE DRIVER)
1- NO SAFETY EQUIP IN PLACE
1- BELTS NOT USED
1- DEPLOYED-FRONT
(BY MECHANICAL MEANS)
A- INCAPACITATING INJURY
2- FRONT CENTER
2- LAP BELT ONLY USED
2- DEPLOYED-SIDE
2- TRAPPED, FREED BY
B- NON-INCAPACITATING INJURY
3- FRONT RIGHT
2- LAP BELT
3- SHOULDER BELT ONLY USED
3- DEPLOYED-FRONT AND SIDE
NON-MECHANICAL MEANS
C- POSSIBLE INJURY
4- SECOND ROW SEAT LEFT
3- SHOULDER BELT
4- LAP AND SHOULDER BELT USED
4- NOT DEPLOYED-SWITCH ON
3- PARTIALLY EJECTED
N- NO APPARENT INJURY
5- SECOND ROW SEAT CENTER
4- LAP & SHOULDER BELT
5- NOT DEPLOYED-SWITCH OFF
4- EJECTED
6- SECOND ROW SEAT RIGHT
5- CHILD SAFETY SEAT
5- CHILD SEAT NOT USED
6- NOT DEPLOYED- UNKNOWN
7- THIRD ROW SEAT LEFT
6- CHILD BOOSTER SEAT
6- CHILD SEAT USED IMPROPERLY
IF SWITCH ON OR OFF
5- NOT EJECTED OR TRAPPED
8- THIRD ROW SEAT CENTER
7- CHILD SEAT USED PROPERLY
9- THIRD ROW SEAT RIGHT
8- BOOSTER SEAT NOT USED
90- OTHER DEPLOYMENTS
10- OUTSIDE OF VEHICLE
(MOTORCYCLE,
9- BOOSTER SEAT USED IMPROPERLY
11- TRAILING UNIT
SNOWMOBILE, ECT.)
10- BOOSTER SEAT USED PROPERLY
12- PICKUP TRUCK BED
13- TRUCK CAB SLEEPER SECTION
11- HELMET NOT USED
14- PASSENGER IN OTHER POSITION
12- HELMET USED
(INCLUDE MOTORCYCLE PASSENGER)
15- PASSENGER IN UNKNOWN POSITION
16- FRONT LEFT (NON-DRIVER)
MY VEHICLE: DRIVER AND PASSENGERS INFORMATION:
DRIVER >>>>>>>>>>>>>>>>>>
DATE OF BIRTH (OR AGE)
PASSENGER NAME
DESCRIBE ACCIDENT IN SUFFICIENT DETAIL BELOW TO DISCLOSE CAUSES.
INDICATE
NORTH
DESCRIBE WHAT HAPPENED:
DIAGRAM WHAT HAPPENED:
BY ARROW
DAMAGE TO PROPERTY OTHER THAN VEHICLES: (MAILBOX, FENCE, SIGNPOST, GUARDRAIL, ETC.)
DESCRIBE
NAME OF
PROPERTY
DAMAGED:
OWNER:
ESTIMATE COST OF REPAIR
SIGN HERE X
SIGNATURE OF PERSON SUBMITTING REPORT IS REQUIRED
DATE OF REPORT
MAIL THIS REPORT TO:
DVS / ACCIDENT RECORDS
445 MINNESOTA STREET, SUITE 181
ST. PAUL, MN 55101-5181
When involved in a vehicle accident in Minnesota that results in property damage of $1,000 or more, injury, or death, it's necessary to complete the Minnesota Motor Vehicle Accident Report form. This documentation is crucial for building safer roads and infrastructure by providing vital data to the Driver and Vehicle Services (DVS). The law mandates that this form be submitted within 10 days of the accident, and failing to do so can lead to misdemeanor charges. It's important to fill out this form accurately to ensure all details about the crash are correctly reported. The information you provide will contribute to traffic safety research and may also be used in legal or insurance matters, although it cannot be used against you in civil or criminal proceedings. Here is a step-by-step guide to completing this form.
Filling out the Minnesota Motor Vehicle Accident Report form with attention to detail and accuracy is essential for road safety analytics and legal compliance. Prompt submission of this completed document ensures that necessary measures can be taken to investigate and, where possible, prevent future incidents.
Any driver involved in a crash resulting in either $1,000 or more in property damage, personal injury, or death must complete the Minnesota Motor Vehicle Accident Report form.
The form is available online at www.mndriveinfo.org or you can obtain a physical copy from the Driver and Vehicle Services (DVS) or local police stations.
The form must be submitted to the Driver and Vehicle Services within 10 days from the date of the accident.
Failing to submit the form within the 10-day period is considered a misdemeanor under Minnesota Statute 169.09, subdivision 7. This could potentially lead to legal penalties.
No, the information collected on this form is used for statistical data regarding traffic accidents. Your personal account of the accident is kept confidential and cannot be used against you in any civil or criminal proceedings.
If the accident involved more than two vehicles, you should fill in section “C” on a separate form for each additional vehicle and attach it to your original report.
Yes, if the accident meets the criteria of involving $1,000 or more in property damage, injury, or death, it must be reported, regardless of whether it occurred on a public street or in a parking lot.
You will need detailed information about the accident, including but not limited to:
While the form provides space for a diagram, it's highly recommended to include one as it helps in understanding the dynamics of the accident. However, if you're unable to draw a diagram, providing a detailed written description is essential.
After completing the form, mail it to the DVS/Accident Records at the address provided: DVS / Accident Records 445 Minnesota Street, Suite 181 St. Paul, MN 55101-5181.
When filling out the Minnesota Accident Report form, individuals often encounter complexities, leading to mistakes that can affect the accuracy and completeness of the report. Recognizing and avoiding these common errors can significantly improve the quality of the information provided to Driver and Vehicle Services. Here are six common mistakes:
Not reporting within the required timeframe: The form must be submitted within 10 days following an accident if it involves $1,000 or more in property damage, or if there is injury or death. Delaying submission can lead to legal consequences under Minnesota Statute 169.09, subdivision 7.
Omitting details about the accident's location: It's crucial to specify whether the crash occurred at an intersection or not and to provide exact street names or road numbers. Accurate location data is essential for analysis aimed at making roads safer.
Failing to provide complete insurance information: If the insurance company name (not agency) or policy number is left blank, it may be assumed that the vehicle was uninsured. This might complicate issues related to coverage and liabilities.
Inaccurate or incomplete descriptions of the accident: Individuals must describe the accident in detail, including how it happened. This description is vital for understanding the circumstances that led to the accident and for determining responsibility.
Incorrectly identifying the type of accident: The form requires selecting the type of collision from a given list. Choosing the wrong type can misrepresent the nature of the accident and affect subsequent analyses and investigations.
Leaving the driver and passenger section incomplete: Every individual in the vehicle needs to be listed, along with their seat positions and any injuries sustained. Missing or incorrect information here might lead to inaccurate records of the accident's impact on those involved.
To ensure the accuracy and completeness of the Minnesota Accident Report form, individuals should carefully review each section, provide precise details as required, and comply with the submission deadline. Taking these steps helps facilitate a thorough evaluation of the accident and contributes to the statewide efforts in building safer roads.
When an individual is involved in a motor vehicle accident in Minnesota, promptly completing and submitting the Minnesota Accident Report form is key. However, to fully document the incident and its aftermath, several other forms and documents might be necessary. These additional documents help in ensuring that all aspects of the accident, from damage assessment to insurance claims, are thoroughly addressed.
In navigating the aftermath of a motor vehicle accident, being prepared with the correct forms and documents can significantly streamline the process of recovery and compensation. Equipping yourself with these essential documents not only aids in the immediate response following an accident but also assists in the meticulous documentation needed for any subsequent legal or insurance procedures.
The California Traffic Accident Report shares similarities with the Minnesota Accident Report form in that both require detailed information about the accident, including the date, location, and how the accident occurred. They also collect data on the vehicles involved, such as make, model, and year, along with driver information, including name, address, and insurance details.
The Florida Traffic Crash Report is similar because it also mandates that drivers involved in accidents resulting in a certain amount of property damage, injury, or death must file a report. This form, like Minnesota’s, requests comprehensive details about the accident conditions, including weather, road conditions, and the sequence of events leading to the collision.
New York Motor Vehicle Accident Report requires the completion by individuals involved in accidents with significant damage or injuries, akin to the Minnesota form. Both documents make it necessary to outline specifics about the accident scene and demand insurance information, driver and vehicle details, and an account of damages and injuries.
The Texas Peace Officer’s Crash Report is paralleled with the Minnesota report in that it is designed to collect extensive data on motor vehicle accidents for safety and statistical analysis. Each form includes sections on the timing and environment of the crash, participant information, and a narrative description of the accident.
Illinois Motorist Report is reconcilable with Minnesota's requirement that drivers report accidents exceeding a certain damage threshold. Both seek information on the accident location, involved parties, insurance status, and vehicle damage, along with a schematic diagram or narrative of the accident.
The Ohio Traffic Crash Report demands thorough documentation similar to Minnesota's, including data about the crash circumstances, participants, vehicle information, and detailed reporting of any injuries or fatalities. It too serves a dual purpose of legal record and data collection for traffic safety.
Washington State Motor Vehicle Collision Report aligns with Minnesota’s form as it compels drivers involved in significant accidents to provide detailed accounts of the incident. These include descriptions of the collision, information on the drivers and vehicles involved, and details on the accident’s context like weather and road conditions.
When you're filling out the Minnesota Accident Report form, there are important steps to follow to ensure your report is complete and accurately reflects the incident. Here are four things you should do and four things you shouldn't do:
There are several misconceptions about the Minnesota Accident Report form that individuals involved in vehicle accidents often encounter. Understanding these can help in accurately completing the form and ensuring compliance with Minnesota law.
Misconception 1: The report is optional for minor accidents. In reality, any crash involving $1,000 or more in property damage, or any injury or death, requires the completion and submission of this form within 10 days.
Misconception 2: Only the driver at fault needs to complete the form. However, every driver involved in such an accident must complete and submit a report, regardless of fault.
Misconception 3: Insurance information is not mandatory. Failing to provide full liability insurance information may lead to the presumption of not having insurance, which can carry legal consequences.
Misconception 4: Personal injury lawyers can use this report in court. The report is protected under the data privacy act, meaning the information cannot be used as evidence in civil or criminal matters, and all narratives or depictions of the accident are confidential.
Misconception 5: Police must be at the scene to complete the report. Whether or not police were present or a police report was made, drivers must still fill out and submit the Minnesota Accident Report form if the damage or injuries meet the criteria.
Misconception 6: All sections must be filled out by both involved parties. Each driver only fills out information pertaining to themselves, their vehicle, and their insurance, not the information of the other involved parties.
Misconception 7: The form is only for automobile accidents. The form is required for all motor vehicle accidents, including cars, pickups, vans, SUVs, motorcycles, trucks, etc.
Misconception 8: Submission is only by mail. While mailing is a primary method, electronic submission options are available, enhancing convenience.
Misconception 9: Estimation of damages is unnecessary or can be guessed. An accurate estimate of the cost to repair damages to the vehicle is required; guesswork can lead to under or overestimation, affecting claims and records.
Clearing up these misconceptions can facilitate a more straightforward and accurate reporting process for individuals involved in vehicle accidents in Minnesota. Ensuring the correct completion of the Minnesota Accident Report form is crucial for compliance with state laws and for the proper handling of traffic accidents from a legal standpoint.
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