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Agency Case No.classified as reportable.or exceeds $1,500 arevehicle damage equalsCrashes in which the(check up to 4)DAMAGE ESTIMATE93 TRACS KEY NO.(up to 5 choices)99 - Unknown06 - <br /> Automation Level Unknown05 - Full Automation04 - High Automation03 - Conditional Automation02 - Partial Automation01 - Driver Assistance00 - No Automation(up to 5 choices)99 - Unknown06 <br /> - Automation Level Unknown05 - Full Automation04 - High Automation03 - Conditional Automation02 - Partial Automation01 - Driver Assistance00 - No AutomationINITIAL CONTACT POINTDAMAGED <br /> AREA(S)Investigator’s Motor Vehicle Crash Report - Vehicle ofSheet Automation System Levels in VehicleEngaged at Time of CrashAutomation System LevelsL VEHICLE NO.01 MOTOR VEHICLE UNIT <br /> TYPE01 - Motor Vehicle in Transport 02 - Parked Motor Vehicle 03 - Working Vehicle/EquipmentNOYESDRIVER PRESENT?1 WEBER, ERIC, A VEHICLE OWNER NAME (Last, First, Middle)CONTACT <br /> PHONE 119 E 4TH ST MAILING ADDRESS HASTINGS CITY NE STATE 68901 ZIP 619BANE STATE 2023 REG. YEAR FORD MAKE FOCUS MODEL 2016 MODEL YEAR WHI COLOR PASSENGER LICENSE PLATE TYPE 1FADP3K28GL348222 <br /> VIN 01 INSURANCE COVERAGE01 - Yes 02 - No 99 - Unk.STATE FARM0289068272 INSURANCE POLICY NO.10 MOTOR VEHICLE TYPE CATEGORY99 - Unknown98 - Other32 - Farm Equipment (tractor, <br /> combine harvester, etc.)31 - Construction Equipment (backhoe, bulldozer, etc.)29 - Motor Home (greater than 10,000 lbs GVWR)**28 - Motor Home (10,000 lbs or less GVWR)27 - Other Bus <br /> Type**26 - Transit Bus**24 - Mini-bus**22 - Cargo Van (greater than 10,000 lbs GVWR)**21 - Cargo Van (10,000 lbs or less)20 - 15-Passenger Van**19 - 9 or 12-Passenger Van**17 - Truck <br /> Tractor**16 - Single-Unit Truck**15 - Medium/Heavy Truck (greater than 10,000 lbs GVWR)**14 - Pickup (greater than 10,000 lbs)**13 - Pickup (10,000 lbs or less)12 - (Sport) Utility <br /> Vehicle11 - Passenger Van (less than 9 seats)10 - Passenger Car09 - Autocycle08 - Motorcycle - 3 Wheel07 - Motorcycle - 2 Wheel06 - Moped or motorized bicycle05 - Snowmobile04 - Recreational <br /> Off-Highway Vehicles (ROV)03 - Low Speed Vehicle02 - Golf Cart01 - All-Terrain Vehicle / Cycle (ATV/ATC)Body Type 00 SPECIAL FUNCTION OF MOTOR VEHICLE IN TRANSPORT99 - Unknown98 - Other23 <br /> - Vehicle Used for Electronic Ride-hailing (Uber, Lyft, etc.)22 - Truck Acting as Crash Attenuator21 - Towing – Incident Response20 - Taxi19 - Safety Service Patrols – Incident Response18 <br /> - Rental Truck (Over 10,000 lbs)17 - Public Utility16 - Police15 - Other Incident Response14 - Non-Transport Emergency Services Vehicle13 - Military11 - Highway/Maintenance10 - Fire <br /> Truck08 - Bus – Other07 - Bus – Transit/Commuter06 - Bus – Shuttle05 - Bus – School (Public or Private)04 - Bus – Intercity03 - Bus – Childcare/Daycare02 - Bus – Charter/Tour01 - Ambulance00 <br /> - No Special Function 97 EMERGENCY MOTOR VEHICLE USE99 - Unknown97 - Not Applicable04 - Non-Emergency, Transport03 - Non-Emergency, Non-Transport Warning Equipment Not in Use02 <br /> - Emergency Operation, Emergency Warning Equipment in Use01 - Emergency Operation, Emergency 02 AUTOMATED DRIVING SYSTEM(S)MOTOR VEHICLEAutomation System(s) in Vehicle?99 - Unknown02 <br /> - No01 - Yes 0002 HIT AND RUN?99 - Unknown02 - No - Did Not Leave Scene01 - Yes - Driver or Car/Driver Left Scene 0001 VEHICLE MANEUVER / ACTION09 - Passing/Overtaking a Vehicle08 - <br /> Parked07 - Negotiating a Curve06 - Making a U-Turn05 - Leaving Traffic Lane04 - Entering Traffic Lane03 - Changing Lanes02 - Backing01 - Movement Essentially Straight Ahead99 - Unknown98 <br /> - Other13 - Turning Right11 - Stopped in Traffic10 - Slowing 02 hazardous materials (HM) placard?Did this motor vehicle display a02 - No 99 - Unknown01 - Yes** <br /> 97 - Not Applicable**Heavy Truck/Bus form must be completed 00 VEHICLE CONTRIBUTING CIRCUMSTANCE(S)99 - Unknown98 - Other13 - Wipers12 - Windows/Windshield11 - Wheels10 - <br /> Truck Coupling/Trailer Hitch/Safety Chains09 - Tires08 - Suspension07 - Steering06 - Power Train05 - Mirrors04 - Lights (head, signal, tail)03 - Exhaust System02 - Brakes01 - Body, <br /> Doors00 - None 97 Number of trailing units97 - Not Applicable (vehicle with no trailing units)00 - No Damage99 - Unknown16 - Vehicle Not at Scene15 - All Areas14 - Undercarriage13 - <br /> TopTotaled$ 300001 04 - Vehicle Not at Scene03 - Disabling Damage02 - Functional Damage00 - No Damage 12 99 - Unknown16 - Vehicle Not at Scene15 - Cargo Loss14 - Undercarriage13 - Top00 <br /> - Non-Collision 01 TOWED DUE TO DISABLING DAMAGE03 - Towed Not Due to Disabling Damage02 - Towed Due to Disabling Damage01 - Not Towed L23112651 <br /> <br />