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OMB Control No. 2127-0714
Expiration Date 12/31/2022
2022 Crash Report Sampling System
CRASH LEVEL
Full disclaimer text: This collection of information is voluntary and will be used for informative purposes only. The collection of information will allow NHTSA to develop and
evaluate programs designed to reduce the number of motor vehicle-related injuries and deaths. NHTSA will not collect any personal information that would allow anyone to
identify persons involved in the motor vehicle traffic crash. A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be
subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information
displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2127-0714. Public reporting for this collection of information is
estimated to be approximately 30 minutes per response, including the time for reviewing instructions, completing, and reviewing the collection of information. Send comments
regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer,
National Highway Traffic Safety Administration, W51-316, 1200 New Jersey Ave, S.E., Washington, DC, 20590
Original Strata :
Final Strata :
PSU #
PAR ID
PAR #
**Number of Forms Submitted for Persons Not in Motor Vehicles
**Number of Vehicle Submitted
**Number of Motor Vehicle Occupant Forms Submitted
Crash Date
Crash Time
/
/
:
2022
Relation To Junction: Within Interchange Area
Relation To Junction: Specific Location
0 - No
01 - Non-Junction
1 - Yes
02 - Intersection
8 - Not Reported
03 - Intersection-Related
9 - Reported as Unknown
04 - Driveway Access
05 - Entrance/Exit Ramp Related
06 - Railway Grade Crossing
07 - Crossover-Related
08 - Driveway Access Related
16 - Shared-Use Path Crossing
17 - Acceleration/Deceleration Lane
18 - Through Roadway
19 - Other location within interchange area
20 - Entrance/Exit Ramp
98 - Not Reported
99 - Reported as Unknown
Type of Intersection
Relation to Trafficway
01 - Not an Intersection
01 - On Roadway
02 - On Shoulder
NHTSA Form 1696
02
Intersection
03 -- Four-Way
T-Intersection
03 - On Median
04 - Y-Intersection
04 - On Roadside
05 - Traffic Circle
05 - Outside Trafficway
06 - Roundabout
06 - Off Roadway-Location Unknown
07 - Five Point, or More
07 - In Parking Lane/Zone
10 - L-Intersection
08 - Gore
11 - Other Intersection Type
10 - Separator
98 - Not Reported
11 - Continuous Left - Turn Lane
99 - Reported as Unknown
12 - Pedestrian Refuge Island or Traffic Island
98 - Not Reported
99 - Reported as Unknown
Work Zone
Light Condition
0 - None
1 - Daylight
1 - Construction
2 - Dark - Not Lighted
2 - Maintenance
3 - Dark - Lighted
3 - Utility
4 - Dawn
4 - Work Zone, Type Unknown
5 - Dusk
6 - Dark - Unknown Lighting
7 - Other
8 - Not Reported
9 - Reported as Unknown
Atmospheric Conditions
School Bus Related
01 - Clear
02 - Rain
03 - Sleet or Hail
04 - Snow
05 - Fog, Smog, Smoke
06 - Severe Crosswinds
07 - Blowing Sand, Soil, Dirt
08 - Other
10 - Cloudy
11 - Blowing Snow
12 - Freezing Rain or Drizzle
98 - Not Reported
99 - Reported as Unknown
Crash Related Factors
Interstate Highway
NHTSA Form 1696
County
Global Position
Deg
Min
Sec
Latitude:
Longitude:
NHTSA Form 1696
2022 Crash Report Sampling System
CRASH LEVEL - CRASH EVENTS
Click here to open Clock Point Diagrams
First Harmful Event
Manner of Collision of the First Harmful Event
Vehicle No.
(This)
Area of Impact (AOI) (This)
Sequence Of Events (SOE)
Vehicle No.
Area of Impact (AOI) (Other)
(Other)
NHTSA Form 1696
OMB Control No. 2127-0714
Expiration Date 12/31/2022
2022 Crash Report Sampling System
VEHICLE LEVEL # 1
PSU #
Number of Occupants
PAR ID
**Vehicle Number
**Number Of Occupants
Unit Type
1 - Motor Vehicle In-Transport (Inside or Outside the
Trafficway)
2 - Motor Vehicle Not In-Transport Within the Trafficway
3 - Motor Vehicle Not In-Transport Outside the
Trafficway
4 - Working Motor Vehicle (Highway Construction,
Maintenance, Utility only)
Hit and Run
Registration State
0 - No
1 - Yes
Travel Speed
Vehicle Underride/Override
0 - No Underride or Override
1 - Underride
2 - Override
7 - Not Applicable
8 - Not Reported
9 - Reported as Unknown
Rollover
Location of Rollover
0 - No Rollover
0 - No Rollover
3 - Rollover
1 - On Roadway
8 - Not Applicable
2 - On Shoulder
3 - On Median/Separator
4 - In Gore
5 - On Roadside
6 - Outside of Trafficway
7 - In Parking Lane/Zone
8 - Not Applicable
9 - Unknown
Areas of Impact-Initial
NHTSA Form 1696
00 - Non-Collision
01 - 1 Clock Point
02 - 2 Clock Point
03 - 3 Clock Point
04 - 4 Clock Point
05 - 5 Clock Point
06 - 6 Clock Point
07 - 7 Clock Point
08 - 8 Clock Point
09 - 9 Clock Point
10 - 10 Clock Point
11 - 11 Clock Point
12 - 12 Clock Point
13 - Top
14 - Undercarriage
18 - Cargo/Vehicle Parts Set-In-Motion
19 - Other Objects or Person Set-In-Motion
20 - Object Set in Motion, Unknown if Cargo/Vehicle
Parts or Other
61 - Left
62 - Left-Front Side
63 - Left-Back Side
81 - Right
82 - Right-Front Side
83 - Right-Back Side
98 - Not Reported
99 - Reported as Unknown
Extent of Damage
Vehicle Towed
0 - No Damage
5 - Not Towed
2 - Minor Damage
6 - Towed
4 - Functional Damage
8 - Not Reported
6 - Disabling Damage
9 - Reported as Unknown
7 - Damage Reported, Extent Unknown
8 - Not Reported
9 - Reported as Unknown
Vehicle Sequence of Events
Most Harmful Event
Vehicle License Plate Number
NHTSA Form 1696
NHTSA Form 1696
DAMAGED AREAS FOR VEHICLE# 1
01-1 Clock Value
02-2 Clock Value
Damaged Areas
Left
12
03-3 Clock Value
04-4 Clock Value
05-5 Clock Value
06-6 Clock Value
07-7 Clock Value
Top
13
11
1
10
2
9
3
8
4
7
5
08-8 Clock Value
09-9 Clock Value
10-10 Clock Value
11-11 Clock Value
12-12 Clock Value
13-Top
14-Undercarriage
15-No Damage
99-Damage Areas Unknown
14
Under
6
Right
VIN INFORMATION FOR VEHICLE# 1
Vehicle Model Year
VIN
00000000000000000 - No VIN Required, Not a Vehicle
for Road Use
88888888888888888 - Not Reported
99999999999999999 - Reported as Unknown
vPIC Make
vPIC Model
vPIC Body Class
Final Stage Body Class
NCSA Make
NCSA Model
NCSA Body Type
Power Unit GVWR From
Power Unit GVWR To
Automation System(s) in Vehicle
NHTSA Form 1696
Highest Automation System Level Present in Vehicle
Highest Automation System Level Engaged at Time of
Crash
NHTSA Form 1696
DETAILS FOR VEHICLE# 1
Motor Carrier ID Issuing Authority
Motor Carrier Identification Number
Vehicle Configuration
00 - Not Applicable
01 - Single-Unit Truck (2- axle and GVWR more than
10,000 lbs)
02 - Single-Unit Truck (3 or more axles)
04 - Truck Pulling Trailer(s)
05 - Truck Tractor (Bobtail)
06 - Truck Tractor/Semi-Trailer
07 - Truck Tractor/Double
08 - Truck Tractor/Triple
10 - Vehicle 10,000 pounds or less placarded for
hazardous materials
19 - Vehicle More Than 10,000 lbs., Other
20 - Bus/Large Van (seats for 9-15 occupants, including
driver)
21 - Bus (seats for more than 15 occupants, including
driver)
88 - Qualifying Vehicle, Unknown Configuration
99 - Unknown
Cargo Body Type
HM1: Hazardous Material Involvement
00 - Not Applicable (N/A)
1 - No
01 - Van/Enclosed Box
2 - Yes
02 - Cargo Tank
03 - Flatbed
HM2: Placard
04 - Dump
05 - Concrete Mixer
0 - Not Applicable
06 - Auto Transporter
1 - No
07 - Garbage/Refuse
2 - Yes
08 - Grain/ Chips/ Gravel
8 - Not Reported
09 - Pole-Trailer
10 - Log
11 - Intermodal Container Chassis
12 - Vehicle Towing Another Motor Vehicle
HM3: Hazardous Material ID Number
0000 - Not Applicable
22 - Bus
8888 - Not Reported
96 - No Cargo Body Type
HM4: Hazardous Material Class Number
97 - Other
98 - Unknown Cargo Body Type
99 - Unknown
00 - Not Applicable
01 - 01
02 - 02
03 - 03
NHTSA Form 1696
04
05 -- 04
05
06 - 06
07 - 07
08 - 08
09 - 09
88 - Not Reported
HM5: Release of Hazardous Material from the Cargo
Compartment
0 - Not Applicable
1 - No
2 - Yes
8 - Not Reported
NHTSA Form 1696
OTHER INFORMATION FOR VEHICLE# 1
Vehicle Trailing
Jackknife
0 - No Trailers
0 - Not an Articulated Vehicle
1 - One Trailer
1 - No
2 - Two Trailers
2 - Yes - First Event
3 - Three or More Trailers
3 - Yes - Subsequent Event
4 - Yes, Number of Trailers Unknown
5 - Vehicle Towing Another Motor Vehicle - Fixed
Linkage
6 - Vehicle Towing Another Motor Vehicle - Non-Fixed
Linkage
7 - Trailing Unit Other than a Trailer or Another Motor
Vehicle
9 - Unknown
Bus Use
Special Use
00 - Not a Bus
00 - No Special Use Noted
01 - School
01 - Taxi
04 - Intercity
02 - Vehicle Used for School Transport
05 - Charter/Tour
03 - Vehicle Used as Other Bus
06 - Transit/ Commuter
04 - Military
07 - Shuttle
05 - Police
08 - Modified for Personal/Private Use
06 - Ambulance
97 - Bus, Unknown Use
07 - Fire Truck
98 - Not Reported
08 - Non-Transport Emergency Services Vehicle
99 - Reported as Unknown
10 - Safety Service Patrols – Incident Response
11 - Other Incident Response
12 - Towing – Incident Response
19 - Motor Vehicle Used for Vehicle Sharing Mobility
20 - Motor Vehicle Used for Electronic Ride-hailing
21 - Mail Carrier
22 - Public Utility
23 - Rental Truck over 10,000 lbs.
24 - Truck Operating with Crash Attenuator Equipment
99 - Reported as Unknown
Emergency Motor Vehicle Use
Vehicle Related Factors
0 - Not Applicable
2 - Non-Emergency, Non-Transport
3 - Non-Emergency Transport
4 - Emergency Operation, Emergency Warning
Equipment Not in Use
NHTSA Form 1696
5 - Emergency Operation, Emergency Warning
Equipment in Use
6 - Emergency Operation, Emergency Warning
Equipment in Use Unknown
8 - Not Reported
9 - Reported as Unknown
Fire Occurrence
0 - No or Not Reported
1 - Yes
NHTSA Form 1696
TRAILER INFORMATION FOR VEHICLE# 1
Trailer VIN (1)
vPIC Make
vPIC Body Class
00000000000000000 - No VIN Required, Not a Vehicle for
Road Use
77777777777777777 - No Trailing Units
88888888888888888 - Not Reported
vPIC Trailer Body Type
vPIC Model
vPIC Model Year
99999999999999999 - Reported as Unknown
Trailer GVWR
Trailer VIN (2)
vPIC Make
vPIC Body Class
00000000000000000 - No VIN Required, Not a Vehicle for
Road Use
77777777777777777 - No Trailing Units
88888888888888888 - Not Reported
vPIC Body Type
vPIC Model
vPIC Year
99999999999999999 - Reported as Unknown
Trailer GVWR
Trailer VIN (3)
vPIC Make
vPIC Body Class
00000000000000000 - No VIN Required, Not a Vehicle for
Road Use
vPIC Trailer Body Type
77777777777777777 - No Trailing Units
vPIC Year
88888888888888888 - Not Reported
vPIC Model
99999999999999999 - Reported as Unknown
Trailer GVWR
NHTSA Form 1696
2022 Crash Report Sampling System
PRECRASH LEVEL (VEHICLE/DRIVER) FOR VEHICLE# 1
PSU #
PAR ID
Contributing Circumstances, Motor Vehicle
00 - None Noted
01 - Tires
02 - Brake System
03 - Steering
**Vehicle Number
Trafficway Description
0 - Non-Trafficway or Driveway Access
1 - Two-Way, Not Divided
2 - Two-Way, Divided, Unprotected Median
3 - Two-Way, Divided, Positive Median Barrier
4 - One-Way Trafficway
04 - Suspension
5 - Two-Way, Not Divided With a Continuous Left-Turn
Lane
05 - Power Train
6 - Entrance/Exit Ramp
06 - Exhaust System
7 - Two-Way Divided, Unknown if Unprotected Median
or Positive Median Barrier
07 - Head Lights
8 - Not Reported
08 - Signal Lights
9 - Reported as Unknown
09 - Other Lights
10 - Wipers
11 - Wheels
12 - Mirrors
13 - Windows/Windshield
14 - Body, Doors
15 - Truck Coupling/Trailer Hitch/Safety Chains
16 - Safety Systems
17 - Vehicle Contributing Factors - No Details
97 - Other
99 - Reported as Unknown
Total Lanes in Roadway
Speed Limit
0 - Non-Trafficway or Driveway Access
1 - One lane
2 - Two lanes
3 - Three lanes
4 - Four lanes
5 - Five lanes
6 - Six lanes
7 - Seven or more lanes
NHTSA Form 1696
8 - Not Reported
9 - Reported as Unknown
Roadway Alignment
Roadway Grade
0 - Non-Trafficway or Driveway Access
0 - Non-Trafficway or Driveway Access
1 - Straight
1 - Level
2 - Curve Right
2 - Grade, Unknown Slope
3 - Curve Left
3 - Hillcrest
4 - Curve - Unknown Direction
4 - Sag (Bottom)
8 - Not Reported
5 - Uphill
9 - Reported as Unknown
6 - Downhill
8 - Not Reported
9 - Reported as Unknown
Roadway Surface Conditions
Traffic Control Device
00 - Non-Trafficway or Driveway Access
00 - No Controls
01 - Dry
01 - Traffic control signal (on colors) without Pedestrian
Signal
02 - Wet
03 - Snow
04 - Ice/Frost
02 - Traffic control signal (on colors) with Pedestrian
Signal
06 - Water (Standing or Moving)
03 - Traffic control signal(on colors) not known whether
or not Pedestrian Signal
07 - Oil
04 - Flashing Traffic Control Signal
08 - Other
07 - Lane Use Control Signal
10 - Slush
08 - Other Highway Traffic Signal
11 - Mud, Dirt or Gravel
09 - Unknown Highway Traffic Signal
98 - Not Reported
20 - Stop Sign
99 - Reported as Unknown
21 - Yield Sign
05 - Sand
23 - School Zone Sign/Device
28 - Other Regulatory Sign
29 - Unknown Regulatory Sign
40 - Warning Sign
50 - Person
65 - Railway Crossing Device
97 - Not Reported
98 - Other
99 - Reported as Unknown
NHTSA Form 1696
Device Functioning
0 - No Controls
1 - Device Not Functioning
2 - Device Functioning-Functioning Improperly
3 - Device Functioning Properly
4 - Device Not Functioning or Device Functioning
Improperly, Specifics Unknown
8 - Not Reported
9 - Reported as Unknown
Driver's Vision Obscured By
Driver Maneuvered to Avoid
Driver Distracted By
Pre-Event Movement(Prior to Recognition of Critical
Event)
Critical Event-Precrash (Category)
Critical Event -Precrash (Event)
1 - This Vehicle Loss of Control Due To:
10 - Over the lane line on left side of travel lane
2 - This Vehicle Traveling
11 - Over the lane line on right side of travel lane
3 - Other Motor Vehicle in Lane
12 - Off the edge of the road on the left side
4 - Other Motor Vehicle Encroaching into Lane
13 - Off the edge of the road on the right side
5 - Pedestrian or Pedalcyclist or Other Non-Motorist
14 - End departure
6 - Object or Animal
15 - Turning Left
7 - Other
16 - Turning Right
9 - Unknown
17 - Crossing Over (Passing Through) Junction
18 - This vehicle decelerating
19 - Unknown travel direction
20 - Backing
21 - Making a U-Turn
Attempted Avoidance Maneuver
Pre-Impact Stability
00 - No Driver Present / Unknown if Driver Present
0 - No Driver Present / Unknown if Driver Present
01 - No Avoidance Maneuver
1 - Tracking
05 - Releasing brakes
2 - Skidding longitudinally rotation less than 30 degrees
06 - Steering left
3 - Skidding laterally clockwise rotation
NHTSA Form 1696
07
rightsteering left
08 -- Steering
Braking and
4
rotation
5 -- Skidding
Skidding laterally
Laterally,counterclockwise
Rotation Direction
Unknown
09 - Braking and steering right
7 - Other vehicle loss-of-control (specify:)
10 - Accelerating
9 - Precrash stability unknown
11 - Accelerating and steering left
12 - Accelerating and steering right
15 - Braking and Unknown Steering Direction
16 - Braking
98 - Other actions (specify:)
99 - Unknown/Not Reported
Pre-Impact Location
Crash Type
0 - No Driver Present / Unknown if Driver Present
1 - Stayed in original travel lane
2 - Stayed on roadway, but left original travel lane
3 - Stayed on roadway, not known if left original travel
lane
4 - Departed roadway
5 - Remained off roadway
6 - Returned to roadway
7 - Entered roadway
9 - Unknown
NHTSA Form 1696
2022 Crash Report Sampling System
DRIVER LEVEL FOR VEHICLE# 1
PSU #
PAR ID
**Vehicle Number
Driver Presence
Driver Zip Code
0 - No Driver Present/Not Applicable
00000 - Not resident of U.S. or Territories
1 - Yes
99998 - Not Reported
9 - Unknown
99999 - Reported as Unknown
Violations Charged
Speeding Related
0 - No
2 - Yes, Racing
3 - Yes, Exceeded Speed Limit
4 - Yes, Too Fast for Conditions
5 - Yes, Specifics Unknown
9 - Reported as Unknown
Condition (Impairment) At Time of Crash
00 - None/Apparently Normal
01 - Ill, Blackout
02 - Asleep or Fatigued
03 - Walking with a Cane or Crutches, etc.
04 - Paraplegic or in a Wheelchair
05 - Impaired Due to Previous Injury
06 - Deaf/Hard of Hearing
07 - Blind/Low Vision
08 - Emotional (depressed, angry, disturbed, etc.)
09 - Under the Influence of Alcohol, Drugs or
Medication
10 - Physical Impairment - No Details
96 - Other Physical Impairment
98 - Not Reported
99 - Reported as Unknown if Impaired
Driver Related Factors
NHTSA Form 1696
NHTSA Form 1696
2022 Crash Report Sampling System
PERSON LEVEL (MV OCCUPANT) FOR VEHICLE# 1 AND PERSON# 1
PSU #
PAR ID
Age
**Vehicle Number
**Person Number
Sex/Gender
1 - Male
2 - Female
3 - Other (e.g., "X", Non-Binary, Not Specified, etc.)
8 - Not Reported
9 - Reported as Unknown
Person Type
Injury Severity
01 - Driver of a Motor Vehicle In-Transport
0 - No Apparent Injury (O)
02 - Passenger of a Motor Vehicle In-Transport
1 - Possible Injury (C)
03 - Occupant of a Motor Vehicle Not In- Transport
2 - Suspected Minor Injury (B)
09 - Unknown Occupant Type in a Motor Vehicle InTransport
3 - Suspected Serious Injury (A)
4 - Fatal Injury (K)
5 - Injured, Severity Unknown
6 - Died Prior to Crash*
9 - Unknown/Not Reported
Seating Position
Transported to First Medical Facility By
11 - Front Seat, Left Side
0 - Not Transported for Treatment
12 - Front Seat, Middle
1 - EMS Air
13 - Front Seat, Right Side
2 - Law Enforcement
18 - Front Seat, Other
3 - EMS Unknown Mode
19 - Front Seat, Unknown
4 - Transported Unknown Source
21 - Second Seat, Left Side
5 - EMS Ground
22 - Second Seat, Middle
6 - Other
23 - Second Seat, Right Side
8 - Not Reported
28 - Second Seat, Other
9 - Reported as Unknown
29 - Second Seat, Unknown
31 - Third Seat, Left Side
32 - Third Seat, Middle
33 - Third Seat, Right Side
38 - Third Seat, Other
39 - Third Seat, Unknown
41 - Fourth Seat, Left Side
42 - Fourth Seat, Middle
43 - Fourth Seat, Right Side
48 - Fourth Seat, Other
49 - Fourth Seat, Unknown
NHTSA Form 1696
50 - Sleeper Section of Cab (Truck)
51 - Other Passenger in enclosed passenger or cargo
area
52 - Other Passenger in unenclosed passenger or cargo
area
53 - Other Passenger in passenger or cargo area,
unknown whether or not enclosed
54 - Trailing Unit
55 - Riding on Exterior of Vehicle
56 - Appended to a Motor Vehicle for Motion
98 - Not Reported
99 - Reported as Unknown
Person Related Factors
SAFETY DEVICES FOR VEHICLE# 1 AND PERSON# 1
Helmet Use
Restraint System Use
Type of Restraint System in Use
Helmet Use
01 - Shoulder Belt Only Used
05 - DOT-Compliant Motorcycle Helmet
02 - Lap Belt Only Used
03 - Shoulder and Lap Belt Used
16 - Helmet, Other than DOT-Compliant Motorcycle
Helmet
04 - Child Restraint Type Unknown
17 - No Helmet
06 - Racing-Style Harness Used
19 - Helmet, Unknown if DOT-Compliant
08 - Restraint Used - Type Unknown
20 - Not Applicable
10 - Child Restraint System - Forward Facing
98 - Not Reported
11 - Child Restraint System - Rear Facing
99 - Reported as Unknown if Helmet Worn
12 - Booster Seat
20 - None Used/Not Applicable
Indication of Helmet Misuse?
97 - Other
98 - Not Reported
0 - No Indication of Misuse
99 - Reported as Unknown
1 - Yes, Indication of Misuse
Indication of Restraint System Misuse?
7 - None Used/Not Applicable
0 - No Indication of Misuse
1 - Yes, Indication of Misuse
7 - None Used/Not Applicable
Air Bag Deployed
01 - Deployed- Front
02 - Deployed- Side (door, seatback)
03 - Deployed- Curtain (roof)
07 - Deployed- Other (Knee, air belt, etc.)
Ejection
0 - Not Ejected
1 - Totally Ejected
2 - Partially Ejected
3 - Ejected - Unknown Degree
7 - Not Reported
NHTSA Form 1696
08 - DeploymentDeployed- Combination
09
Unknown Location
20 - Not Deployed
8 - Not Applicable
9 - Reported as Unknown if Ejected
98 - Not Reported
99 - Reported as Deployment Unknown
NHTSA Form 1696
2022 Crash Report Sampling System
ALCOHOL FOR VEHICLE# 1 AND PERSON# 1
Police-Reported Alcohol Involvement
Alcohol Test Status
0 - No (Alcohol Not Involved)
0 - Test Not Given
1 - Yes (Alcohol Involved)
2 - Test Given
8 - Not Reported
8 - Not Reported
9 - Reported as Unknown
9 - Reported as Unknown if Tested
Alcohol Test Type
Alcohol Test Result
00 - Test Not Given
01 - Blood
02 - Breath Test (AC)
03 - Urine
08 - Other Test Type
10 - Preliminary Breath Test (PBT)
11 - Breath Test, Unknown Type
95 - Not Reported
98 - Unknown Test Type
99 - Reported as Unknown if Tested
Police Reported Drug Involvement
NHTSA Form 1696
File Type | application/pdf |
File Modified | 2022-12-19 |
File Created | 2022-10-20 |