24-11395 PKW Orig and Supp R
24-11395 PKW Orig and Supp R
24-11395 PKW Orig and Supp R
CASE STATUS:
Closed
MO v8.0.0.1
ALASKA MOTOR VEHICLE COLLISION REPORT SR# INCIDENT/CASE #
A241030432 / 24-011395
CRASH INFORMATION -- (One choice per field unless otherwise noted - Other * should be explained in narrative)
Law Enforcement Use Only:
Crash Date: 04/12/2024 Crash Day: Friday Crash Time Unknown: Crash Time: 15:19
CRASH CLASSIFICATION Property: - Location: - In Parking Lot:
CRASH LOCATION Lat: Long: Crash City / Place: Anchorage
County / Borough: Anchorage
On: OLD SEWARD At Street/nearest street, bridge, etc.: TUDOR
Photos Taken: 01 - Yes Non-Vehicular Property Damage: 00 - No Most Contributing Unit Known: 01 - Yes
Total Witnesses: 0 Total Motorized Units: 2 Total Non-Motorized Units: 0 Total Motorists: 2 Total Non-Motorists: 0
WORK ZONE RELATED Work Zone: 00 - None Location of the Crash: 97 - Not Applicable
CASE STATUS:
Closed
Motor Vehicle # 1 Most Contributing Unit: 01 - Yes Total Number of People in Vehicle: 99
Motor Vehicle Type: 01- Motor Vehicle In-Transport (Inside or Outside the Driver Presence: 00 - No Driver Present
VIN: 2GCFK29K5S1207849 License Plate # LHE391 State: AK Registration Year: 2024 Color: Red
OWNER INFORMATION
Vehicle Owner Name (Last, Frist, Middle,Suffix): GLORE, ANTHONY M Mailing Address:
DAMAGE INFORMATION
Initial Contact Point on Vehicle: Damaged Area(s): 99 Undercarriage Damage: 99 - Unknown
SEQUENCE OF EVENTS
1st: - -
2nd: - -
3rd: - -
4th: - -
CARRIER (If this crash involves a carrier, forward a copy of the report to: Commercial Vehicle Operations, 11900 Industry Way, Anchorage, AK 99515)
Motor Vehicle Type: 01- Motor Vehicle In-Transport (Inside or Outside the Driver Presence: 01 - Yes
VIN: 2C4RC1FG5MR6 License Plate # DNTBLNK State: MS Registration Year: 2026 Color: Whi
OWNER INFORMATION
Vehicle Owner Name (Last, Frist, Middle,Suffix): WAY, COURTNEY Mailing Address:
DAMAGE INFORMATION
Initial Contact Point on Vehicle: Damaged Area(s): 06 Undercarriage Damage: 00 - No
SEQUENCE OF EVENTS
1st: - -
2nd: - -
3rd: - -
4th: - -
CARRIER (If this crash involves a carrier, forward a copy of the report to: Commercial Vehicle Operations, 11900 Industry Way, Anchorage, AK 99515)
PERSON INFORMATION
Alcohol Suspected: 00 - No Alcohol Test Status: - Alcohol Test Type: 00 - Test Not Given
Alcohol Test Result: - Reading Value:
Drugs Suspected: 00 - No Drug Test Status: - Drug Test Type: 00 - Test Not Given
Drug Test Result: - Drugs Detected: -
Fill these only for person types 01, 02, 03, 04 and 09
Row: - Seat: -
Other Location: - Airbag Deployed: -
Ejection: 99 - Unknown if Ejected Ejection Path: 99 - Unknown / Unknown Path Extrication: 99 - Unknown
Fill these only for person types 04, 05, 06, 07, 08, 10 and 19
Collision with Motor Vehicle Unit #: 00
Direction of Travel: 97 - Not Applicable
Action(s) / Circumstance(s) Prior to Crash: 97 - Not Applicable
PERSON INFORMATION
Alcohol Suspected: 00 - No Alcohol Test Status: - Alcohol Test Type: 00 - Test Not Given
Alcohol Test Result: - Reading Value:
Drugs Suspected: 00 - No Drug Test Status: - Drug Test Type: 00 - Test Not Given
Drug Test Result: - Drugs Detected: -
Fill these only for person types 01, 02, 03, 04 and 09
Row: - Seat: -
Other Location: - Airbag Deployed: -
Ejection: 97 - Not Applicable Ejection Path: 97 - Not Applicable Extrication: 97 - Not Applicable
Fill these only for person types 04, 05, 06, 07, 08, 10 and 19
Collision with Motor Vehicle Unit #: 00
Direction of Travel: 97 - Not Applicable
Action(s) / Circumstance(s) Prior to Crash: 97 - Not Applicable
ATTACHMENT / IMAGE #
Attachment Description:
4(1)
AMC 3.90.040- Confidentiality of personal 5(4)
A- PII Identifying information. 6(4)