24-11395 PKW Orig and Supp R

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Report Type: Incident/Case #

COLLISION REPORT CONTINUATION NARRATIVE Original 24-011395


Crash Date: Crash Time (24 hr): Name of Street or Highway: Cross Street, Bridge, etc:
04/12/2024 15:19 OLD SEWARD TUDOR
SYNOPSIS:
On 4/13/24, at approximately 1540 hours, I responded to OLD SEWARD/TUDOR for the report of a hit and run collision. I
contacted COURTNEY WAY, who told me a white male with facial piercings and tattoos, who she believed was named WADE
THOMAS, had rear ended her CHRYSLER PACIFICA bearing AK Plate DNTBLNK. WADE was driving a red pickup truck
bearing plate LHE391 and had collided with DNTBLNK in the Westbound turn lane on OLD SEWARD. The man who she
believed was WADE THOMAS provided her with expired insurance information and left the scene. COURTNEY did not want to
press charges, but only wanted to make a police report for her insurance. A computer check showed that a potential match for
WADE THOMAS was actually WADE BENEDICT, who matched the description given by COURTNEY. I attempted to locate
WADE to speak with him about the incident, however I was unable to locate him. I uploaded all Axon recordings and Traffic
camera footage.

CASE STATUS:
Closed

Page 1 of 1 Shackelford, Braden: 65981 Revised 09/19/2012

MO v8.0.0.1
ALASKA MOTOR VEHICLE COLLISION REPORT SR# INCIDENT/CASE #
A241030432 / 24-011395

OFFICER / AGENCY INFORMATION


Officer Name: Officer Perm ID: Agency: Reviewing Review Date:
Shackelford, Braden 65981 APD Officer Perm ID: 63889 04/14/2024

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

First Harmful Event: 12 - Motor Vehicle In-Transport

Location of First Harmful Event Relative to Trafficway: 01 - On Roadway


Manner of Collision Impact: 01 - Front-to-Rear
Weather: 01,00 - Clear, No Additional Atmospheric Conditions Light Condition: 01 - Daylight
Roadway Surface Condition: 01 - Dry
Contributing Circumstances, Environment Conditions: -
RELATION TO JUNCTION Within Interchange Area: 01 - Yes
Specific Location: 18 - Through Roadway
Intersection Type: - School Bus Related: -

WORK ZONE RELATED Work Zone: 00 - None Location of the Crash: 97 - Not Applicable

Type of Workzone: 97 - Not Applicable Workers Present: 97 - Not Applicable


Law Enforcement Present: 97 - Not Applicable
CRASH DESCRIPTION CRASH DIAGRAM:
Veh 2 was in the EASTBOUND turn lane at OLD SEWARD/TUDOR
on OLD SEWARD. Veh 1 was traveling SOUTHBOUND in the OLD
SEWARD turn lane. Veh 1 did not slow down in time and rear-ended
Veh 2. The Driver of Veh 1 was unable to provide valid insurance to
Veh 2 and left the scene. The Driver of Veh 2 had valid insurance,
and was issued an NFR before leaving. I was unable to locate Veh 1
or the driver of Veh 1.

CASE STATUS:
Closed

Check if Supplemental Diagram

Page 1 of 6 12-200 Revised 07/02/2013


ALASKA MOTOR VEHICLE COLLISION REPORT SR# INCIDENT/CASE #
A241030432 / 24-011395

MOTOR VEHICLE INFORMATION

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

Make: Chevrolet Model: Model Year: 1995

OWNER INFORMATION
Vehicle Owner Name (Last, Frist, Middle,Suffix): GLORE, ANTHONY M Mailing Address:

City: State: Zip: Contact Phone:


Body Type: PK - Pickup Special Function: -
Emergency Use: - Posted Speed Limit: mph
Direction of Travel: - Trafficway Description: -
Total Thru Lanes: 03 - Three Lanes Roadway Horizontal Alignment: - Grade: -
Traffic Control Device Type: -
Traffic Control Device Working: -
Vehicle Maneuver/Action Prior to Recognition of Critical Event: -
Bus Use: -

DAMAGE INFORMATION
Initial Contact Point on Vehicle: Damaged Area(s): 99 Undercarriage Damage: 99 - Unknown

Damage > $501: 99 - Unknown

Extent Of Damage: 99 - Unknown

Vehicle Removal: 01 - Driven Away

Towed By: Not Applicable

00 - Non-Collision 15 - Cargo Loss 00 - Non-Collision 98 - All Areas


13 - Top 99 - Unknown 13 - Top 99 - Unknown
Hit and Run: 01 - Yes, driver or car and
14 - Undercarriage 14 - Undercarriage driver left scene
MOST HARMFUL EVENT
-

SEQUENCE OF EVENTS
1st: - -

2nd: - -

3rd: - -

4th: - -

Vehicle Contributing Circumstances: - Headlights On: -


Contributing Circumstances: -

CARRIER (If this crash involves a carrier, forward a copy of the report to: Commercial Vehicle Operations, 11900 Industry Way, Anchorage, AK 99515)

Motor Carrier Type: - Identification #: -

Issuing Authority: - Issuing State: Carrier Name Source: -


Carrier Name: Address:
City: State: Zip: Country: Phone:
GVWR / GCWR: - Vehicle Configuration: -
Cargo Body Type: -

HAZARDOUS MATERIALS (CARGO ONLY)


Involvement: - Placard Displayed: - HM 4-Digit #: 0000 HM Class #: Haz Mat Released: -

Page 2 of 6 Shackelford, Braden: 65981 12-200 Revised 07/02/2013


ALASKA MOTOR VEHICLE COLLISION REPORT SR# INCIDENT/CASE #
A241030432 / 24-011395

MOTOR VEHICLE INFORMATION

Motor Vehicle # 2 Most Contributing Unit: 00 - No Total Number of People in Vehicle: 1

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

Make: Chrysler Model: Pacifica (Sport Wagon) Model Year:

OWNER INFORMATION
Vehicle Owner Name (Last, Frist, Middle,Suffix): WAY, COURTNEY Mailing Address:

City: State: Zip: Contact Phone: A- PII


Body Type: - Special Function: 00 - No Special Function
Emergency Use: - Posted Speed Limit: mph
Direction of Travel: 02 - Eastbound Trafficway Description: -
Total Thru Lanes: 03 - Three Lanes Roadway Horizontal Alignment: - Grade: -
Traffic Control Device Type: 03 - Traffic Control Signal (on colors) not known wheth
Traffic Control Device Working: 03 - Device Functioning Properly
Vehicle Maneuver/Action Prior to Recognition of Critical Event: -
Bus Use: -

DAMAGE INFORMATION
Initial Contact Point on Vehicle: Damaged Area(s): 06 Undercarriage Damage: 00 - No

Damage > $501: 99 - Unknown

Extent Of Damage: 02 - Minor Damage

Vehicle Removal: 01 - Driven Away

Towed By: Not Applicable

00 - Non-Collision 15 - Cargo Loss 00 - Non-Collision 98 - All Areas


13 - Top 99 - Unknown 13 - Top 99 - Unknown
Hit and Run: 00 - No, did not leave scene
14 - Undercarriage 14 - Undercarriage

MOST HARMFUL EVENT


-

SEQUENCE OF EVENTS
1st: - -

2nd: - -

3rd: - -

4th: - -

Vehicle Contributing Circumstances: - Headlights On: -


Contributing Circumstances: -

CARRIER (If this crash involves a carrier, forward a copy of the report to: Commercial Vehicle Operations, 11900 Industry Way, Anchorage, AK 99515)

Motor Carrier Type: - Identification #: -

Issuing Authority: - Issuing State: Carrier Name Source: -


Carrier Name: Address:
City: State: Zip: Country: Phone:
GVWR / GCWR: - Vehicle Configuration: -
Cargo Body Type: -

HAZARDOUS MATERIALS (CARGO ONLY)


Involvement: - Placard Displayed: - HM 4-Digit #: 0000 HM Class #: Haz Mat Released: -

Page 3 of 6 Shackelford, Braden: 65981 12-200 Revised 07/02/2013


ALASKA MOTOR VEHICLE COLLISION REPORT SR# INCIDENT/CASE #
A241030432 / 24-011395

PERSON INFORMATION

Person # 1 Motor Vehicle # 1 Most Contributing Unit: 01 - Yes

Person Type: 01 - Driver of a Motor Vehicle In-Transport


Full Name (Last, First, Middle, Suffix): BENEDICT, WADE T Sex: M - Male
Mailing Address: City: State: Zip:
Physical Address: 743 BRAGAW ST APT 4 City: ANCHORAGE State: AK Zip: 99508
Contact Phone: A- PII DOB: A- PII OL / DL # : A- PII State: AK APSIN ID #: A- PII

Injury Status: 99 - Unknown Source of Transport to First Medical Facility: -


EMS Vehicle Agency ID: EMS Run #:
Name of Medical Facility:
Contributing Action(s) / Circumstance(s) at Time of Crash: -

Speeding Suspected: - Visual Obstruction: -


Restraint System / Safety Equipment(s): 99 - Unknown if Used

Restraint Mis-Use: 00 - No Distracted By: -

Condition(s) at Time of Crash: -

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: -

Charges: Total Charges for this Person: 1


Fill these only for person type 01 (DRIVERS only)
CDL: 00 - No DL Class(es): 00 Non-CDL Status: 01 - Suspended CDL Status: 00 - Not Licensed or Not a CDL
License Compliance with Class of Vehicle: 00 - Not licensed DL Endorsement(s): 00
Compliance with CDL Endorsement(s): 99 - Unknown, if required Driver's License Restriction(s): 0

Compliance with Driver's License Restriction(s): 99 - Unknown


Insurance Coverage: - Insurance Company: Insurance Policy #:
NFR: 00 - No

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

Going to of from School (K-12): 97 - Not Applicable


Traffic Control Device Type: 97 - Not Applicable
Location at Time of Crash: 97 - Not Applicable

Page 4 of 6 Shackelford, Braden: 65981 12-200 Revised 07/02/2013


ALASKA MOTOR VEHICLE COLLISION REPORT SR# INCIDENT/CASE #
A241030432 / 24-011395

PERSON INFORMATION

Person # 2 Motor Vehicle # 2 Most Contributing Unit: 00 - No

Person Type: 01 - Driver of a Motor Vehicle In-Transport


Full Name (Last, First, Middle, Suffix): WAY, COURTNEY Sex: F - Female
Mailing Address: City: State: Zip:
Physical Address: 1394 MUSKOX LP UNIT B City: Fort Richardson State: AK Zip: 99505
Contact Phone: A- PII DOB: A- PII OL / DL # : A- PII State: AR APSIN ID #: A- PII

Injury Status: 00 - No Apparent Injury Source of Transport to First Medical Facility: -


EMS Vehicle Agency ID: EMS Run #:
Name of Medical Facility:
Contributing Action(s) / Circumstance(s) at Time of Crash: -

Speeding Suspected: - Visual Obstruction: -


Restraint System / Safety Equipment(s): 03 - Shoulder and Lap Belt Used

Restraint Mis-Use: 00 - No Distracted By: -

Condition(s) at Time of Crash: -

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: -

Charges: Total Charges for this Person: 0


Fill these only for person type 01 (DRIVERS only)
CDL: 00 - No DL Class(es): D Non-CDL Status: 06 - Valid CDL Status: 00 - Not Licensed or Not a CDL
License Compliance with Class of Vehicle: 03 - Valid license for this class vehicle DL Endorsement(s): 00
Compliance with CDL Endorsement(s): 00 - No endorsements required for the vehicleDriver's License Restriction(s): 0
Compliance with Driver's License Restriction(s): 00 - No Restrictions
Insurance Coverage: 01 - Yes Insurance Company: Progressive Insurance Policy #: 977253932
NFR: 01 - Yes

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

Going to of from School (K-12): 97 - Not Applicable


Traffic Control Device Type: 97 - Not Applicable
Location at Time of Crash: 97 - Not Applicable

Page 5 of 6 Shackelford, Braden: 65981 12-200 Revised 07/02/2013


ALASKA MOTOR VEHICLE COLLISION REPORT SR# INCIDENT/CASE #
A241030432 / 24-011395

CHARGES FOR THIS CRASH

Person # 1 Citation Issued: Citation Number:

Charge: B- Name Conf

ATTACHMENT / IMAGE #

Attachment Description:

Page 6 of 6 Shackelford, Braden: 65981 12-200 Revised 07/02/2013


Redaction Date: 9/4/2024 10:36:42 AM
Redaction Log

Total Number of Redactions in Document: 10

Redaction Reasons by Page


Page Reason Description Occurrences

AMC 3.90.040- Confidentiality of personal


4 A- PII 1
Identifying information.

AMC 3.90.040- Confidentiality of personal


5 A- PII 4
Identifying information.

AMC 3.90.040- Confidentiality of personal


6 A- PII 4
Identifying information.

AMC 3.90.040 (C3)- Confidentiality of


7 B- Name Conf suspects, defendant, victim or witness 1
name.
Redaction Date: 9/4/2024 10:36:42 AM
Redaction Log

Redaction Reasons by Exemption


Pages
Reason Description (Count)

4(1)
AMC 3.90.040- Confidentiality of personal 5(4)
A- PII Identifying information. 6(4)

AMC 3.90.040 (C3)- Confidentiality of 7(1)


B- Name Conf suspects, defendant, victim or witness
name.

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