INSTRUCTIONS FOR COMPLETING FORM TE-213

This form is used in conjunction with the TE 56 Collision Diagram. When it becomes impractical to put descriptive information on the diagram, this
form can be used to list the details of each accident.

Column No. 1: Accident No.

Provides a reference character which refers to a particular accident on the
diagram, but may be unnecessary if the date is included on the diagram
itself.

Column No. 2,3 & 4: Date, time and Number of Vehicles

Date, time and number of vehicles

Column No. 5: Severity

Classifies each accident as either Fatal (F), Injury (I) or Property Damage
(PDO). Non-Reportable accidents (NR) can be included if desired.
Column No. 6,7,8 & 9: Environmental
Uses coded numbers from the MV 104 police accident report listed on the
form.

Column No. 10: Apparent Contributing Factors

Uses coded numbers from the MV 104 police accident report. The apparent
contributing factors are listed below.

Column No. 11: Description

Include a brief description of each accident. Include any information deemed
relevant. This information may include such items as accident type, direction
of vehicles, existing traffic control & driver characteristics.
Apparent Contributing Factors

HUMAN VEHICULAR ENVIRONMENTAL

2. Alcohol Involvement 41. Accelerator Defective 61. Animal's Action
3. Backing Unsafely 42. Brakes Defective 62. Glare
4. Driver Inattention* 43. Headlights Defective 63. Lane Marking - Improper/Inadequate
5. Driver Inexperience* 44. Other Lighting Defects 64. Obstruction/Debris
6. Drugs (illegal) 45. Oversized Vehicle 65. Pavement Defective
7. Failure to Yield Right-of-Way 46. Steering Failure 66. Pavement Slippery
8. Fell Asleep 47. Tire Failure/Inadequate 67. Shoulders - Defective/Improper
9. Following Too Closely 48. Tow Hitch Defective 68. Traffic Control Device Improper/
10. Illness 49. Windshield Inadequate Non-working
11. Lost Consciousness 60. Other Vehicular* 69. View Obstructed/Limited
12. Passenger Distraction 80. Other Environmental*
13. Passing or Lane Usage Improper
14. Pedestrian's Error/Confusion
15. Physical Disability
16. Prescription Medication
17. Traffic Control Disregarded
18. Turning Improperly
19. Unsafe Speed
40. Other Human*