Fill in a Valid 12 209 Alaska Template Get My Document Now

Fill in a Valid 12 209 Alaska Template

The Alaska Motor Vehicle Crash Form 12-209 serves as a comprehensive report to document motor vehicle accidents within the state. It meticulously records various details from the incident including the number of vehicles involved, crash time and date, location specifics, and characteristics of the crash scene such as weather, road conditions, and lighting. Designed for official use, it also captures in-depth information about the drivers, vehicles, any injuries sustained, and circumstances that may have contributed to the accident, ensuring a thorough understanding of each collision for investigative and insurance purposes.

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Overview

In the vast and diverse landscape of Alaska, the occurrence of motor vehicle accidents presents unique challenges and complexities, necessitating a comprehensive and detailed documentation process for effective management and analysis. The Alaska Motor Vehicle Crash Form 12-209 serves as a critical tool in this endeavor, structured to capture an array of crucial data points post-accident. The form encompasses a wide range of information, from basic crash details such as the total number of vehicles involved, the crash date, time and specific location within the city or borough, to more nuanced data like weather conditions, lighting, and specificities of the roadway or junction where the crash occurred. Furthermore, it delves into the nature of the crash with sections dedicated to the first sequence of events, including both collision and non-collision types and the exact location of these events on the road surface. Crucially, it seeks detailed information about the drivers and vehicles involved, including the driver's contact information, vehicle damage assessment, direction of travel, actions leading up to the crash, and any contributing roadway circumstances. Additionally, the form features sections for other drivers' information, vehicle configurations, and specifics about traffic control at the scene. Injury and insurance information play a significant role in the form, ensuring all involved parties' health status and coverage details are accurately recorded. This thorough documentation framework not only facilitates the immediate response and intervention efforts but also aids in long-term crash analysis and prevention strategies. By compiling and analyzing data from the Alaska Motor Vehicle Crash Form 12-209, stakeholders can identify patterns, assess risk factors, and implement targeted measures to enhance road safety across the state.

Form Preview Example

ALASKA MOTOR VEHICLE CRASH FORM 12-209

SR #

C R A S H I N F O R M A T I O N

(One choice per field unless otherwise noted. Other* should be explained in narrative)

 

 

 

Total # Vehicles

Crash Date

Time of Crash

am Crash Day

01 MON

03 WED

05 FRI

07 SUN

Crash occurred in (City / Borough)

 

 

 

 

 

pm

 

 

02 TUE

04 THU

06 SAT

 

 

 

 

Name of Street or Highway

 

 

Miles

North of:

South of:

Name of Cross Street, Highway, Bridge, etc.

OFFICIAL USE ONLY

 

 

 

 

 

East of:

West of:

 

 

 

Location Control

Reference Point

 

 

 

 

Feet

 

 

 

 

 

 

 

 

 

At intersection with:

 

 

 

 

 

 

Weather

 

 

 

Lighting

 

 

 

 

Roadway / Junction

 

 

 

 

01 Blowing dirt, snow

07 Sleet, hail (freezing rain)

01 Dark - lighted roadway

07 Not reported

 

01 Crossover

07 Roundabout

13 Other*

02 Clear

 

08 Severe crosswinds

 

02 Dark - not lighted

 

08 Unknown

 

02 Driveway

08 T - intersection

 

 

03 Cloudy

 

09 Snow

 

03 Dark - unknown lighting

 

 

03 Not a junction

09 Y - intersection

 

 

04 Fog/ smoke

 

10 Other*

 

04 Daylight

 

 

 

 

04 On ramp

10 Four way intersection

 

05 Ice fog

 

11 Not reported

 

05 Twilight

 

 

 

 

05 Off ramp

11 Five point or more

 

 

06 Rain

 

12 Unknown

 

06 Other*

 

 

 

 

06 Railway crossing

12 Unknown

 

 

First Sequence of Events (what was the first thing you crashed into, or what was the first event that resulted in the crash. (CHECKONLY ONE FOR EITHER COLLISION OR NON-COLLISION

 

 

 

 

COLLISION

 

 

 

 

 

NON-COLLISION

 

 

 

01 Aircraft

 

09 Ditch

17 Median barrier

 

25 Train

 

 

33 Cargo loss / shift

 

40 Overturn

 

02 Animal

 

10 Embankment

18 Moose

 

26 Tree / shrub

 

34 Crossed median / centerline

41 Ran off road

 

03 Bicyclist

 

11 Fence

19 Parked vehicle

 

27 Utility pole

 

35 Downhill runaway

 

42 Separation of units

04 Bridge / overpass

12 Guard rail face

20 Pedestrian

 

28 Vehicle in transit

 

36 Equipment failure

 

43 Other*

 

 

05 Bridge rail

 

13 Guard rail end

21 Sideswipe

 

29 Vehicle - rear end

 

37 Explosion / fire

 

44 Unknown

 

06 Crash cushion

14 Light support

22 Sign

 

30 Vehicle - head on

 

38 Immersion

 

 

 

 

07 Culvert

 

15 Machinery

23 Snowberm

 

31 Vehicle - angle

 

39 Jackknife

 

 

 

 

08 Curb / wall

 

16 Mail box

24 Traffic signal pole

 

32 Other fixed object

 

 

 

 

 

 

 

Location of First Sequence of Events (where did the crash happen first?)

 

 

 

Road Surface

 

 

 

Did police

 

01 Bike lane

 

04 Outside of trafficway

 

07 Roadway

 

10 Unknown

01 Dry

04 Sand, mud, oil

07 Wet

Yes

 

 

 

investigate

02 Gore

 

05 Parking lot

 

08 Shared use paths

 

 

02 Ice

05 Slush

08 Other*

No

 

 

 

 

this crash?

03 Median

 

06 Roadside

 

09 Shoulder

 

 

 

03 Water

06 Snow

 

 

 

 

 

 

 

 

 

 

 

Y O U R D R I V E R I N F O R M A T I O N

Your Name (Vehicle Driver's Last Name, First Name, Middle Name)

Your Date of Birth

Your Contact Telephone

Your Mailing Address

Your Driver License Number

Your Driver License State

Your Driver License Country

Your City

Your State

Your Zip Code

Your Residence Country

Y O U R V E H I C L E I N F O R M A T I O N

 

Your Vehicle Damage

No. of Occupants

 

 

 

Your Vehicle Owner's Name (Last, First, Middle Initial)

 

 

 

 

Vehicle Owner's Telephone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

01 None / minor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

03 Disabling

05 Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Your Vehicle Owner's Mailing Address

 

 

 

 

 

 

 

 

02 Functional

04 Totaled

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

02

03

 

04

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Your Vehicle Owner's City

 

 

 

Your Vehicle Owner's State

 

Vehicle Owner's Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle Year

Vehicle Make

 

Vehicle Model

 

 

 

License Plate #

 

Vehicle License State

 

01

 

 

05

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Your Vehicle's Direction of Travel

 

 

 

 

 

 

Damage Estimate

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

01 North

02 South

03 East

04 West

 

05 Unknown

 

Over $501

 

 

 

 

 

 

 

 

Your Vehicle Driver's Injury Status (vehicle passengers are listed on page 2)

 

 

 

08

07

 

06

 

 

 

01 Fatal

 

 

03 Non-incapacitating

 

05 None

07 Unknown

 

CHECK ONLY ONE TO SHOW FIRST AREA OF IMPACT

 

 

02 Incapacitating

04 Possible

 

06 Not reported

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Roadway Circumstances (that may have contributed to the crash)

 

 

 

 

Your Vehicle Action

 

 

 

 

 

 

 

 

01 Debris

 

07 Road surface condition

 

 

13 Other*

 

01 Avoiding objects in road

 

08 Out of control

 

15 Straight ahead

 

02 Inoperative traffic device

08 Ruts, holes, bumps

 

 

14 Unknown

 

02 Backing

 

 

09 Passing

 

16 Turning right

 

03 Missing traffic device

 

09 School zone

 

 

 

 

 

03 Changing lanes

 

 

10 Parked

 

17 Turning left

 

04 Obscured traffic device

 

10 Work zone

 

 

 

 

 

04 Entering traffic lane

 

 

11 Skidding

 

18 Other*

 

05 Obstruction in roadway

 

11 Worn, polished road surface

 

 

05 Leaving traffic lane

 

 

12 Slowing

 

19 Unknown

 

06 Shoulder

 

12 None

 

 

 

 

 

 

 

06 Making U-turn

 

 

13 Starting in traffic

 

 

 

 

 

 

 

 

 

 

 

07 Merging

 

 

14 Stopped

 

 

 

Traffic Control

 

 

 

 

 

 

 

 

Vehicle Configuration

 

 

 

 

 

 

 

 

01 Flashing signal

05 School zone signs

09 Officer / Flagman / Guard

 

01 Dog sled

 

 

05 Off highway vehicle

 

09 Other*

 

02 No traffic controls

06 Stop sign

 

 

10 Yield sign

 

 

02 Light truck (4 tires)

 

 

06 Passenger car

 

10 Unknown

 

03 Road construction signs

07 Traffic control signal

11 Other*

 

 

03 Motorhome

 

 

07 Pedalcycle

 

 

 

04 RR crossing device

08 Warning signs

 

 

12 Unknown

 

 

04 Motorcycle

 

 

08 Pedestrian

 

 

 

C R A S H D E S C R I P T I O N

(Write a brief narrative describing the crash)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fairbanks Police Department Rev. 07/05

Crash Form 12-209 - Page 1

ALASKA MOTOR VEHICLE CRASH FORM 12-209

O T H E R D R I V E R ' S I N F O R M A T I O N

Other Driver's Name (Last Name, First Name, Middle Name)

Other Driver's Date of Birth

Other Driver's Contact Telephone

Other Driver's Mailing Address

Other Driver's License #

Other Driver's License State

Other Driver's License Country

Other Driver's Mailing Address City

Other Driver's State

Other Driver's Zip Code

Other Driver's Residence Country

O T H E R D R I V E R V E H I C L E I N F O R M A T I O N

 

Other Vehicle Damage

Other Vehicle No. of Occupants

 

 

 

Other Vehicle Owner's Name (Last, First, Middle Initial)

 

 

 

Other Vehicle Owner's Telephone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

01 None / minor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

03 Disabling

05 Unknown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other Vehicle Owner's Mailing Address

 

 

 

 

 

 

 

 

02 Functional

 

04 Totaled

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

02

 

03

 

04

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other Vehicle Owner's City

 

 

 

Other Vehicle Owner's State

 

Other Vehicle Owner's Zip

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle Year

Vehicle Make

 

Vehicle Model

 

 

License Plate #

 

Vehicle License State

 

01

 

 

 

05

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other Vehicle's Direction of Travel

 

 

 

 

 

 

Damage Estimate

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

01 North

02 South

03 East

04 West

 

05 Unknown

 

Over $501

 

 

 

 

 

 

 

 

 

Other Vehicle Driver's Injury Status (vehicle passengers are listed below)

 

 

 

08

 

07

 

06

 

 

 

01 Fatal

 

 

03 Non-incapacitating

05 None

07 Unknown

 

CHECK ONLY ONE TO SHOW FIRST AREA OF IMPACT

 

 

02 Incapacitating

04 Possible

06 Not reported

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other Driver's Roadway Circumstances (that may have contributed to the crash)

 

Other Driver's Vehicle Action

 

 

 

 

 

 

 

 

01 Debris

 

 

07 Road surface condition

 

 

13 Other*

 

01 Avoiding objects in road

08 Out of control

 

15 Straight ahead

 

02 Inoperative traffic device

08 Ruts, holes, bumps

 

 

14 Unknown

 

02 Backing

 

09 Passing

 

16 Turning right

 

03 Missing traffic device

 

 

09 School zone

 

 

 

 

 

03 Changing lanes

 

10 Parked

 

17 Turning left

 

04 Obscured traffic device

 

10 Work zone

 

 

 

 

 

04 Entering traffic lane

 

11 Skidding

 

18 Other*

 

05 Obstruction in roadway

 

11 Worn, polished road surface

 

 

05 Leaving traffic lane

 

12 Slowing

 

19 Unknown

 

06 Shoulder

 

 

12 None

 

 

 

 

 

 

 

06 Making U-turn

 

13 Starting in traffic

 

 

 

 

 

 

 

 

 

 

 

 

 

 

07 Merging

 

14 Stopped

 

 

 

Other Driver's Traffic Control (traffic control for the other driver may have been different from yours)

Other Driver's Vehicle Configuration

 

 

 

 

 

 

 

01 Flashing signal

 

05 School zone signs

09 Officer / Flagman / Guard

 

01 Dog sled

 

05 Off highway vehicle

 

09 Other*

 

02 No traffic controls

 

06 Stop sign

 

 

10 Yield sign

 

 

02 Light truck (4 tires)

 

06 Passenger car

 

10 Unknown

 

03 Road construction signs

07 Traffic control signal

11 Other*

 

 

03 Motorhome

 

07 Pedalcycle

 

 

 

04 RR crossing device

 

08 Warning signs

 

 

12 Unknown

 

 

04 Motorcycle

 

08 Pedestrian

 

 

 

 

 

 

 

I N J U R Y S E C T I O N

(Fill in the name of injured person, injury status, telephone number, and which vehicle they occupied when the crash occurred)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

Injury Status

 

 

 

Telephone

Vehicle License

02 Incapacitating

03 Non-incapacitating

04 Possible

05 None

07 Unknown

 

02 Incapacitating

03 Non-incapacitating

04 Possible

05 None

07 Unknown

 

02 Incapacitating

03 Non-incapacitating

04 Possible

05 None

07 Unknown

 

02 Incapacitating

03 Non-incapacitating

04 Possible

05 None

07 Unknown

 

YOUR INSURANCE INFORMATION

C E R T I F I C A T E O F

I N S U R A N C E

 

Failure to complete the Certificate of Insurance could

 

 

 

result in the suspension of your driver's license)

CRASH

 

Crash Date

 

Crash Location

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Your Name (Driver's Last Name, First Name, Middle Initial)

 

 

Your Date of Birth

 

 

 

Your Driver's License Number

Your Driver's License State

DRIVER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMATION

 

Your Mailing Address

 

 

 

Your City

 

 

 

 

Your State

 

 

 

 

Your Zip Code

Your Contact Telephone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE

 

Vehicle Owner's Name (Last Name, First Name, Middle Initial)

 

 

 

Owner's Date of Birth

 

 

Owner's License Number

Owner' License State

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OWNER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle Owner's Mailing Address

 

 

Owner's City

 

 

 

 

 

Owner's State

 

 

 

 

Owner's Zip Code

Owner's Contact Telephone

INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE

 

Vehicle year

Vehicle make

 

Vehicle model

 

License plate #

 

Vehicle License State

 

Vehicle Identification Number (VIN)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Did you have a current automobile liability policy in effect covering this accident?

YES

NO

 

 

 

 

 

 

Insurance Company or Insurance Carrier Name

 

 

 

 

 

 

 

 

 

 

Insurance Policy Number

 

 

INSURANCE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address and Telephone Number of Insurance Agent

 

 

 

 

 

 

 

 

Insurance Policy

FROM

 

TO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Period:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE

 

YOUR SIGNATURE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INSURANCE VERIFICATION: If the motor vehicle liability insurance policy listed above was not in effect for the motor vehicle listed at the time of the crash indicated above, the insurance company is to complete the following and return this form to the Division of Motor Vehicles at the address listed on the bottom right corner on page 2 of this form. If indicated coverage was in effect at the time of the crash, no action is required.

REASON FOR DENIAL:

Policy expired before crash

Driver is not covered on policy

 

Policy effective after crash

Lapse in policy

 

Policy number given is incorrect

Other:

 

 

Authorized Representative Signature / Date

 

MAIL THIS FORM TO:

DMV MAIN OFFICE

P.O. BOX 110221

JUNEAU, AK 99811-0221

(907) 465-4361

Crash Form 12-209 - Page 2

Form Breakdown

Fact Number Fact Name Description
1 Form Type Alaska Motor Vehicle Crash Form 12-209 is designed for reporting motor vehicle crashes.
2 Governing Law The form is governed by Alaska state laws pertaining to motor vehicle operations and crash reporting.
3 Use Requirement This form is required for officially reporting a vehicle crash to Fairbanks Police Department, as per the revision note.
4 Components of the Crash It includes details like crash information, vehicle information, driver information, injury section, and insurance information.
5 Crash Information Information about the crash such as date, time, location, weather, and lighting conditions is collected.
6 Driver and Vehicle Details Both parties involved must provide driver’s license information, vehicle details, and insurance information.
7 Insurance Verification A section is dedicated to verifying insurance coverage at the time of the crash, which the insurance company must complete if applicable.
8 Signature Requirement The form must be signed by the reporting party, indicating that the provided information is accurate.
9 Submission Address Completed forms are to be mailed to the DMV Main Office in Juneau, Alaska, with the provided address.
10 Specifics on Crash Dynamics Details such as the first sequence of events leading to the crash, roadway circumstances, and vehicle action before the crash are recorded to understand the dynamics of the incident.

Instructions on Writing 12 209 Alaska

Filling out the Alaska Motor Vehicle Crash Form 12-209 is an important step if you've been involved in a vehicle crash in the state. This detailed form helps in documenting the specifics of the incident, which is crucial for insurance claims and legal matters. Let's navigate through this process step-by-step to ensure you complete the form accurately and comprehensively.

  1. Start with the CRASH INFORMATION section. Enter the total number of vehicles involved, the crash date, time (AM/PM), and day. Select the weather and lighting conditions from the provided options and describe the crash location, including the name of the street or highway and any relevant control points like cross streets or bridges.
  2. Proceed to the First Sequence of Events section. Check only one box to indicate whether it was a collision or non-collision and specify what was first impacted. This helps in understanding how the crash initiated.
  3. In the Location of First Sequence of Events and Road Surface sections, detail where exactly the crash happened first and describe the condition of the road. Indicate whether the police investigated the crash.
  4. Fill in YOUR DRIVER INFORMATION. Provide your full name, date of birth, contact telephone, mailing address, driver license number, state, country, and residence information.
  5. Under YOUR VEHICLE INFORMATION, describe your vehicle's condition following the crash, including the extent of its damage, the vehicle's direction of travel at the time of the crash, a damage estimate if available, and the driver's injury status.
  6. Next, detail any Roadway Circumstances and Your Vehicle Action that might have contributed to the crash. This can include existing debris, road surface conditions, and your maneuvers to avoid the crash.
  7. Review the OTHER DRIVER'S INFORMATION and OTHER DRIVER VEHICLE INFORMATION sections if applicable. Fill these out if another driver was involved in the crash, with details mirroring those you provided for yourself and your vehicle.
  8. In the INJURY SECTION, list the name, injury status, telephone number, and vehicle license of any injured individuals, providing as much detail as available.
  9. Finally, complete the YOUR INSURANCE INFORMATION section with your insurance details at the time of the crash, including the insurance company or carrier name, policy number, and the period the policy covers. Sign the CERTIFICATE OF INSURANCE at the bottom to affirm the provided information’s accuracy.
  10. Double-check all entered information for accuracy before signing at the YOUR SIGNATURE line. If the insurance policy listed was not in effect at the time of the crash, the insurance company must fill out the "Sign and Date" section for denial reasons.
  11. Mail the completed form to the DMV MAIN OFFICE at the address provided, ensuring it reaches them for processing.

Correctly filling out this form is critical for the accurate assessment of any claims or legal issues resulting from the crash. Take your time to provide thorough and accurate information for each section. This meticulousness ensures your interests are well-represented in any subsequent evaluations or investigations.

Common Questions

What is the Alaska Motor Vehicle Crash Form 12-209 used for?

The Alaska Motor Vehicle Crash Form 12-209 is a document used to report a motor vehicle crash in the state of Alaska. It captures essential information about the crash, including details of vehicles involved, driver and occupant information, crash circumstances, and damages incurred. This comprehensive report aids in official documentation and helps in the investigation of the incident.

Who needs to fill out this form?

Any driver involved in a motor vehicle crash in Alaska that results in injury, death, or property damage must complete the Form 12-209. If the police investigate the crash, they might also fill out or assist in completing this document.

Can I fill out the Alaska Motor Vehicle Crash Form 12-209 online?

As of the latest update, the Alaska Motor Vehicle Crash Form 12-209 needs to be filled out on paper. It's recommended to check with the Alaska Department of Motor Vehicles (DMV) for any updates or changes regarding the submission process.

What happens if I don't submit the Alaska Motor Vehicle Crash Form 12-209?

Failing to submit the Form 12-209 after a crash can result in penalties, including the suspension of your driver's license. It is a legal requirement to report crashes involving injury, death, or significant property damage to the Alaska DMV.

How do I submit the completed Alaska Motor Vehicle Crash Form 12-209?

The completed form should be mailed to the DMV MAIN OFFICE at the address provided at the bottom of the form. It is important to ensure that the form is completely and accurately filled out to avoid any delay in processing.

What information do I need to provide in the form?

You need to provide detailed information regarding the crash, including the date, time, and location of the crash, details about the vehicles involved, driver and passenger information, a description of the crash, and any injuries or damages sustained. Additionally, insurance details must also be provided.

Is it mandatory to have police investigate the crash to fill this form?

No, it is not mandatory for the police to investigate the crash for you to fill out this form. However, if the police do investigate, they might complete or assist with the form based on their findings.

What should I do if I wasn't able to gather all the information at the scene of the crash?

If you're unable to gather all the necessary information at the scene, provide as much detail as you can and note the missing information clearly. Contacting the other parties involved to gather additional details or obtaining the police report if available can be helpful.

How can I get a copy of the Alaska Motor Vehicle Crash Form 12-209?

Copies of the form can be obtained through the Alaska Department of Motor Vehicles website or at a local DMV office. It’s advisable to keep a blank copy handy in your vehicle for unforeseen circumstances.

Common mistakes

Filling out the Alaska Motor Vehicle Crash Form 12-209 requires careful attention to detail. Several common mistakes can occur during this process, which can potentially complicate the recording and understanding of a vehicular accident. Here are nine mistakes often made:

  1. Not checking only one choice per field when the form explicitly asks for it, unless otherwise noted. This mistake can create confusion about the circumstances of the crash.
  2. Misinterpreting the location control reference points such as "Miles North of" or "East of," leading to inaccuracies in pinpointing the crash location.
  3. Failure to explain "Other" selections in the narrative section when the fields provided do not adequately describe the crash circumstances.
  4. Incorrectly identifying the first sequence of events that resulted in the crash, which is crucial for understanding the cause and flow of the accident.
  5. Omitting or inaccurately reporting the roadway or junction type where the accident occurred, which is important for statistical and analysis purposes.
  6. Inadequately describing vehicle damage by misunderstanding the classification options between "None/minor," "Functional," "Disabling," and "Totaled."
  7. Not properly listing all occupants of the vehicle and their injury statuses, thereby not providing a complete account of the crash's impact.
  8. Leaving the insurance verification section incomplete or inaccurately filled, potentially causing issues with insurance claims or legal matters post-accident.
  9. Failure to sign the certification at the end of the form, which is necessary for the validation of the provided information.

By ensuring that these common mistakes are avoided, individuals can fill out the form more accurately, aiding both their personal records and any ongoing investigations or insurance claims related to the accident.

Documents used along the form

When completing or using the Alaska Motor Vehicle Crash Form 12-209, several other documents and forms often come into play, especially when documenting the specifics of a vehicle accident or following up on the event. These additional forms and documents are vital for various reasons such as insurance claims, legal issues, or personal records. Here’s a look at some of those key documents:

  • Police Report: A detailed report prepared by the responding officer at the scene of the accident. It includes observations, statements from those involved and witnesses, and the officer's assessment of the accident.
  • Insurance Claim Form: This form is submitted to your insurance company to initiate a claim. It outlines the accident details and requests compensation for damages and injuries.
  • Vehicle Damage Report: An assessment report detailing the extent and nature of damage your vehicle sustained in the crash. It's typically prepared by an auto repair shop.
  • Medical Records: If injuries were sustained in the crash, medical records document the treatment received. These records are crucial for insurance claims and personal injury cases.
  • Witness Statements: Written accounts from individuals who witnessed the accident can support your version of events and may be necessary for insurance or legal purposes.
  • Photographs of the Accident Scene: Photos can provide clear evidence of road conditions, vehicle placement, and damage, which is helpful for insurance claims and legal matters.
  • Personal Injury Claim Form: If the accident resulted in injuries, this form would be used to file a claim with insurance companies to cover medical expenses and other losses.
  • DMV Accident Report: In some jurisdictions, you’re required to file an accident report with the Department of Motor Vehicles, especially if the accident involves significant damage, injuries, or fatalities.
  • Receipts for Repairs and Medical Treatment: Keeping all receipts related to the accident is essential for reimbursement from insurance companies. This includes repairs to your vehicle and medical treatment costs.

Gathering and managing these documents promptly and efficiently can significantly influence the outcomes of insurance claims and legal matters resulting from the accident. It’s also a step toward ensuring all aspects of the accident are thoroughly documented for future reference.

Similar forms

The Alaska Motor Vehicle Crash Form 12-209 is akin to the California Traffic Accident Report (SR1), particularly in its purpose to document details of a vehicle crash. Both forms gather comprehensive information about the accident, including the date, time, location, and weather conditions, as well as details about the drivers, vehicles involved, and the sequence of events leading to the crash. The requirement to provide specific information about road and lighting conditions, vehicle movements, and driver actions emphasizes the forms' roles in assessing accident causes and liabilities.

Similarly to the New York State DMV Accident Report Form (MV-104), the Alaska form collects data not only on the crash circumstances but on specifics such as road surface conditions and traffic controls present. Like the Alaska variant, the MV-104 is designed to capture a nuanced picture of the accident environment, which can be crucial for insurance claims and legal proceedings. Drivers in both states are obligated to detail the physical context of the accident, ensuring a clear understanding of external factors that might have contributed.

The Texas Peace Officer's Crash Report (CR-3) shares objectives with the Alaska form in recording accident specifics for law enforcement purposes. Each form includes fields for detailed narratives of the crash, allowing officers to describe the sequence of events. Both documents are integral to the post-accident investigation process, aiding in the determination of fault and the application of traffic laws.

The Florida Traffic Crash Report (HSMV 90010S) is another document with similarities to Alaska's crash form, particularly in how it captures data on vehicle damage and passenger injuries. Each form makes provisions for documenting the direction of travel, actions preceding the crash, and the nature of impacts. This information is critical for insurance assessment and for improving road safety measures based on crash patterns.

Illinois Motorist Report (SR 1050) shares commonalities with Alaska's form in the detailed personal and vehicle information required from drivers involved in a crash. Both forms necessitate driver, vehicle, and insurance details to ensure accountability and to facilitate the insurance claim process. The emphasis on thorough information collection is key to understanding crash dynamics and legal responsibilities.

The Ohio Traffic Crash Report (OH-1) parallels the Alaska form in its comprehensive approach to documenting crash details, including diagrams and narratives. Both forms allow for the illustration of crash scenes, offering valuable visual context to complement written descriptions. These diagrams can be pivotal in legal evaluations and insurance determinations, aiding in the accurate reconstruction of events.

Michigan Traffic Crash Report (UD-10) aligns with the Alaska form in the granularity of data collection regarding crash circumstances and conditions. The focus on specific crash events, road conditions, and traffic controls serves a similar purpose of aiding in the forensic analysis of traffic accidents, with implications for both legal and insurance outcomes.

The Pennsylvania Police Crash Reporting Form (AA-500) shares similarities in its design to capture a wide array of data points regarding a vehicular accident, much like Alaska's form. This inclusivity in documentation is vital for providing a detailed account of the crash, which is beneficial for investigative, legal, and insurance purposes. Both forms are tools for compiling data that can influence traffic safety policies.

Georgia Motor Vehicle Crash Report (Form SR-13) bears resemblances in its coverage of accident specifics, including driver actions and environmental conditions, similar to the Alaska form. The careful documentation of these elements is crucial for understanding causation and liability in crashes, serving both preventative and legal needs.

Lastly, the Washington State Motor Vehicle Collision Report mirrors Alaska’s form in the emphasis on detailed descriptions of the collision, the involvement of pedestrians or bicycles, and the conditions under which the crash occurred. Both forms require information about the sequence of incidents leading to the crash, underscoring the importance of narrative accounts in comprehending and preventing future accidents.

Dos and Don'ts

Filling out Alaska Motor Vehicle Crash Form 12-209 correctly is crucial to ensure the accuracy and completeness of a crash report. Here are five important dos and don'ts to keep in mind.

Things to Do

  1. Double-check all sections for completeness: Ensure every required field is filled out to prevent delays in processing.
  2. Use clear and legible handwriting: This helps in avoiding misinterpretations of the data provided.
  3. Be specific in the description: When filling out the crash description section, provide as many details as possible to give a clear picture of the incident.
  4. Report accurately: Ensure the information about the crash date, time, and location is correct to aid in the investigation.
  5. Review the form before submission: Check for any errors or omissions that could affect the accuracy of the report.

Things to Avoid

  1. Leaving sections blank: Do not skip any sections or questions. If a section does not apply, indicate with "N/A" (Not Applicable).
  2. Making assumptions: Only report the facts as you know them. Avoid guessing or estimating unless absolutely necessary, and specify when you do.
  3. Using correction fluid: Mistakes should be corrected by neatly crossing out incorrect entries and writing the correct information nearby.
  4. Forgetting to report all vehicles and parties involved: Ensure every vehicle and person involved in the crash is listed on the form.
  5. Ignoring the narrative section: This section is vital for providing context and additional details about the crash. Do not leave it blank.

Misconceptions

Navigating the intricacies of Alaska's Motor Vehicle Crash Form 12-209 can be a daunting task, with myths and misunderstandings complicating what should be a straightforward process. Let's debunk some of the most common misconceptions surrounding this important document.

  • Misconception 1: "The form is only necessary for major accidents."

    This misconception could not be farther from the truth. Regardless of the severity, the form is crucial for documenting any incidents on the road, ensuring all parties have accurately recorded information for insurance and legal matters.

  • Misconception 2: "You need to file the form immediately at the scene of the crash."

    While timely filing is important, accuracy and completeness matter more. It’s essential to collect as much information as possible at the scene, but the form should be filled out carefully and thoughtfully, which might mean taking a bit more time to ensure all details are correct.

  • Misconception 3: "Police investigation details aren’t necessary if you fill out this form."

    On the contrary, the involvement of law enforcement and their findings can be pivotal information that complements the details provided in your report, often affecting fault determinations and insurance claims.

  • Misconception 4: "Every section of the form must be filled out for it to be accepted."

    Although thoroughness is encouraged, some sections of the form may not apply to every incident. It's crucial to complete all relevant sections to the best of your ability and knowledge.

  • Misconception 5: "Only the vehicle driver needs to provide information on the form."

    This is not the case. Information regarding all parties involved, including other drivers, passengers, and even witnesses, can be vital. The form is designed to capture a comprehensive overview of the crash, not just the perspective of one driver.

  • Misconception 6: "You don’t need to report minor damages or injuries."

    Even seemingly minor details can have major implications down the line, especially when it comes to injuries that might not become apparent until after the incident. Reporting all damages and injuries, regardless of their initial assessment, is critical.

  • Misconception 7: "Submitting this form will automatically determine fault in the crash."

    While the form is an essential piece of the puzzle, determining fault involves a comprehensive review of all available information, including but not limited to this report, police reports, witness statements, and any other evidence.

  • Misconception 8: "The form must be mailed to the DMV to be officially recorded."

    Although mailing the form is one option, it’s not the only way to submit it. Checking with local jurisdictions is essential as digital submissions or direct submissions to insurance companies may also be viable options.

  • Misconception 9: "If the other driver admits fault at the scene, you don’t need to fill out or submit this form."

    No matter what is said at the scene, documenting the incident formally is crucial. Admissions of fault at the scene do not negate the need for official documentation, as circumstances and recollections may change over time.

Understanding the Alaska Motor Vehicle Crash Form 12-209 is imperative for anyone on the roads in Alaska. Dispelling these misconceptions ensures that all parties involved are better prepared to accurately report any unfortunate incidents, aiding in the seamless processing of claims and legal matters.

Key takeaways

When filling out the Alaska Motor Vehicle Crash Form 12-209, there are several key takeaways that are essential for ensuring the information you provide is accurate and comprehensive. This can not only aid in the processing of your form but also in any subsequent legal or insurance procedures.

  • Accurate information is crucial: Accurately complete all sections, including personal, vehicle, and crash information. Misreporting can lead to issues with insurance claims or legal proceedings.
  • Weather and lighting conditions matter: Clearly indicate the weather and lighting conditions at the time of the crash, as these factors can significantly impact fault determinations and insurance assessments.
  • Detail the crash sequence: The form requires a detailed account of the crash sequence, including the first event that led to the collision. Being precise here helps construct a clear narrative of the incident.
  • Roadway circumstances can be important: Document any roadway circumstances that may have contributed to the accident, such as debris or poor road conditions. These details are essential for a comprehensive understanding of the crash.
  • Your vehicle's condition post-crash: Accurately describe your vehicle’s condition after the crash, including any damage estimates. This is vital for insurance purposes.
  • Injury information is critical: If there were any injuries, document the severity and provide contact information for those injured. This information is crucial for insurance and legal assistance.
  • Insurance information must be current: Ensure that the insurance information you provide is current and covers the date of the accident. This is necessary for processing your claim.
  • Sign the document: Your signature is required to validate the form. An unsigned form may be considered incomplete and could delay processing.
  • Know where to send the form: Finally, be aware of where to send the completed form. For Alaska, it's sent to the DMV Main Office in Juneau. Timely submission is essential for prompt action.

This form plays a crucial role in documenting motor vehicle crashes in Alaska, serving as an official record that can impact legal and insurance outcomes. Whether you're a driver, a vehicle owner, or a witness, providing complete and accurate information is in your best interest and assists in the fair resolution of the aftermath of the crash.

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