Instructions for Form Mv-104l - Report of Motor Vehicle Accident Police Line of Duty Accident

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SECTION 6
Instructions for Completing
REPORT OF MOTOR VEHICLE ACCIDENT
POLICE LINE OF DUTY ACCIDENT
Form MV-104L
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SECTION 6
Instructions for Completing
REPORT OF MOTOR VEHICLE ACCIDENT
POLICE LINE OF DUTY ACCIDENT
Form MV-104L
-89-
REPORTING LINE OF DUTY CRASHES
Operators/owners of police vehicles must notify DMV of on-duty crashes by filing a "Report of Motor Vehicle
Accident" (MV-104), or by submitting a "Police Line of Duty Accident" (MV-104L) and a “Police Accident Report”
(MV104A or MV-104AN). Form MV-104L is NOT acceptable by itself.
COMPLETING THE "REPORT OF MOTOR VEHICLE ACCIDENT POLICE LINE OF DUTY ACCIDENT",
FORM MV-104L
Enter the following information:
Page number - the MV-104L should be consecutively numbered following the last numbered page of the MV-104A
or MV-104AN.
Precinct - NYC only
Local Accident Number - enter a case number; complaint number, or any other identifying information the police
agency finds helpful.
Accident Date - enter the 2-digit month, day and year
Accident Time - enter the military time of the crash
County
enter the name of the county reported on the MV-104A
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enter the name of the borough (Bronx, Kings, New York, Queens or Richmond) reported on the MV-104AN
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Names of Drivers (Vehicles 1 - 6)
Last, First, MI - enter the driver’s name exactly as shown on the license document.
State of Veh. Reg. - abbreviate the state or province where the vehicle is registered (see Appendix B).
Plate Number - enter the registration plate number of the vehicle involved in the crash.
Driver License State - abbreviate the state or province that issued the driver license (see Appendix B).
Driver License Number - print the number from the license document.
Vehicle Number - enter the Vehicle Number for this report (1-6).
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ENFORCEMENT OFFICER INFORMATION
Date - date officer completed this report
Signature of Owner of Police Vehicle/Police Agency Representative
NCIC # - enter the middle five positions of the NCIC
Identifying the crash as an “emergency operation”:
To help DMV staff know that a crash was “emergency operation” related, the police personnel completing the police
accident report should use the following text when describing the crash:
“The crash occurred in a police vehicle owned/operated by (fill in the name of the police
agency) while responding to an emergency.”
If the MV-104, “Report of a Motor Vehicle Accident”, is being used to file the report, the above text should be
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printed in Section 4, after “How did this accident happen?”
If the MV-104L, “Report of Motor Vehicle Accident Police Line of Duty Accident”, is being used, the above
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text should be printed in the “Accident Description/Officer’s Notes” section of the MV-104A or MV-104AN.
The MV-104A or MV-104AN must be submitted with the MV-104L.
"The crash occurred in a police vehicle owned/operated by (fill in the name of the police
agency) while responding to an emergency."
Note: DMV will not display reportable motor vehicle crashes on the license abstract of a police officer who was
involved in a reportable motor vehicle crash while operating a police vehicle during an "emergency operation" as
defined by Section 114-b of the Vehicle & Traffic Law.
An "emergency operation" crash will be displayed on the license abstract if the operator of the police vehicle has been
charged with a violation of the Vehicle and Traffic Law or Penal Law, or if a court of law finds the operator to have
been grossly negligent when the crash occurred. The crash will remain on the operator's record unless the
commissioner receives evidence that the charge has been dismissed or that the charge or action against the defendant
operator has been dismissed or adjudicated in his or her favor.
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Download Instructions for Form Mv-104l - Report of Motor Vehicle Accident Police Line of Duty Accident

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