Traffic Incident Report

The Laurel District Association created this form to collect information on traffic incidents in The Laurel to develop an empirical understanding of traffic and safety conditions within the District.

The LDA is a private non-profit organization dedicated to the improvement of the Laurel District. Information submitted in this form will be used by the LDA to advance our organizational goals.

This is NOT a police report and is not intended to serve as an official record of any kind.

We encourage you to report all traffic incidents to the Oakland Police Department as follows:

Injury accidents should be reported by calling 911;
For assistance with non-injury accidents, call the non-emergency line at (510) 777-3333.

Date of Incident

YYYY

Time of Incident

Hour

Minute

Second

Nearest Street Address or Intersection

Type of Incident

Vehicle Collision

Speeding

Red Light Violation

Reckless/Unsafe Driving

Other Traffic Safety Concern

INCIDENT DESCRIPTION:

Please provide a brief description of what happened.

Was anyone injured?

Was any Private Property damaged aside from the vehicles involved? (e.g. fences, buildings etc.)

Was any Public Property damaged? (light poles, planters, trashcans etc.)

Was a police report filed?

Line

VEHICLE INFORMATION:

How many vehicles were involved?

Vehicle 1 description

Vehicle 1 License Plate Number

Vehicle 2 description

Vehicle 2 License Plate Number

Additional Info:

Line

YOUR INFORMATION:

First Name

Last Name

Phone

(###)

###

####

To give the LDA permission to share your name and contact information with law enforcement type "CONSENT" below.