Laserfiche WebLink
~^.olo.75.o3 ~ PRINT OR TYPE ~ Snow~nobil~ <br /> <br /> OFFICIAL ACCIDENT REPORT <br />~.n accident re.suiting in injury requiring medical attention or hospitalization to. or death of any person, or total damages of <br />~500~or more shall be reported by the investigating officer/operator on this form and fonvarded to the MINNESOTA <br />DEP,'Iffi~IRvlENT OF NATURAL RESOURCES, Division of Enforcement, 500 Lafayette Road, St. Paul, MN 55155-4047 <br />a, itlain ten business days. <br /> <br />QUESTIONS: 1-800-766-~000 METRO 296-~157 TDD Statewide 1-800-d57-$929 TDD METRO 296-5484 <br /> <br /> Add'tess df'Inve.stigatmg Department (No. & Street, RFD, Box No., City, Stat~, 'Zip Code) <br /> <br />Date of Accident J Time AM <br />DeSCripaon of Personal Injuries <br /> <br />T~uae of <br /> lty {-'-[ Fatal [-'-]FatalN°n' <br /> <br /> P?.roperty County <br />['?q uamage <br /> <br />JUVENILE OPERATOR <br /> <br />NON MUSA AREA <br /> <br />NON RESIDENT <br /> <br />Machln¢ B I Full Name (First, Middle, Last) D.O.tL ~ injured ~ male Age <br /> 7. / / ~ kilted fcmak <br /> Operator [---] Passenger ]-''-} Pedestrian [---] Other (explain) <br /> <br /> · I Full Name (First, Middle, Last) D.O.B. ~---~jure---~ male Age <br /> ! ! <br /> <br /> Operator [--] Passenger ~'~ Pedestrian ~ Other (explain) <br /> <br />(Over) L <br /> <br /> <br />