MISSOURI UNIFORM CRASH REPORT PAGE 1 0F 5

1- GENERAL CRASH INFORMATION

SPACE uSED FOR BARCODE

LEFTTHESCENE DRIVERNO. CLEARED

[] Yes @l NO l I I I I € Yes € xo.....CRASH @CLASSIFICATION

'!M*

la'im )Th i';ai lml4') -i I . . - 8 Wm 44406-27-20181200 06-27-20"l8 '1'2Ci5 - ""'1"2'T'0""""""""""' ""m""'es"""'5"'t'iti"""""""""""""'

ROADWAY NON.COLLISION COLLISIONINVOLVING IDIRECTIONALANALYSISFORIMPACTWITHMOTORVEHICLE[] Overkumlng [] Fell/Jumped [] Animal [] RaltwayVehicle [] FionttoFiont [] Angle [] Other

W Roadwayon € :;,:s,On z FcLO'ao,"golM/svEhllq;,,p O ::::'::c. m ::".:,':.:.a:',',',",':'a" Ig ::',:,o:eaaa" ::::=::'::':a';:' a ::aO:. Cl ::aoway g J"'ac"ka,',,',oe' z oNO,hn,rcolrlsllOn g ;e;eepo(lbaineci z :0';',n;':',,;,o','::.:,: la ReartoSlde a Falling/ShningCaigo (Explain)(Set in motion by MV)

111 I I , .

1. Does this crash involve any oT the follomng? 2. Examine each vehlcle to determine if it is a commetcial vehicle based upon the follomng:

1a. A person fatally inluretl OR @ NO _ NO commeicial vehicle 2a A tiuck/cargo Van mkh GVWR/GC'jWR OT nX)re tMan 0 NO _ No commercial vehicle fields1b.ApersontransporkedfotmedlmlatkentionOR fieldsneedcompletion. 10.OOOlbs;OR needcompletion.

jc A vehicle !owed due to disabling damage. z Ye, Goto numbe, z. __, 2b. A motor vehicle wlth seating lor 9.or mtxe Including dnver; OR z Ye, Complete Section 7G (0720. A vehicle mth a hazaidous mtenals plamrd. appropnate vehicle.

EVIDENTIARY PHOTOS TAKEN

€ Yes m No

BY WHOM AVAILABLEFROM € lnvestigatingAgency

RECONSTRuCTION

€ Yes XI No

BY WHOM AVAILABLE FROM [] Investlgating Agenty

2 - uOCATION

W!;4 N,ON mNEOSHO M W "'

ifflMfflUil!!lHHWl91%!l[NiF_ffll4)!

SWi!ilHii.,'ili)l:iii:iiiii:iiiiii"iiiii"

NFD2-Aiiiiiiliiiiiiijiiii""'i"ii"i""'i"9i';l'l'ii';'ll'ifllii"%l';")i{"i';';i';ili'i';'i'iii;l'

N R

""' USHIGHWAY60

ijffiiffi

m€ Afiei € NA[]Befoie

Ml xt

iIS INTERSTATE 49

a EI[BI E'Ela

E "' "' i"'?A Feek

- s Miles

TRAFFICWAY

0 0ne-Way [:l Two-Way; Not Divlded [] Two-%y; DYded unprohided Median [] Othet@ TwoWay; Not D*idetl Contlnuous Centei Tum Lane [] Two-Way; D*lded Posltive Median Baniei [] Unknown

I ROADALIGNMENT

I MI Sttalght [] Curvei[:l unknown (Biplain)

I ROAD PROFILEi % Level [] Dowihill [] Dipi[] uphlll [] Hillcrest [:l unknown(Explain)

INTERSECTIONTYPE € NA

% 4-waylntersection [3 Y4nteisection [] !>way/More [] unknowi(Explain)[:l T-Intetsettion [] Roundabout [0 0thei(Explaln)

ROAD SuRFACE

[] Conciete 0 Bilck [] Ditt{Sand [] Cobblestone7d Asphalt [0 Giavel [] MulllSuface [] Unknown(Explain)

WEATHER CONDITION

@ Cleai [] Rain [] SlsetlHail [] FoglMisi 0 0ther[Explain)[] Cloudy [:l Snow [] Fieezin(l(Temp) [] SeveteCrossmnd [] Unknown(Explain)

uST OWNER'S NAME & MX)RESS, DESCRIPTION OF PROPERTY, AND DAMAGE. 0 MODOT [] County 0 Municipality

4-WITNESS € None IdemiTied Cl Additional tnesses In Nanative

NAME ADDRESS (Street, City, State, Zip) PHONE NUMBER

ROSE,LAKOTALYNN 3251RTV-STELLA,MO64867

6- PEDESTRIAN % NA I € Law Emoicernent Officer a Other Emergency Services Personnel [] MoDOT Worker [] Other Tiafficway Woiker CI Other PedestrianNO NAME (Last, Firsk, Ml) & ADDRESS (Sttegk, City, State, Zip) PHONE NUMBER

DATE OF BIRTH SEX STRLICK BY VEH #: INJ TRANS-PORT

SAFETYDEVICES

I

LOCATION

[] On Roadwy [] In Diiveway Access € On Median / Crossing Island

[] On Sidewalk [] Off Roadway 0 unknowi

CROSSING noao K NA

[] WRh Signal l[:l Not At Crosswalk

Oao:@aB':gs:as:gna'l8'lnnu"nam"aer"kec;oCaaio"sswa"'lk0 unknown l[] Llnknown

OTHER ACTIONS g NA/None[] GetkingOn/OffVehu:le [] WoiklnglnTrafficway [] Unknown

0 Standing/Lying/Sitfing In Traffiy [] Playing In Trafficway [] Othei (Explain)[] Pushing/%ikingOnVehicle [] Walking/RunninglnTraffiomy

[] Behind/InFiontofParked/StoppedVeh. [] WithTraffk. [:l AgainstTraffic

SCHOOL INFO. K NA[] Going To/From School

[] Getking On / OfT School Bus

[] Both 01 The Above

[] unknown (Explain)

PROBABLECONTRIBuTINGCIRCuMSTANCES [] None

0 Failed To Yield [] Alcohol [] Vision Obstiuded (Explain) [] CXher (Explain)[] Distiacted / Inatientive [] Drugs [] Physiml Impakmenl (Explaln) [] Unknown (Explaln)

DISTRACTED/INATTENTIVECODE(S) WNA

111ALCOHOL USE

[] Yes [] No [] Unknown

DISTRIBLITION: COPY-AGENCYFILE; ORIGINAL-MISSOuRISTATEHIGHWAYPATROL-TRAFFICRECORDSDIVISION-P.0.BOX568-JEFFERSONCITY,MO65102 SHP-2Q 01/12

REPORT # W PAGE 2 0F 5

_ I I : I I I I I I I I ' $7(;j ,..,.... ;14, -!

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- ix@52 Interstate49offramp ! !l

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W60

. %

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! INDICATE ROAD NAMES DIAGRAM NOT TO SCALE "J'lllllllllill'l!

REPORT # g!aau PAGE 3 0F 5

7 - ORIVERS, VEHICLES, OWNER8, & OCCUPANTS

i=tA'il'7! d 4 'zThrflpri-xpne:wri hhnpzqsn mPHONE NuMBER

I M Wl AQCl_RFiA7i im I l + 0 # I il M M ffi M I % ffi %l I I I iil ii I I & I M %l I 11 I I I M -' Ili- %l M I I %l, I M I %/ IJ ffi IJ IJ M B

nonico i irycxis_ r iri hn ihaoco ariirc i ira w v._i*_. # _ . . I ll- - _ _. c - _ .!!. !!!! ,-! [0 A i- !'!!!l! !",!m -"} I

ws !Th M WIm W.!fiu! lj a wJlL .-

"-""""""" -"'- ;-: :::/Rev/Denied ::::... "- : :W'::.:.:_'a"- 8 ::'.':'a'!!W'!!a!tG'NAG202118009 MO € NA € Canceled/Othlnvalid z Unknown € NA z Interm/Grad z Unlicensed []unknown(Explain)

W SEX SEAT INJ TRANS- EJEC- ]§ VISION z NokObsttucted € Tiees/Brush a Sign € MovingVeh u Othei(Explain)LOC PORT TION aNa OBSTRuCTED [3 ndshield 0 Building [] Hillcrest [J StoppedVeh [] unknown

06-12-1943 F FL 5 1 2 03 051 € NA z LoadonVeh € Embankment € ParkedVeh € Glare (Explaln)

PHONE NO. (Opfiona0(417) 451-4873 -

POLICY NuMBER [] NA

24-1-9341030-1 mii s

Not RecluliedyB1yg, "aT'ii'i"a'51@i'i{151ji a=A !!am

""al'Y;,-"- € 'N"'o e 'EiFlE[TER ""' ""udtiaiiiiim

!!l)p!)!i5!@!e(@9!gQJ4KIQ! K SAD PHONENUMBER (X[ SAD

YEAR

2004

MAKE

Pontiac

MODEL

VERSATRA

COLOR

MAR IVEH. TYPE

1

TOT AL NO. OF OCC.

4ta

W,YEff3l8 "!'G M D V 1 3 E 6 4 D . 1 2 . 5 2 , 3 8llllllllllil:lil

W; lfflMtNel iGl$ a EEE[!II lEi?J4-1@1#'l;

€ Yes I;;"H'mlll",,F;'./=mg No ""'jj"Yes"""'lgl"'ii;"""""""""""""""""""""'

m(RII aWW kammil!'@'m! ,49445j9

Wl i_(1

rlG)-4-l--51'-;T7 ==;a maaU;de::';;!age'22 - Ca+go

0 NA

3

1 /"'%15 nj6il7 12 -------- --------

19 - Wndshield 23 - Unknowi

64 _ TrA I In! {(:vi'ilalnl

14 I 13 li211-1 I 10 I 9 -' - ' "" -"" """-""

ffl!!17!?#!i! i[!!!l!@!!!!!W4n!W@!'! €@M!NIC

OE'E',W,,,Q8 :=::':==:;':W=.a,: O ::'i §EE,'=,.:,p,,,,yM,,h E_:=:_:===_:==_=:=:='=:_:=g(P,,,AF,:ES'E';:7,,,,

:il(=i:ffij-==- :Ni:;=-[E]is.t=#;:(;;;a'- :Wi'i€fflffl,i:'i;Tifii(fii=:iiit[]To/FromSchool l[]unknown

EMERGENCYVEHICLEINVOLVEMENT % NA

[] Pollce [] Ambulance 0 A. Emeigency Vehk.le on Emergency Run[] Fiie [] Other (Musl check "A" / "!") % 0 B. Stationaiy With Emergenq Equip. Adlvated

d!jAW'mXIM

7C. VEHICLE ACTION/SEQUENCE OF EVENTS CODES [] Additional Codes Listed in NanaUve (See Codes in Section 8) A__LCOHOL u_SE

M)ffla' -n unknown'iiit'l!!i"!t't. - € Yes € unk

"lJ"A'WWTUWWW !None " " "---=T-'a'-r='aaa=-a'-a'-"T"""-=aaa-a"' sNo zNA

IJ Failed io yieio IJ Impropet I um IJ Wrong Side (One-Way) Q Imptopet Riding / Clinging To Veh. Exteiioi

[] Alcohol 0 ImproperPasslng [] Physlmllmpakment(Explain) [] FailedToSecuieLoad/lmpropeiLoading

[] Diugs [3 Impiopeily Parked [] Improper Start Fiom Paik [] Animal(s) In Roadway

DISTRACTED t INATTENTIVE CO[)E(S) % NA(See Codes in Section 8)

l"mmmm

_Q_Qs__;o _p2n:wnWorkeis Present

€ Yes E NO Cl unknown

M;uaaaiWIJ!FJF/F'iW%lffl!

[3 Yes (Explain) @ No

CI Unknown [] NA

O(:(tlPANTS - NAME (Last, Flrst, Ml)7F.

ADDRESS (Skreet, CRy, State, Zlp)

DATE OF BIRTH SEX SEATLOC

INJ TRANS-PORT

EJEC;-TION

AIRBAG

SAFETYDEVICES

PHONENuMBER

BROWN, DONALD RAY

11276 0AK RD - NEOSHO, MO 64850M FR 5 "t 2 03 05 (417) 499-8547

MARTIN, GUNNER05-23-2012 M SL 5 1 2 03 10 (417) 499-854717450 H HIGHWAY - NEOSHO, MO 64850

MARTIN, HARLEY05-05-2009 M SR 5 1 2 03 05 (417) 499-8547

17450HH1GHWAY -NEOSHO,MO64850

70. COMMERCIAL MOTOR VEHICLE @l NA l Requiied on vehicle if 'Yes" was answeied to questions in parts 1 and 21n CMV involvement ciitetia and vehlcle meets one oT the thiee criteiia in pri 2.MOTOR CARRIER IDENTIFICATION (Leasee, etc.) - NAME & ADDRESS (Street. City, Skate, Zip) [] SAO PHONE NUMBER [] SAO

COMMERCIAL / [] Inlerstate Canier [] Not In Commerce - Government Vehicle [] Nok In Corrmerce Othet VehicleNON-COMMERCIAL [] Intiastate Canlei 0 Not In Commerce - Rental Vehlcle

M(jMX71CCNO. uSOOT NO

CARGO [] EnclosedBox [] Flatbed 0 ConcreteMixei [] Garbage/Refuse [J PoleTrailer 0 Vehk:leTomng 0 Intermodal € NA(NO € Other

TYPEBooY € CargoTank € Dump € AutoTiansporter € Grain/Chip/Gravel a Log AnotherVeh. C;:;er C:;gr z unknownPLACARD DISPLAYED

HAZARDOLIS z Yes z No

MATERIALS a unknown

4.DIG1T NO. CLASS HM CARGO PRESENT

€ Yes € No

[] unknown

HM CARGO RELEASED

€ YesCINo

[J Unknown

REPORT # W PAaE 4 OF 57 - DRIVERS, VEHIC:LE8, OWNERS, & OC(llPANTS

PHONE NuMBER

(417) 451-2450

DRIVERLICENSE/lDNuMBER STATE

NO78"l49010 I MO

LIC % Valld [] Expked'ATus [] Susp/Rev/Denied [] DisqualCDL

0 NA [] Canceled/Oth Invalid [] Unknown

i ir m - . _. C m & m kl N AMaa ws mm m

'- '= ='::"" Qai'!f!!CI NA [] Inteim/Grad []

i

04-13-1 987

SEX

M

SEATLOC

FL

INJ

5

TRANS-PORT

1

EJEC.

TION

2 !' FVISION W NotObstructed [] Treas/Biush [] Sign 0 MovingVeh [:l Othei(Explaln)OBSTRuCTEo z ndshjeld 0 Building [] Hillcrest [] StoppedVeh [] Unknown[] NA z LoadonVeh [] Embankment [:l PatkedVeh [] Glaie (EXPlain)

PHONE NO. (Optiona0(417) 451-1173 -

POLICY NUMBER [] NA41031-85693-82 gati!)_a..i((a0-.tR+!IX:-..i:i..aa...:a...lHH

i Not Requkeda[]"';eso-6a-- 5 -yicprrnivti

pQi9Qqpmwiil'w't*m'lrimmmi

phoxexuveen (g sAo:!Wwamm:mmiW

YEAR

2003

MAKE

Dodge

MO € EL

1500COLOR

RED IVEH. TYPE

i

TOT AL NO. OF OCC.

1

I W,Y7319 '!""D 7 H A 1 8 N 9 3 J 6 4 4 0 . 1 1llllllllll'l:l:l

i:'a'; i; ii@ ffi # &a'EUIE ffiBaENamMA(ff41)lQiff4 Wt

-111111111111-'a4EA2195 ' O"'i;S " (gl"No """" -=i:j'ye;"""E NoIlWlll'll)i/lJIMMi :'@A)!}t!'Wllilll;GIXGliDltl ;5aAWl;Wfl'ffiall !)1811W Q. .. ........... . W ......... !J2m

-_ 5 "-a"ffi-0 'd"'-'-'i-s-J'-u;:a;nca:;age"""ffi-caigo

W NA -1

(4

E______(B % H ;;T:ield € H ::own-11-l 61 _ TrsuaA I 1711) /l-vnlalt'tl

1(-9P)e')(")l(") "-""'-'-"" """""'IJlltliillf?At}lMk'f%W&M'T#lll{'aQffflffi € ))

::E==;=w,,..(,5 :=::==(=:='::=o:=,;' O ::"-a : EEE:a,,,pH,,,yM,,h E-:=:-:===L::==-=:':='=:-:==u(P,,k'iF,,:5S"5::'::,,,

:i:t=::ffi$-==- ::(i:;=-[E]aisi=HJJ;;;;a)- :-ffl-i'iNffi'i:'il=ii=:i=l='::ii'[lTo/FromSchool l[]unknown

EMERGENCYVEHICLEINVOLVEMENT [NA

0 Police [] Ambulance [1 A. Emergency Vehicle on Emeigency Run0 Flte 0 0thet (Must check "A" / "ET') - [] B. Stationary With Emeigent.y Equlp. A6ated

iMElmlJffmmhi3"WIM '

7C. VEHICLE ACTION/SEQuEN(:E OF EVENTS CODES [] Addltional Codes Listed in Nanatlve (See Codes In Sectlon 8) ALCOHOL uSE€ Yes Cl unk(g NO 0 NA

a)!a)M!fi%'tffW'[!4[WWJ'ffiRfa!t 58 N.-

IJ Failed TO Yleld LI Imptoper 1-um IJ- Wrong Side (One-Way) [3 Impioper Riding / Clinging To Veh. Exterioi[] Alcohol 0 Imptoper Passing [] Physiml Impaiiment (Explaln) [] Falled To Secure Load / Impiopei Loadlng[3 Dtugs [] ImpropeilyPaiked [] lmproperStarkFromPark [] Animal(s)lnRoadway

DISTRACTED I INATTENTIVE CODE(S) M) NA

(See Codes in Section 8)

l"mm_tb_.[] Yes_pj0No []unknowi_

Woikers Present

[] Yes H NO € unknown

"4m € None O unknownElectric: MI Green/Yellow/Red [] Flashing Red € Flashing Yellow € Ramp Meter € Olher (Explain)

Othet O Siop sign € NO Passlng Zone [] Turn Resttlcted [] Offlcei / Flagman € Slgnal on School BusControls: [] Waming Sign/Device [:l Rallway Crosslng Sign/Device 0 School Zone [] Yield Sign [] Othei (Explain)

ffl[ae>NlhTffl

€ Yes (Explain) Jgl No€ unknown 0 NA

OC:CuPANTS - NAME (Last, Flrst, Ml)7F.

ADDRESS (Skieet, CRy, State, Zlp)

DATE OF BIRTH SEX SEATLOC

INJ TRAN&PORT

EJEC-TION

AIRBAG

SAFETYDEVICES

PHONE NUMBER

7a. COMMERCIAL MOTOR VEHICiLE MI NA I Required on vehicle iT 'Yes" was answeied to questions in parts 1 and 2in CMV involvement criteiia and vehicle mests one ol the thiee ciiteria in part 2.MOTOR CARRIER IDENTIFICATION (Leasee, etc.) - NAME & ADDRESS (Street, Clty, State, Zip) [] SAO phoxexuxeen [] 540

COMMERCIAL / [] Interstate Catrier [] Not In Commetoe - Government Vehicle [] Not In Comnerce - Other VehicleNONCOMMERCIAL [I Intrastate Canlei [] Not In Commetce - Rental Vehlcle

MC / MX / ICC NO. USDOT NO.

CARGO [:l EnclosedBox [] Flatbed [] ConcreteMixei [] Garbage/ReTuse [] PoleTtailer [] Vehk:leTomng [] Inteimodal [] NA(No [3 0thei

np=eooy [] CargoTank [] Dump [] AutoTiansporker [] Graln/Chip/Gravel [] LOg A"o'ana' chasslco"a'5'sBOdy)a'ca'go [] unknownPLACARD DISPLAYED

F171ZAR[)OuS z Yes € No

MATERIALS € unknown

4-DIGIT NO. CLASS HM CARGO PRESENT

ClYes CI No

0 Unknown

HM CARGO RELEASED

€ Yes € No

[] unknown

REPORT # 5 PAGE U OF 5

8-CODES

8EAT LOCtATION /XX - Not Known

B - Pedalcycle %M - Motorcycle %%CP - Commercial PassaiOE - Occupant - EncloseOu -Occupant - unendtRC - Rail CrewSV - O)her (Explain in NNA - Not Applicable

TRANSPORTED(For MedlcalTreatrnent)

1. No

2 EMS3. OtheiU. unknowi

N. NA

EIECTION

1. NA2. No3. Paflally4. Totallyu. Unknown

AIR BA(I1. None/ NA 9. Deployed -3. Not Deployed Comblnation4. Removed 10. Deployment5. Deployed - Fronf unknown6. Deployed - Slde u. Ak Bag Presence7. Deployed - Curkain unknown8. Deployed - Othet

(Knee, Aii Belt, etc.)

1. None It v nMfkmmm , .._flM [' a [:!

E053j,:,,7:o,.ywq'4531Q!%;5. Shouldet and Lap Belt 14. Reflective Clothing7. DOTCompliant 15. Othei

MC Helmet u. Use Unknown8. No Helmet N. Not Applicable

VEHICLE ACiTION/SEQllENCiE OP EVENTS (ltems mth double-asteiisk ["] iequire additional coding)

1. Going Sialght 10. Shrk From Paiked 19. Alibome 28. Separatlon Of unlts 37. Collision Inv. Othei Oblect (Explaln) 44. ThrownFalllng Oblect2. Overta)ttng 11 Backlng 20. Ran Off Roadway - Right 29. Re(urned To Roadway 38. Othet Noncolllslon 45. Sttuck By Falllng, Shming Caigo,3. Making Right Tum 12. Skipped In Tiaffic 21 Ran Off Roadway - Lefk 30. Collision Inv. Pedeslnan 39. Collision Inv. Bicyde/Pedakycle Object Set In Motion By Owi MV4. Right Tum on Red 13. Paiked 22. Overkum / Rollover 31. Collision Inv. BicyclelPedalt.ycle In Bicycle Lane 46. Ran Off Roadwy - Other (Explain)5. Making Leff Turn 14. Changing Lane 23. Flie/ Explosion 32. Collislon Inv. Railway Veh. 40. Collision Inv. Animal Diawi Vehk.le / 47. Cross Separator6. Making UTuin 15. Avoiding 24. Imrreislon 33. Collislon Inv. Animal (') Anlmal Ridden Foi Transportation

7. SkiddinO / Sliding 16. C(OSFI Median 25. JackkniTe 34. Collislon Inv. MV in Tianspork 41. Collislon Inv. Working MV8. Slowing/Stopping 17. Cioss Centei OT Road 26. Caigo Loss/Shifk 35. Collision Inv. Parked MV 42. Downhill Runaway9. Stark In Traffic 18. Cross Road 27. Equipment Failure 36. Collislon Inv. Fbied Object (") 43. FelVJumped Fiom MV

ANIMAL CODES POR VE:HICLE ACTION / SEQLIENCE OF EVENTS

60. Deer 61. FarmAnlmal 82. D(Xl 63. OtheiAnimal U Unk'o'l

FIXED OBJECT CODES FOR VEHICLE ACTION / SEQuENCE OF EVENTS

20. Tree/Stump(Standing) 2a Cutverk 32. Building 38. BridgeRail 44 Wall

21. Embankment/Dtveway/Ground/RockBluff 27. HighwayTiaffk.SignPost/Suppod 33. Tiaffk.SiHnalSuppork 39. GuardrailEnd 45. CableBaniei22. Guard+ailFace 28. BridgePier/Abutment/Suppork 34. lmpactAtkenuatoi/CrashCushion 40. OtheiTrafficBanisi 46. BridgeOverheadStructuie

23. UUlity Pole 29. Cuib 35. Fke H7dlant 41. OWITmad Sign Suppork 47. OVeThead Lln8 / Cable24. Fence 30. MailBox 36. Othei(Explaln) 42. Ditch U. Unknown

:is. Street LlOhl Suppork 31. Concrete Tiaffic Baniei 37. Bridge Paiapet End 43. Other Post i Pole i suppori

DISTRAC:TED / INATTENTIVE COOES

t ExtemalDistradion 5. CommunimtionDevioe-Hand-held 9. Eating/DrinKng 13. ComputerEquipment/Eleckronk:Games/elc.

2. Passengers 6. Communlcation Devlce - Hands Fiee 10. Reading 14. Adlusting Vehicle Controls3. Steteo/Audio/VideoEquipment 7. CommunimtionDevioe-Texting/E-mailing 11 TobaocoUse 15. Othet(Explam)a. Navigatlon Devk.e 8. Communimtion Devioe - Web Browng 12. Giooming

VEHICLE TYP!_ CODES

t Motor Vehlcle In Transport 3. Worklng Motoi Vehicle 5. Animal Drawn Vehicle / Animal Ridden Foy Ttansport Putposes2. ParkedMotorVehtcle 4. Pedalcycle u. Unknown

OTHER VEHICLE CODES

t Rlding Mowet/Garden Tractar 3. Snowrnobile 5. Animal Drawn Vehicle / Anlmal Ridden Foy Transporkation 6. Low Speed Vehk.le2.GolTCa(t 4.Forklifk 7.0ther(Explaln)

On 06/27/2018 at approximately 1210 hours, Officers responded to the intersection of Highway 60 and interstate 49 in regards to a

vehicle crash.

upon my arriva! I noticed a red Dodge pickup (MO 4EA495) with damage to multiple sides of the vehicle and a maroon Pontiac

Versatrak (MO WH1Z3E) with damage to the front passenger side fender. I made contact with the driver of the Dodge, Jason Lovrencic(identified by Missouri identification).

Mr. Lovrencic stated he was traveling eastbound on Highway 60 when the other vehicle moved over into his lane of traffic and struckthe rear end of his vehicle. Mr. Lovrencic stated affer she struck his vehicle it caused him to slid and then roll his pickup.

I then made contact with the driver of the Pontiac, Dolores Brown (identified by Missouri identification). Ms. Brown stated she was

traveling east bound on highway 60 when she was struck by another vehicle. Ms. Brown informed me that she did not see the other

vehicle and thought the pickup pulled out in front of her.

I then made contact with a witness, Lakota Rose (identified by Missouri identification). Mr. Rose stated he was traveling behind thepickup when the Pontiac attempted to pull behind the pickup and struck the rear end of the vehicle causing the vehicle crash.

After my investigation was complete I cleared the scene, due to the disabling damage the dodge pickup sustained Neosho towingI -

arrived on scene and towed the vehicle.

Nothing further.

10. REPORTIN(I AND REV1EWIN3 0FFICER jNFOR%'lATJC)%ffl Wjg6ij0ffl0a

NFD2-A

m[i !e tm! ffgkjf ft'f4g[ V ' /DUSTIN HONEYFIELD _-

'JaQH}:a:a';;Caa:Ji;aaHfa;iiffA;}11"! l

PG.u

"7""'I 1 ""'l

W /7_ ilD'l-t m * I REVIEWING OFFICER 2 NAME DSN / BADGE NO.;tmmea m \le l!lllnli 1!ll'il!15Y tm

--')-GTUI-CHAELWHITEHEAD //l/g ' ' "" "' i'O'/"