The Form FR-10 is a part of the four-part collision report form. The items listed below on the Form FR-10 are completed first and separated from the remainder of the collision report. The officer then completes the remainder of the collision report form.
(1) DATE – Enter the appropriate month, day of the month and year (mm-dd-yyyy). Please follow this sequence to provide uniformity for the Department records. Use a hyphen (-) to separate the numbers.
(2) TIME – Enter the time at which the collision occurred. Use military time and do not indicate a.m. or p.m.
(3) COUNTY – Enter the appropriate code number for the county in which the motor vehicle collision occurred.
(4) ROUTE CATEGORY – Circle the number that corresponds to the route category on which the collision occurred.
(5) COLLISION LOCATION – Enter the appropriate route or road number, or if a street name, enter the name of the street.
(6) AUXILIARY CODE – Circle the auxiliary code that identifies the specific route or controlled access highway location on which the collision occurred.
(7) UNIT NUMBER– Enter a “1” for the first unit in the collision; a “2” for the second unit, a “3” for the third, etc.
(8) SEX – Enter M for male, F for female and U for Unknown.
(9) RACE – Enter A for Asian/Pacific Islander, B for African American, C for Caucasian, H for Hispanic, I for Alaskan Native or American Indian, O for Other or U for Unknown.
(10) DRIVER OR PEDESTRIAN FULL NAME – Enter the name of the person who was operating the vehicle at the time of the collision. Record the last name first, and then insert a hyphen (-), the first name and middle initial.
(11) STREET – Copy from the driver‟s license if available and acknowledged to be correct. (12) DATE OF BIRTH – Enter as it appears on the driver license. If no license, enter month, day and year of birth. Separate the month day, and year with a hyphen (mm-dd-yyyy).
(13) CITY, STATE AND ZIP – Copy from the driver‟s license if available and acknowledged to be correct.
(14) STATE – Enter standard abbreviation for the name of the state that issued the driver‟s license.
(15) DRIVER LICENSE NUMBER – Copy this completely and accurately from the driver license possessed by the vehicle operator. If the driver is not licensed enter “NONE” in this field. There should be no hyphens (dashes) in the driver license number.
(16) YEAR – Enter the year the vehicle was manufactured. (17) BODY – Enter as shown on the vehicle registration card.
(18) MAKE AND IDENTIFICATION NUMBER – Enter the complete brand name and identification number of the vehicle as shown on the vehicle itself. Check this number against that on the registration card.
(19) STATE – Enter abbreviation of the state that issued the license plate.
(20) YEAR – Enter the four digit year (yyyy) of expiration as shown on the registration card. (21) LICENSE PLATE NUMBER – Enter the letters and/or numbers that appear on the metal plate on the vehicle. No spaces or hyphens should be used.
(22) PHONE NUMBERS – Enter this information if available to assist with possible future contact.
(23) OWNERS FULL NAME, STREET OR RFD, CITY, STATE AND ZIP – Enter the current information from the registration card, driver or any other source.
(24) COLLISION INSURANCE INFORMATION – The law enforcement officer is asked to obtain the name of the insurance agency, insurance company and policy number from each driver for this section, if available. It is not mandatory that the officer does this, but it will serve as a
convenience to the driver to exchange insurance information and a follow-up for insurance
companies. After completing the Form FR-10, write the adverse party‟s insurance information on his Form FR-10. This will also assist the officer in any further investigations. Remember, this section has no relationship in having the driver/owner verify his insurance through our established
procedures. The driver/owner must not be led to believe that this is positive proof of insurance by completing this section. If there is no insurance indicate “NONE”. If self insured indicate “SELF INSURED”.
(25) SIGNATURE – This line should be signed by either the operator or the owner of the vehicle to clarify which person actually received the form.
(26) INSURANCE INFORMATION – The law enforcement officer will not be
responsible for entering the insurance information in this section of the Form FR10; the owner or operator is to forward this to the insurance representative to verify by completing that portion of the form or by transmitting it electronically to the Department of Motor Vehicles.
(27) FORM FR-10 NOT ISSUED UNDER SECTION 56-10-520 – This will be completed at the time of the collision investigation. If it is determined that liability insurance is not in effect, the officer should complete this section and sign in the designated location. No Form FR-10 will be issued to the operator or owner of a motor vehicle if a summons is issued at the time of the collision investigation under Section 56-10-520 of the 1976 South Carolina Code of Laws, as amended (see Section IX in general instructions for Form FR-10). For paper reports, please complete the bottom right hand corner of the FR-10. Attach FR-10 to the TR-310. For SCCATTS E-Reports indicate the summons number issued in the summons number block. Also indicate in the narrative that this is the unit operating uninsured.
SUPPLEMENTAL BUS AND TRUCK COLLISION REPORT FORWARD