20170705 Rawlings17070504
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN03 Wisconsin Motor Vehicle
Crash Report
Secondary
CrashAmendedCrash Type
Non-Domesticated Animal w/ No InjuryReportable
TagsSchool Bus Related
NoActive School ZoneGovernment
Property
Trailer or TowedWork ZoneLane ClosureHit and RunOn Emergency
Total Killed
00
Total Injured
00
Total Units
01
Time Notified
02:13 PM
Date Notified
07/05/2017
Time ArrivedDate ArrivedCrash Time
02:00 PM
Crash Date
07/05/2017
Investigating Officer/Deputy
DEPUTY KEVIN GILLIS
Agency Crash NumberPrimary Crash Document #Document Number Override
6V
L
1
2
X
V
N
0
3
Structure Type
Y Coordinate
5105926.5
X Coordinate
160057.984375
Longitude
-91.392109949
Latitude
46.022446816
ON STH77 WB
0.40 MI W
OF CTHK
IN THE TOWN OF HAYWARD
IN SAWYER COUNTY
Location
Special StudyAccess ControlTribal Land
Crash Classification - Jurisdiction
No Special Jurisdiction
Crash Classification - Location
Public Property
Relation To Trafficway
Trafficway - On Road
Animal Type
Deer
Weather Condition(s)
Environment Factor(s)
Roadway Factor(s)Road Surface Condition(s)
Light ConditionManner of Collision
No Collision W/Vehicle In Transport
First Harmful Event Location
On Roadway
First Harmful Event
Non Domesticated Animal (Alive)
Crash Scene
Reporting Threshold
No
Truck Bus or HazMat
No
Road GradeRoad CurvatureSurface Type
Traffic Control Inoperative/MissingTraffic ControlTraffic Way
Emergency Motor Vehicle UseSpecial FunctionMost Harmful Event: Collision With
Non Domesticated Animal (Alive)
Total LanesSpeed LimitPre CrashTire
Mark
Direction Of Travel
Westbound
Insurance?
YES
Total HazMat Types
0
Total TrailersTotal # Citations Issued
0
Train/Bus # InjuredTotal Occs
1
Operating As EndorsementsVehicle Type
(Sport) Utility Vehicle
Unit Type
Automobile
Vehicle Operating As Classification
D CLASS
Unit Status
In Transit
UN
I
T
01
Unit Summary
Vehicle
Crash Time 02:00 PM
Crash Date 07/05/2017Wisconsin Motor Vehicle Crash
Form DT4000 1 of 3
This report does not include any CJIS data.
17070504
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN03 Wisconsin Motor Vehicle
Crash Report
Driver DistractionsNot Distracted
Driver ActionsNo Contributing Action
Driver Prior Action Other
Vehicle FactorsWhat Driver Was Doing
Vehicle Removed ByTowed Due To Damage
Towed Due To Disabling Damage
VE
H
I
C
L
E
UN
I
T
01
Extent Of Damage
Disabling Damage
Vehicle Damage
12--Front
Initial Contact Point
12--Front
Bus UseBody Style
UT - SPORT UTILITY VEHICLE
Color
BLK - Black
Model
RENEGADE
Year
2017
Make
JEEP
Vehicle Identification Number
83969
Country of Issuance
UNITED STATES
St
IA
Plate Type
AUT - Automobile
License Plate Number
FBA345
VE
H
I
C
L
E
UN
I
T
01
Individual
RICHARD RAWLINGS
Insurance Company
PROGRESSIVE-CLASSIC-INS-CO
Policy Holder
UN
I
T
Crash Time 02:00 PM
Crash Date 07/05/2017Wisconsin Motor Vehicle Crash
Form DT4000 2 of 3
This report does not include any CJIS data.
17070504
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL12XVN03 Wisconsin Motor Vehicle
Crash Report
Individual Condition
Appeared Normal
Drug Type
Drug Test ResultsDrug Test TypeDrug Test GivenTest Not Given
Alcohol Test ResultsAlcohol Test TypeAlcohol Test Given
Test Not Given
Suspected Drug UseSuspected Alcohol Use
Action Other
IN
D
I
V
I
D
U
A
L
UN
I
T
Action
To/From SchoolLocationPrior ActionStriking Unit #
00
1
01
Time of DeathDate of DeathHospital
EMS Run #EMS Agency IdentifierMedical Transport
Not Transported
Trapped/ExtricatedEjection PathEjected
AirbagInjury Severity
No Apparent Injury
IN
D
I
V
I
D
U
A
L
UN
I
T
Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
1--Front Seat-Left Side (Driver/Motorcycle/Bicycl
00
1
Safety Equipment
Shoulder & Lap Belt
On Duty Crash
01
Driver License Number07334608
State: Texas Country: UNITED STATES
Address
RICHARDSON, TX 75081 , US
RaceWHITEDate of Birth
01/18/
Sex
Male
Citations Issued
0
DriverRICHARD M RAWLINGS
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
Crash Time 02:00 PM
Crash Date 07/05/2017Wisconsin Motor Vehicle Crash
Form DT4000 3 of 3
This report does not include any CJIS data.