ATLANTA POLICE DEPARTMENT

OFFICE OF PROFESSIONAL STANDARDS

OPS - VEHICLE ACCIDENT REQUEST FORM

OFFICER INFORMATION

Employee Involved:

Race:	Sex:	ID#:	Rank:

Employee work assignment: Division: Section: Unit:

INCIDENT AND VEHICLE INFORMATION

Incident Date: Incident Time: CADS#: County/Location:

Incident location:

Incident Zone:	Shift:	Vehicle(s) Involved:

Summary of Incident:

Type of Accident:	Light Conditions:

Weather conditions:	Vehicle #:

Vehicle Information:	Year:	Make:	Model:

Employee sustained any injuries:	Others sustained any injuries:

Requested by:	Rank:	Date:

In order to obtain an OPS number; this form needs to be completed entirely and e-mailed to the following people. Once received; an OPS number will be issued.

SPO Fields, Sharian	SFields@Atlantaga.gov

Ofc. Freeland, David	DFreeland@Atlantaga.gov

Ofc. Cruz, Balmore	BCruz@Atlantaga.gov

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2012-02-06

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