HomeMy WebLinkAbout24-5073 Redacted: Driver's license number redacted pursuant to 18 U.S. CODE 4 2721 - PROHIBITION ON RELEASE
AND USE OF CERTAIN PERSONAL INFORMATION FROM STATE MOTOR VEHICLE RECORDS; RCW
42.56.230(7);42.56.240(1); and 42.46.590(5) for safety and privacy. There is no legitimate public interest in knowing
the information.
Redacted: Social Security Number redacted pursuant to Title 5, Section 552(a) United States Regulations,
Annotated Secs 102, 301, 106(1);42 USC 405 (c) (vii) (1); RCW 42.56.050 and RCW 42.56.230 (5) and (7) for
safety and privacy. There is no legitimate public interest in knowing the information.
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C.JAOOBS 953 A0 f 71300
26
PART 3000-3a1 D-t!x7 'R 9 i:98'v PAGE 01 OF
STATE OF HINGTON
COLLISION REPORT CORRECTION REPORT NO. EE83364—�
1591972 CASE# 24-5083
ADDITIONAL PERSONS INVOLVED ASSENGERS AND/OR WITNESSES ONLY)
NAME PERMAL SHAHIL
�IIAST.FIRST.M1Dp1.E INRVLt.t
ADDRESS d PHONE b
BELLEVUE SEX M MMODYBYYY - 23 _ 2008
PASSENGER a WITNESS I UNIT# P y aRBAG 2 RESTfl. q EJECT HELMET INJURY NATURE OF INJURIES
USE 2 CLASS
NAME
A Asr RRsr MIDDLE iwnAU NIXON NAIMAH
ADDRESS d PHONE b
3005125TH AVE SE 3C BELLEVUE SEX F MMD D.oD YVYY.B• 00-9 _ 11 2020
PASSENGER O WITNESS[:] UNIT HELMET INJURY NATURE OF INJURES
UNIT# 2 P� 7 AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS
NAME
QAST,FIRST;MIDDLE INRIAL)
ADDRESS a PHONE b SEX D.O.B.
MMDDYYYV
PASSENGER Q WITNESS UNIT# SPOTS AIRBAG RESTR. EJECT HELM
USES CI INJURY NATURE OF INJURES
NARRATIVE
On 5-13-24 at about 08251 arrived in the 300 block of Rainier Ave S for a 2 vehicle collision. I
contacted both drivers in or near their vehicles. Both drivers were identified via WADL. Driver 2 told
me she was in lane 2 driving northbound in the 400 block of Rainier Ave S when unit 1 came over and
collided with the side of her vehcile. There were no injuries reported in her vehicle. Driver 1 told me
he did not change lanes but he is not sure how the collision occurred. There were no injuries
reported from unit 1. This collision occured in the city of Renton, County of king.
I CERTIFY{DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.JACOBS 05.20-24 08:51 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 61412024 9:59:32 AM
BADGE OR ID# 1953 OR1# WA0171300 TIME POLICE DISPATCHED 8:21 AM TIME POLICE ARRIVED 8:25 AM
PART B 3WO-346-160(A„lia) PAGE 0 of
REPORT NO. EE83364 CASE# 24-5083 DATEANDTIMF 05/13/24 08:19
OF COLUSION
7-
Scene not observed .
PAGE 3 OF 3