No preview available
HomeMy WebLinkAbout24-11531 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 5 27c COLLISION REP FIT 1591971 CASE 24-11531 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4900 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 1 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS OZ STRUCK RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ COLLISION'. 11 - 1-- 2024 1627 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ NE 4TH ST BLOCK NO. e✓ 3813 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5 500 00 FEET e S ❑ E e UNION AVE NE❑ 0 1 29 MOTOR PEDAL- DAM THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El YES NO F,/ D:3072990921 0 11 30 6� LAST NAME SCHERR FIRSTNAME RION MIDDLE 1 2 31 INITIAL STREET ❑ 432 MONROE AVE NE 108 CITY RENTON ST WA 2jp, 98056 z= NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 CLASS 1 NATURE OF INJURIES z❑ 3 10 9❑ P1 aTES� BST1131 sTArI WAvIN# 2G1WG5E3XC1284728 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM To TRLR. TRLR 7 3 33 12 3 5 VIN#' VIN# >; FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 $ 34 13❑8 2012 CHEV IMPALA SD DAMAGE YES NO YES[:] NO✓ REGISTERED OWNER INFO RION SCHERR 432 MONROE AVE NE 108 RENTON WA 98056 D:3072990921 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE z INSURANCE CO STATEFARM 4635956C2447A 4 LI EFFECT I POLICY# TOPVEHICLE CHARGE 36 LEGALLv res❑NO❑ CITATION# <1�3 OTTOM 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2064224049 16 a LAST NAME SAJAD FIRST NAME ABDUL MIDDLE M INITIAL 17 STREET❑ NEW ADOREss❑' 19722 INTERNATIONAL BLVD H313 CITY SEATAC ST WA ZIP 98188 4❑ 37 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED � 38 INTERLOCKYEs❑No� INTERLOCK v�Es No� YEs NO F 19 D IVEW # STATE WA SEX M MMDDYY 01 12 _ 1988 39 20 ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1 HE 2 INJURY 6 NATURE of INJURIES 40 USE CLASS SORENESS ❑21❑ PLATE# CKU9410 TArE WA VIN 1 41 SYFBU4EEXDP203224 1 42 22❑ PILER LATE# STATE PLATE# STATE 23❑ VIN#. 43 TRLR RLR 'IN#. VEH YEAR 2013 MAKE TOYT MODEL COROLL STYLE SO VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO ABDUL SAJAD 19722INTERNATIONAL BLVD H313 SEATAC WA 98188 D:2064224049 VEHICLE NO.2 SHADE IN DAMAGEbAREA 2 3 Cd LIABILITY INSURANCE INSU POLICY#E CO GEICO 6172816479IN I 9TOP 'E""LE ❑ N`L J ,J� CITATION# CHARGE i o BOTTOM LEGALLY YES 25 $ ' OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 R.PHILLIPS 11649 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF36443 COLLISION REPORT III III III III III 111 1591972 CASE# 24-11531 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) SAJAD BANAFSHA (LAST FIRST, ADDRESS&PHONE# 19722 INTERNATIONAL BLVD H313 SEATAC WA 98188 2064224049 SEXi F MMDOYyry 01 - 12 - 1988 SEAT HELMET INJURY NATURE OF INJURIES PASSENGER WITNESS❑!UNIT# 2 SOS 8 AIRBAG 2 RESTR, q EJECT USE 2 CLASS 6 SORENESS NAME '(LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# DOB SEX MMDDYVYV PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES POS. USE CLASS NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&PHONE# SEX D.O.B. MMDDYYYY. - PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES ❑ ❑ POS. USE CLASS ----� NARRATIVE' Please see subsequent narrative pages I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. R.PHILLIPS 11-07-24 05:10 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE P.KORDEL 9676 1 1111712024 4:46:22 PM BADGE OR ID# 11649 OR]# WA0171300 TIME POLICE DISPATCHED 4:28 Pry] TIME POLICE ARRIVED',4:35 PM PART I PAGE IT]OF 4] REPORT NO. EF36443 CASE# 24-11531 OF COLLISION 11/06/24 16:27 OF CbLLI510N NARRATIVE On 11-06-2024 at 1628 hours I was dispatched to a traffic accident at 3813 NE 4th ST in the city of Renton, King County WA. I arrived on scene and observed two males standing outside of two sedans with a female in the front passenger seat of the white sedan. I spoke with the driver of unit 1, Rion Scherr who was identified by his WA driver's license photo. Rion's vehicle was a 2012 Chevy Impala bearing WA license plate BST1131. Rion told me he was traveling east on NE 4th St when unit 2 slowed in front of him. Rion tried to avoid the collision but was not able to. The vehicles made contact but it was slight. I was able to see what appeared to be the imprint of a license plate on the rear of unit 2. Unit 1 sustained a bent license plate, not sure what else was damaged but it was slight. I spoke with the driver of unit 2, Abdul Sajad who stated he was traveling east of NE 4th street when he was rear ended. He stated his wife Banafsha was injured and had soreness in her shoulder, neck and back. A vehicle drove by laughing and mocking the injuries the woman complained of. They stated the witness the crash and felt this was an insurance scam and the crash was very minor. Both parties were given the case number. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. This report was electronically signed by Officer R. PHILLIPS #11649, November 7th, 2024 Renton, WA. PAGE 3 OF 4 REPORT NO. EF36443 CASE# ' 24-11531 DATE AND TIME 11/06/24 16:27 OF COLLISION kAv .� Z4 k 1� w k 3 4 � t ti ki ,n 7P 3 yt ¢ f PAGE 4 OF 4