(Contact information updated 5/2001)

Contact Name:

Sebastian Puglisi
Connecticut Department of Transportation
Transportation Supervising Planner
2800 Berlin Turnpike
Newington, CT  06131-7546

Phone: (860) 594-2094

E-Mail: sebastian.puglisi@po.state.ct.us

For more information on this state please visit  http://24.123.50.125/trsystems

Reporting Threshold:  $1000

This version of the State Crash Forms was posted on this site on 7/2000, and revised by the state on 12/1994.

Click on the thumbnails below to view a full sized image.

Select the appropriate page number below to view a printable Acrobat (.pdf) version. 

Page 1 - Environment & Vehicle Information Template           
Page 2 - Instructions             
Page 3 - Contributing Factors & Maneuvers Template               
Page 4 - State Abbreviations
Page 5 - Occupant Information
Page 6 - Narrative & Diagram