Fatal Supplement DT3480
A Fatal Supplement Form (either electronic or paper) is required whenever there is a traffic crash resulting in a fatality. Beginning in 2017 the only way to create a Fatal Supplement is to replicate from the crash form. The death must occur within 30 days of the crash to be considered a traffic fatality. A fetus must be 28 weeks developed to be counted as a traffic fatality. This form replaces the paper MV3480 Fatal Supplement Form when submitted as part of a TraCS electronic crash report and is necessary to comply with the requirements of the federal Fatality Analysis Reporting System (FARS). This form is transmitted when validated.
NOTE: this form is only accessible with a replicate from the Crash form with the Fatality.
This form is owned by Department of State Patrol Crash Records Unit
Instructions for most scenarios in filling out the crash form are found in the F2 Help field in the Police Number field. If you have any other question on how to fill out the crash form please contact the Crash Records Department and they will be able to get this corrected for you.
Use their contact info below for future reference whenever you have issues filling out the crash form.
CRASH FORMS SUPPORT QUESTIONS
Email: crash.database@dot.wi.gov
Phone #1: 608-709-0084
Phone #2: 608-266-2265
Form Design
The Fatal Supplement form contains following groups:
Document
Summary
Unit
Individual
How to:
Additional Information
Agency Tables associated with form
Document Group |
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Each Fatal Supplement form contains one Document group. The fields within the group are shown in the figure below.
Document Number
Document number of the fatal supplement form. Automatically generated via TraCS. For amended reports, this value is taken from the document number override field.
Machine Number
TraCS Machine Number that the Crash report was written on.
Pack
Wisconsin TraCS Pack version that the Crash Report was written on.
Baseline
TraCS Baseline version that the Crash report was written on.
Tags
Used to categorize different types of contacts such as “Click It or Ticket It”. Agencies can add their own tag types. This is an agency table with values being entered using the table manager tool. Instructions for this are in the installation guide in Task 3-5
Summary Group |
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This section contains general information about the accident. Every Crash report contains one summary group. Most fields in this group are not editable on the Fatal Supplement and if needed needs to be Modified on the Crash form.
Document Number (From DT4000)
This field is not editable in the Fatal Supplement
Document number of the initial form submission for the crash. Automatically generated via TraCS. For amended reports, this value is taken from the document number override field.
Crash Date
This field is not editable in the Fatal Supplement
The date at which the crash occurred.
This crash form, DT4000, has an effective date of 1/1/2017. Any forms prior to that need to be filled out on the MV4000 (paper or electronic). Entering a Crash Date prior to 1/1/2017 will result in TraCS opening the old MV4000 form.
Crash Time
This field is not editable in the Fatal Supplement
The military time at which the crash occurred.
Total Units
This field is not editable in the Fatal Supplement
The total number of units involved in the crash. All modes of transportation, including equipment and non-motorized units.
This field is sometimes grayed out and set to 1. If the Crash Type is a non-domesticated animal without injury, then this field is always set to 1. This field adds and deletes the Unit group. If the unit group is not empty, then it will not delete automatically, and deletion will need to be manually completed.
Total Killed
This field is not editable in the Fatal Supplement
The total number of fatalities (motorists and non-motorists) that resulted from injuries sustained as the result of a specific motor vehicle crash. If a pregnant woman is involved in a fatal crash, she must be in the 3rd trimester for the fetus to be considered a fatality. In reporting fatality statistics, a 30-day counting rule is generally used for highway safety statistics. This rule provides that only deaths that occur within 30 24-hour periods of a crash will be counted for statistical purposes.
If this field is greater than zero, then fields throughout the form will turn yellow. These yellow fields are required is sending an email to the FARS group at the DOT. See document for more information on Fatal Crashes.
Unit Group |
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This section contains information about the units involved in the crash. There should be a Unit group for each unit in the crash/fatal supplement. A unit can be the following
Automobile and all the passengers in it.
Truck and all the passengers in it.
Motorcycle and all the passengers on it.
Bus, Driver and all injured passengers in it.
Equipment and all passengers in it unless it is a train, then the train engineer and all injured passengers.
Bicycle and all passengers on it
Pedestrian, each separate pedestrian is considered a Unit.
A unit contains 1 or more subgroups, below is an example of the unit group.
NOTE: Vehicle Override Underride will be available Fall 2023
Unit # on Crash
This field is not editable in the Fatal Supplement
Number assigned to uniquely identify each motor vehicle involved in the crash.
Unit Status
This field is not editable in the Fatal Supplement
The status of the vehicle at the time of the crash. In Transit refers to a general motor vehicle crash
Unit Type
This field is not editable in the Fatal Supplement
The type of vehicle involved in the crash. Can be identified by license plate type
License Plate Number
This field is not editable in the Fatal Supplement
The alphanumeric identifier or other characters, exactly as displayed, on the registration plate or tag affixed to the motor vehicle. For combination trucks, motor vehicle plate number is obtained from the power unit or tractor.
Vehicle Type
This field is not editable in the Fatal Supplement
Describes the vehicle body type. This field is limited by the Unit Type field.
Total Occs
This field is not editable in the Fatal Supplement
The total number of occupants in a unit.
Total Occs Killed
This field is not editable in the Fatal Supplement
The total number of occupants killed in a unit.
Individual Sub-group
This section contains information about the passengers in vehicles involved in the crash. The number of individuals on a fatal supplement report can be different than on the crash report.
Every unit driver should be added.
Every individual that suffered a fatality.
Every individual that was transported to the hospital.
Occupant # on Crash
This field is not editable in the Fatal Supplement
Individual Sequence number on the Crash form.
Person Type
This field is not editable in the Fatal Supplement
The type of person involved in the crash.
Sex
This field is not editable in the Fatal Supplement
The sex of the person involved in the crash.
Last Name
This field is not editable in the Fatal Supplement
The last name of the person involved in the crash.
First Name
This field is not editable in the Fatal Supplement
The first name of the person involved in the crash.
Middle Initial
This field is not editable in the Fatal Supplement
The middle name of the person involved in the crash.
Suffix
This field is not editable in the Fatal Supplement
The suffix of the person involved in the crash.
Date of Birth
This field is not editable in the Fatal Supplement
The year, month, and day of birth, of person involved in the crash.
Hospital
This field is not editable in the Fatal Supplement
The number of the medical facility receiving patient.
This information is most important for Fatal Crash Reporting to the Federal Government.
Date of Death
This field is not editable in the Fatal Supplement
The Date of Death of the Individual in a fatal Crash
Time of Death
This field is not editable in the Fatal Supplement
The Time of Death of the Individual in a fatal Crash
Agency Group
Each TraCS form contains one Law Enforcement Agency group. The fields within the group are shown in the figure below. The Agency Space field is 200 characters. The fields within the group are shown in the figure below.
NOTE: The Officer mobile phone and officer fax fields were added in Fall 2023
In Fall 2023 an attempt was made to fix the issue where other another person information is entered into this section.
In March 2024 the fix was finalized to fix DOT officer ID’s in lower case.
Agency Space
Space for law enforcement officer to collect any info they want. This field is available for your agency’s use. They will instruct you how to use it.
Officer Rank
The Rank of the officer completing the report.
Officer Last Name
The last name of the officer completing the report.
Officer First Name
The first name of the officer completing the report.
Officer Middle Name
The middle name of the officer completing the report.
Suffix
The preferred suffix of the officer completing the report.
DOT Officer ID
The reporting officer ID number. This number is sent to the DOT and Courts and is used to uniquely identify the officer.
DNR Officer ID
The reporting officer DNR ID number. Unless the officer works for the DNR, this 9 digit number is the same for the agency the officer works for.
Officer Badge Number
The Badge Number of the officer completing the report. This number can change in the agency.
Officer EMail
The email of the officer completing the report.
Officer Phone Number
The cell phone number of the officer completing the report (Added Fall 2023)
Used for Fatal notification and Ambulance Inspection Reports
Officer Fax Number
The fax number of the officer completing the report (Added Fall 2023)
Used for Ambulance Inspection Reports
Local Agency Number
Identifying number for the law enforcement agency that reported.
Law Enforcement Agency Jurisdiction
The jurisdiction of the enforcement agency that reported.
Law Enforcement Agency Type
The jurisdiction of the enforcement agency that reported.
State Patrol
County Sheriff
City Police
Village police
Town Police
Tribal
Other
Law Enforcement Agency Name
The name of the enforcement agency that reported.
TAS Agency Name
The TraCS name of the enforcement agency that reported.
Law Enforcement Agency Street Address
The current street address of the law enforcement agency responding to the scene.
Law Enforcement Agency Street Address2
The current street address of the law enforcement agency responding to the scene.
Law Enforcement Agency City
The current city where the law enforcement agency responding resides.
LEA State
The current state where the law enforcement agency responding resides.
Law Enforcement Agency ZIP Code
The current ZIP code where the law enforcement agency responding resides.
Law Enforcement Agency Phone Number
The telephone number of the law enforcement agency reporting.
ORI Number
9 digit NCIC number assigned to the enforcement agency by the Department of Justice.
BFUNC Agency
The ID number that uniquely identifies a law enforcement agency in Wisconsin that reported.
TraCS Agency Number
The 3 digit TraCS ID of the enforcement agency that reported.
Attachment Group
Each form contains one or more Attachment Groups. The fields within the group are shown in the figure below. Depending on the policies of your agency, you may attach files to your report. Not all agencies use attachments.
Attached File -In the Databar choose
File - to choose the file to attach.
File Upload - To attach a file link and upload the attachment to a central server. The file is encrypted and will be unavailable to view except through TraCS.
Bar Code Imager - To import an image from the bar code scanner. (needs IT to set up.)
Scanner - To import from a scanner attached to the computer.
File Link - To attach a file link. The file will be saved in a common TraCS attachment directory.
File Name - Enter the file name, this field is automatically generated if blank from eh attached file name.
Agency Space - Enter any miscellaneous comments to include.
Documents
How to Add or Delete a Group
Attachments 101
Attachments in the Hosted Environment
Law enforcement agencies will not be able to use embedded attachments (storing attachments in the database) in the Badger TraCS Hosted Environment but will be able to use file upload (files saved outside of the database on a file server). The file upload attachments are limited to 2MB in size with the form and will reside on the Badger TraCS Hosted Environment Server as encrypted files. If Law enforcement doesn’t want to use the file upload option, they can store all their attachments on their own server, PC or workstation, using File Link.
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