DI-9 Manual PDF - Utah Department of Public Safety

Property DamageDamage to Property other than VehiclesWrite the name and nature of the object struck in the crash. If any light, power, or telephone polewas damaged, indicate the number of the pole along with description.Note: Utah Power and Light and DOT addresses are located in most drop down boxes of theelectronic versions.Example: Light pole #P-135 (Indicate your estimate of the damage and check appropriate box.)Name and Address of Owner of Object StruckState the name and address of the owner. Please make sure to include the zip code and phonenumber. Both are very important for the Financial Responsibility Department of Drivers LicenseDivision.Property Damage EstimateEstimate the cost of the damage to the property and check either ‘$1000 or more’ or ‘Less than$1000’ damage.WITNESSES INFORMATIONWrite names, addresses, and phone numbers for persons who witnessed the crash in the spacesprovided. Passengers in the vehicles involved in the crash should not be listed here, but should beshown under the passenger section. If additional space is needed, fill out the Additional PersonForm.NamePrint the witness’ full name. Using first, middle (if available), and last.AddressWrite out the entire address including street, state and zip code.Phone NumberWrite the entire phone number. Be sure to include area code with the phone number.39