FILED: KINGS COUNTY CLERK 10/09/2018 09:58 AM
`NYSCEF DOC. NO. 39
`
`INDEX NO. 504883/2018
`
`RECEIVED NYSCEF: 10/09/2018
`
`EXHIBIT
`
`"16"
`
`

`

`FILED: KINGS COUNTY CLERK 10/09/2018 09:58 AM
`NYSCEF DOC. NO. 39
`
`INDEX NO. 504883/2018
`
`RECEIVED NYSCEF: 10/09/2018
`
`PGDei of 2" Penes
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`___
`
`..
`Dis/TW:Pavievaid
`
`

`

`FILED: KINGS COUNTY CLERK 10/09/2018 09:58 AM
`NYSCEF DOC. NO. 39
`
`INDEX NO. 504883/2018
`
`RECEIVED NYSCEF: 10/09/2018
`
`FiiiiiBOhis
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`ENTER INSURANCE POLICY NUMBER PRONI INSURANCE IDENTIFICATION CARD, EXPIRATION DATE 0N ALL CASES), AND VIN .
`163462330532
`Vehicle No.m
`Vehtole No.:
`aGQ5:LD1
`__.._..
`,
`
`EMplration Date 03/0;I/2917
`
`Expiration Date 03/011/2516
`
`-
`
`VIN
`
`57argrn8598BQ
`
`21577
`
`VIN ___.._. .
`
`154ED)MD32C130B1
`
`WITNESS (Attach separate sheet,
`Nemir
`
`If necessan )
`
`Address
`
`Phone
`
`DUPLICATE COPY REQUIRED FOR±
`DepL of Motor Vehicks
`Of artyonels
`killed4njured)
`
`McLor Transport DIvlelon
`(P.D. vehicle Involved)
`
`Other City Agaricy
`(Specify)
`
`.
`
`NYC Taxl & Limonalne Comm
`(lf a Licensed taxior
`limousine
`Irivolved)
`Highway Unit
`
`Olileeof Comptrollet
`Personnel Safely Unit
`(Na Cliy vehicle 1tivolvoti)
`(if a RD. vehIole involved)
`(Enter narne,eddress, nad ½Mü.C.|p of RIOndof ielaBVpnolll]ed. If aided person la unidentified, list MIdolab PersonSquad niember who
`NOTlFECATIONSI
`was r16tifted.In eliber ca60, give dale and Ilms of nollfle.anon.)
`
`. .....
`
`.
`
`PROPERTY DAMAGED (other than vehicles)
`
`OWNER OF PROPERTV (include city agency, where
`
`S)
`
`IF NYPD VEHICIE IS INVOLVED:
`PelleoVehto¼ -oparstar's FirstNump
`
`LastNarre
`
`Rai1k
`
`31116tdNo.
`
`Tant.ID,No.
`
`Command
`
`MakeofVBhMe
`
`Year
`
`Typaul Whuds
`
`Re
`
`DepL¾linch No.
`
`AssignedToWimtCommimisl
`
`Ikulpmentinure AtTuneofAccldent
`siren
`noni
`
`ACTIONS OF POLtea VEHICLE
`Responding to Code signe
`Pureulng Violator
`Other (Describe)
`
`TurretLlgtt
`
`4Way Flasher
`
`High4mel Wamlog I,Ights
`
`Traffic Cones
`
`Headlights
`
`caniplying with StationHouse Directive
`Retitina Petn$
`
`

`

`FILED: KINGS COUNTY CLERK 10/09/2018 09:58 AM
`NYSCEF DOC. NO. 39
`
`INDEX NO. 504883/2018
`
`RECEIVED NYSCEF: 10/09/2018
`
`Rear
`
`Reporting
`Rêv!êw!ñg
`
`End : MV-2010-168410904
`: POM AUCKLEY
`E CROOKS
`Officer
`; SGT HUGO G ARICA
`Reviewed
`
`Officer
`
`r
`
`Date
`
`: 05/16/2016
`
`12:37
`
`Vehicle1
`
`VaNole 2
`
`

`

`FILED: KINGS COUNTY CLERK 10/09/2018 09:58 AM
`NYSCEF DOC. NO. 39
`
`INDEX NO. 504883/2018
`
`RECEIVED NYSCEF: 10/09/2018
`
`CeLS
`
`.
`
`This is to. certify
`that
`is a true and complete
`this deõüm‡nt
`copy of a
`record
`on file in the New York State Departinent
`of Motor Vshiñ|õs,
`Albany, New York.
`
`ABS-2 (7/15)
`
`EXECUTIVE
`
`DEPUTY COMM!SSIONER
`
`OF MOTOR-VEMICLES
`
`