FILED: KINGS COUNTY CLERK 09/06/2018 04:22 PM
`.FILED: KINGS COUNTY CLERK 09m2018 04:22 P
`NYSC 3F DOC. NO.
`5
`NYSCEF DOC. NO. 5
`
`IND
`EX NO.
`518095/2018
`INDEX NO. 518095/2018
`
` VYSC
`
` «IIV-4 .D
` 3F:
`
`09/06/2018
`RECEIVED NYSCEF: 09/06/2018
`
`A
`EXHIRIT
`EXHIBIT A
`
`

`

`FILED: KINGS COUNTY CLERK 09/06/2018 04:22 PM
`NYSCEF DOC. NO. 5
`
`INDEX NO. 518095/2018
`
`RECEIVED NYSCEF: 09/06/2018
`
`,
`
`.
`
`•
`
`•'
`
`o12
`
`Pages
`
`8
`
`18
`
`.5 . Page1
`emone
`006
`co=vate
`anam.,an
`MV-2014 -006 - 000032 Number
`omyaswsma
`NONDAY
`VEMICLE1
`
`., .. 1
`vtHICt.En Dmer
`Ue.eseIDNonew 85 70S 4739
`ROBERTS , DATTONS'A
`rtmed a
`
`NewYorkStateDopprimentof MotorVehicles
`REPORT
`POLICE
`ACCIDENT
`(NYC)
`MV•104AN (7/11)
`AMENDED REPORT
`No.\oned NotfewantigsledetSonne
`No.Inked
`®8
`0
`0
`. VEHICLE3 L BlCYCLISTDPEDESTRIAN OTHERPEDESTRAN
`Stateofth. VSBCLEa•0river
`SistsofLet
`Lt:enselDNurntor
`,.,
`.
`NT
`
`I
`1
`ushavens
`
`23:20
`
`12
`
`®®®®Ÿ®''®®
`
`a
`
`1
`
`20
`
`CayorTown
`BROOKLYN
`
`fe
`
`so.
`
`na---a
`
`State
`NY
`ner
`
`21pCods
`11236
`lemens
`
`u
`Ÿ9tes
`Addess(sess
`
`CILyorTonn
`
`pate
`
`nof
`
`a
`
`Agn.No.
`
`b
`
`sex
`
`strie
`
`20 code
`
`unmansea mer
`
`|Puiso
`
`Name-axactlyesprintedansugMrstion
`ROBBRTS , DAYTON
`Address(footnfeMaabarsatree4
`948 RALPH AVBNUE
`
`80s
`N
`10
`ApLNot Har.
`=•
`1173°6"
`
`16
`
`18s•
`
`Name-exacyasprintedantegistratbn
`
`sax
`
`Adeens(hclutreNummer8 Shes0
`
`°''°"""
`
`^pt No. Hss.
`=.
`**°""
`
`**
`
`.,..
`Halepsed
`
`. O 7
`
`'#
`StateofReg.WalicleYear&Risks
`NT
`2014
`Z,BKUS
`
`V
`'
`
`c
`
`vstilcle1ype
`SEDAN
`
`Ins,CodepfatsNinnbur
`693
`
`orNeg.WehicleYear&tAste
`JBBP
`
`VsiticleType
`
`as.Code .
`
`UctstfAnat
`Numbet(s)
`Violation
`section(s)
`
`CirclethediagramIIelownist deso1besmeacxfdent,or emuryourown 10
`diagramInspace#9. Numberthevehicles.
`ItaerEnd
`Rigtd
`Let he
`Alpthrn
`Hendon
`JP
`,.++
`,Á
`p.
`2 Onunedismahne
`
`,.
`$1pposlie
`
`gg
`.
`
`3
`
`1
`
`2
`
`4"08i°r,rN
`PlateNumber
`BPB9350
`Anat
`Number(e)
`Violation
`sectients)
`CheckNInvolvedvehicleis:
`morethan95 Incheswide;
`V
`morethan34Isst long:
`2'" W,ana
`" 8==
`VEHICLE1DAMAGECODES
`g
`1
`C Box1• Poirdor hepact
`L Bor 2 - MostDamage
`10
`E Enteruptothrao
`4
`moreDamagecodes 1
`Vehicis By
`Towed:
`To
`me ME CoD940:
`
`3
`
`2
`10
`5
`
`C acckNinvolvedvehicleis:
`morethanSSIncheswidel
`morethanS4feetlong:
`°'.'"
`: 2'"=2'"'.:""A
`VENICLE2 DAMAGECC085
`g
`1
`C Sox1- PolmarImpang
`L Box2- MostDamage
`E Entersp tothree
`_vnoseDamagecodes
`Vehkee By
`Towee
`To
`
`S
`
`4
`
`'
`
`1-13.SEEDIAGRAMONRIGHT.
`14. UNDERCARRIAGE17. DEMOLISHED
`15. TRAtLER
`18, NODAMAGE
`16. OVERTURNED
`19. OTHER
`
`8
`
`•
`
`:
`
`s
`
`G
`
`DZAGRAN ATTACHBD CN SUBSBQUENT PAGB
`
`2 SIDE
`
`SWZPB
`
`(SAMB DIR)
`
`a.
`
`"'"
`
`Cost of repairs to any one vehicle will be ntere than $1000.
`'
`QUnknowntUnobletoDetermine
`o
`8'''ar Coonanstesgme#aeW Place Where Accictent Occurredt¤ BRONX¤KINGS @ NEW YORKO QUEENS
`LaGtmbrAtuU11ng:
`Roadonwhichaculdentoccused WBST HOUSTON STREBT
`(RouteNurnberorSilentNams)
`
`RICHMOND
`
`LongitudefEasting:
`
`.
`
`at 1)Intersectingstreet
`or2) 200
`AccidentDescriptionfOfficer'sNotes AT TPO DRZvBR 1 STATES THAT DRIVBR 2 WAS DRIVING WBST BOUND ON W
`BOUSTON 8TREBT WHEN DRIVER
`2 STRUCR LBFT SIDB OF VERICLE
`DAMAGING BACK LBFT AND FRONT
`LBFT BUMPER AND DRZVBR 2 LBFT
`THE SCENB.
`
`...._ ..
`
`.
`
`out NusheorStfestNaen
`AVENUE OF TBB AMERICAS
`
`1
`
`1
`
`•
`
`A 1
`L B 1
`
`1
`3
`
`9
`
`x
`x
`
`to
`
`11
`
`1
`1
`
`29
`33
`
`M
`F
`
`14
`
`•
`-
`
`19
`
`-
`-
`
`14 17 BY
`-
`-
`
`-
`-
`
`18
`
`ro
`-
`-
`
`unmasaryggnyg|ved
`DAYTON
`ROBERTS,
`BTNDE, SEMINTAA, NZEEISHA
`
`Dateef DeathOnts
`
`TaxB No.
`
`NCICNo. Precinct
`
`964171
`
`03030
`
`006
`
`Posv6ector Reviewing
`Omoer
`SGT CBSAR
`
`-
`
`DetemmeReviewed
`
`01/09/2020
`
`13:02
`
`..__
`
`oL
`
`D .
`Oncer'sRank
`arid
`
`PringName
`InFull
`JAMBS J NZLLER
`
`Received
`
`Date:
`
`02/16/2018
`
`

`

`FILED: KINGS COUNTY CLERK 09/06/2018 04:22 PM
`NYSCEF DOC. NO. 5
`
`INDEX NO. 518095/2018
`
`RECEIVED NYSCEF: 09/06/2018
`
`PERSONS KILLED OR INJURED IN ACCIDENT
`First
`LastName
`
`(i.siter designation of persons Miled crin usedmustcorrespond with letter designation on tent
`M.I.
`First
`LastName
`M.I.
`
`Address
`
`h
`
`LastNarns
`
`sy
`
`Year
`
`LastNarne
`
`Telephone(AreaCode)
`
`AcIdress
`
`Dateof Bidh
`
`lbtephone(Areacode)
`
`Fbst
`
`Fest
`
`M.L
`
`LeatName
`
`First
`
`M.L
`
`M.I.
`
`HighwayOIst.stScene?
`Name:
`
`Mr
`
`Yes No
`
`Date Birth
`emh
`
`Qmy
`
`Telephone(AreeCode)
`
`ShleidNo.
`
`ENTER INSURANCE POLICY NUMBER FROM INSURANCE IDENTlFICATION CARD, EXPIRATION DATE (IN ALL CASES), AND VIN.
`Vehicle No. a
`913279171
`Vehicle No.2
`
`Expiration Date 01/30/2018
`
`VIN
`
`JTHBE1BL635043323
`
`WITNESS (Attach separate sheet,
`
`if necessary)
`
`Expiration Date
`
`VIN
`
`DUPLICATE CDPY REQUIRED FOR
`Dept. of Motor Vehicles
`(if anyone is knlad.ª=j"-ed)
`
`O Motor Transport Divialon
`(P.D. vehicle involved)
`O Personnel Safety Unit
`Ollice of Comptroller
`(if a City vehicle involved)
`(if a P.D. vehicle involved)
`(Entername. address, and relaUonshipof friend or relative nostled. If aided person is unidentified, Ilst Missing PessonSquad member who
`NOTIFICATIONS:
`was notified. In either case, give date and llrpe of notification.)
`
`.
`
`NYC Taxi & Limousine Comm. O Other City Agency
`(if a Licensed taxior
`limousine
`(Specify)
`Involved)
`Highway Unit
`
`RGPERTY DAMAGED (other
`
`than vehicles)
`
`OWNEROF PROPERTY (include city agency, where applicable)
`
`IF NYPD VEHICLE IS (NVOLVED:
`PellceVehicle
`-operator's FlfstName
`
`LastNarne
`
`Rank
`
`GNeldNo.
`
`linx ID.No.
`
`comunend
`
`MalteciVeNote
`
`Year
`
`TypeofVehicle
`
`PlateNo.
`
`DepLVoldcleNo.
`
`AssignedTowhatCommand
`
`Equipinentin UgeAtTimeofAccident
`Hom
`aren
`
`ACTIONS OF POLICE VEHICLE
`Responding to Code Signal
`Pursuing Violator
`Other (Describe)
`
`"
`
`Received
`
`Date:
`
`02/16/2018
`
`TurretLigN
`
`4-Way Rasher
`
`High-1.evelWaming Lights
`
`Traffic Cones
`
`Headlights
`
`O Complying wills Station House Directive
`O Routine Patrot
`
`Page 2
`
`of 2
`
`Pages
`
`

`

`FILED: KINGS COUNTY CLERK 09/06/2018 04:22 PM
`NYSCEF DOC. NO. 5
`
`INDEX NO. 518095/2018
`
`RECEIVED NYSCEF: 09/06/2018
`
`.
`
`.
`
`.
`
`Side Swipe
`
`(same
`
`Reporting
`
`Reviewing
`
`Officer
`
`Officer
`
`: MV-2018-006-000032
`dir)
`: POM JAMES
`: SGT CESAR
`
`J MILLER
`MORA Reviewed
`
`Date
`
`: 01/09/2018
`
`13:02
`
`-O-
`
`-
`
`-
`
`vehicle
`
`2
`
`··
`
`.
`
`.
`
`.
`
`..
`
`..
`
`-
`
`....
`
`..
`
`.
`
`..
`
`Received
`
`Date:
`
`02/16/2018
`
`