SECRETARIA DE SEGURIDAD PBLICA

TRANSITO MUNICIPAL
PRE-INFORME DE ACCIDENTE
CD. OBREGON SONORA, A________DE_____________________DEL 2012
LUGAR DEL ACCIDENTE________________________________________________________________TIPO______________________
COLONIA____________________________________________________SECTOR__________ HORA________UNIDAD___________

VEHICULO (1)

SERIE______________________________________________________

TIPO______________________MARCA__________________________________LINEA_________________________________________
MODELO____________________COLOR_______________________PLACAS_____________________EDO_____________________
CONDUCTOR____________________________________________________________________________EDAD_________________
DOMICILIO___________________________________________________________COLONIA________________________________
LIC # Y TIPO_____________________________________EDO_______________________TEL________________________________
PROPIETARIO_________________________________________________________________________TEL_____________________
DOMICILIO___________________________________________________________COLONIA________________________________
VEHICULO (2)

SERIE_____________________________________________________

TIPO______________________MARCA__________________________________LINEA_____________________________________
MODELO____________________COLOR_______________________PLACAS_____________________EDO_____________________
CONDUCTOR____________________________________________________________________________EDAD__________________
DOMICILIO___________________________________________________________COLONIA________________________________
LIC # Y TIPO_____________________________________EDO_______________________TEL________________________________
PROPIETARIO_________________________________________________________________________TEL_____________________
DOMICILIO____________________________________________________________COLONIA_______________________________

VEHICULO (3)

SERIE______________________________________________________

TIPO______________________MARCA__________________________________LINEA______________________________________
MODELO____________________COLOR_______________________PLACAS_____________________EDO_____________________
CONDUCTOR____________________________________________________________________________EDAD__________________
DOMICILIO___________________________________________________________COLONIA_________________________________
LIC # Y TIPO_____________________________________EDO_______________________TEL_________________________________
PROPIETARIO_________________________________________________________________________TEL_______________________
DOMICILIO______________________________________________________________COLONIA______________________________
LESIONADOS______________________________

VICTIMAS____________________

MUERTOS________________________

OBSERVACIONES:__________________________________________________________________________________________________
_________________________________________________________________________________________________________________

________________________________________________________________________________________________________
DAOS MATERIALES
VEHICULO (1) _________________VEHICULO (2)_____________________VEHICULO (3)____________________

SECRETARIA DE SEGURIDAD PBLICA

DESCRIPCION

DE

ESTE ACCIDENTE:

_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________

CROQUIS

ILUSTRATIVO

DESCRIPCION
1.-_____________________________
2.-_____________________________
3.-_____________________________
4.- ____________________________
5.-_____________________________
6.-_____________________________
7.-_____________________________
8.-_____________________________
9.-_____________________________
10.-____________________________

OBSERVACIONES:_______________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________

CONFORME
______________________
CONDUCTOR (1)

CONFORME
___________________________
CONDUCTOR (2)

CONFORME
________________________
CONDUCTOR (3)

COMO LO ESTABLECE EL ART. 217 DE LA LEY 47 DE TRANSITO, PARA EL ESTADO SONORA.

POL.3RO VIVIANO ALONSO MURRIETA GONZALEZ.