Traffic Safety Watch Report
I observed an obvious violation (check one)
Aggressive
Driver: Driving in an unsafe and reckless manner.
(Please Note Drivers' Actions in
Comment Section Below)
Unbuckled Child: A child under age four not protected by a child safety seat or child over age four and under age 16 not in a child restraint or seat belt.
| License Plate Number:
License State: Vehicle color and style (I.E. two-door, four door, truck): |
| Date of Observation: / / Time: a.m. or p.m. |
| Location of Moving Vehicle---Street
and City:
|
| Approximate Age(s) of Unbuckled
Child(ren): Infant 1 Yr. - 2 Yrs. 3 Yrs. - 4 Yrs. 4 Yrs. - 8 Yrs. 8 Yrs. - 12 Yrs. 13 Yrs. - 16 Yrs. |
| Number of Unsecured Child(ren): ___ Front Seat ___ Back Seat ___ Other |
| Child(ren) Sighted:
Pickup Truck
Bed Moving
Around in Vehicle Sitting on Passengers Lap Standing in Vehicle Sitting on Drivers Lap Sitting, but not secured Other (Please Comment) |
| Aggressive Driver's Actions and/or
Comments: Male
Female
|
(Please return report within 10 days of
observation)
Thank You for Helping Save Lives
Fairfax County Police Department
Traffic Division
3911 Woodburn Road
Annandale, VA 22003