LOUISIANA STATE POLICE-MOTOR CARRIER SAFETY
Louisiana State Police-Motor Carrier Safety
Report of Serious Safety Violations on CMV At-Fault Crashes
Request for compliance review
PO Box 66601, 2nd floor-a21
Attn: Compliance Review Coordinator
baton rouge, la 70896-6601
(225)925-3800
This motor carrier is believed to be engaged in unsafe operations OR practices which contributed to a motor vehicle crash.
Carrier Name
Address
Owners Name
Telephone Number
US DOT# ICC#
OR DUE THE FOLLOWING:
The cause for this belief is based on the following violation(s), which identified the following critical safety violation:
On duty use of possession of alcohol or any controlled dangerous substance, or failing to be subject to
an alcohol and controlled substance test when required.
Operation of CMV by a driver, who is unqualified, suspended or disqualified.
Complaint received from the public of:
Name of Investigating Agency/ Office Contact Number
Officer’s Name Date of Crash
Crash Report Number Dept. Item Number
For FHWA Use Only
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