Vehicle Fire - Michigan
Vehicle Fire |Incident Number | |
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| |Investigator |
|Information | |
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|Day/date/time of fire |
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|Location (Street, City, Zip, Township and County) |
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|Day/date/time of investigation |
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|Location of investigation |
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|Police Department |
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|Fire discovered/reported by |
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|Interview person who discovered fire |
|Scene Description |
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|Where was smoke/fire first observed |Doors Left |Windows |
| |Open Closed |Up Down |
|Smoke/fire blowing which way |
|Hood |
|Open Closed |
|Who notified the fire department |
|Fire Department response time |
|Police Present |
|What do you think cause the fire |
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|Other information |
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|Fire Department |
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|Suppression Information |
|Interviewed |Dispatched |Arrival |Cleared |
|Officer in Charge (OIC) |Wind direction and speed |Temperature |Conditions |
|Time of Alarm |
|Weather |
|First fire fighters on the scene/Observations |
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|Location of smoke/flames |
|Vehicle security upon arrival |
| |Last area extinguished |
|Locations/types of ventilation |
|First area extinguished |
|Problems with extinguishment |Overhaul |
| |Yes No |
|Rekindle |
|Yes No |
|Consent to Search |Served - Date/Time: |
| |Tabulation returned to court |
|Verbal Written From whom: |yes no |
| Criminal search warrant |Served By: |
|Administrative search warrant | |
|Court / Judge |
|Affiant: |
|Suggested Interviews |
| OIC Fire department personnel Police personnel Witnesses Owner Neighbors |
|Driver Passengers Others (list) |
|Victim Rights Form (UD-30) |
| yes no By: |
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|Interview |
| Owner |When Purchased |From Whom |
|Driver | | |
|Passenger (s) |Financed |Financial Institution |
| |Yes No | |
|Engine Size |Amount owed |Monthly payment (current?) |
|Amount Paid |Current Mileage |
|Extended Warranties: |Who regularly drives the vehicle |
|Mileage at time of purchase |Amount of Fuel |
|Problems/Complaints |
|Fluid Levels |Where |Reason |
|Last person to enter engine compartment |Any problems with animals |
|Date of last service |
|How often is oil changed |
|Recalls |Telephone |Accidents |
|Any add-on to vehicle |
|Alarm System |
|Parts replaced on vehicle |
|Driven/Parked (how long) |
|Where were you coming from/going to |Pulling a trailer |Any leaks prior to fire |
|What accessories were being operated prior to the fire |
|All accessories work |Any noises heard |
|How did vehicle run prior to fire |
|Any odors |
|Short scenario leading up to fire |
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|Doors Left |Windows |
|open closed |up down |
|Where was fire/smoke first observed |How long for fire department response |Police present |
|Hood |
|open closed |
|Who notified fire department |
|What do you think caused the fire |
|Other information |
|Interview |
| Owner |When Purchased |From Whom |
|Driver | | |
|Passenger (s) |Financed |Financial Institution |
| |Yes No | |
|Engine Size |Amount Owed |Monthly payment (current?) |
|Amount Paid |Current Mileage |
|Extended Warranties: |Who regularly drives the vehicle |
|Mileage at time of purchase |Amount of Fuel |
|Problems/Complaints |
|Fluid Levels |Where |Reason |
|Last person to enter engine compartment |Any problems with animals |
|Date of last service |
|How often is oil changed |
|Recalls |Telephone |Accidents |
|Any add-on to vehicle |
|Alarm System |
|Parts replaced on vehicle |
|Driven/Parked (how long) |
|Where were you coming from/going to |Pulling a trailer |Any leaks prior to fire |
|What accessories were being operated prior to the fire |
|All accessories work |Any noises heard |
|How did vehicle run prior to fire |
|Any odors |
|Short scenario leading up to fire |
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|Doors Left |Windows |
|open closed |up down |
|Where was fire/smoke first observed |How long for fire department response |Police present |
|Hood |
|open closed |
|Who notified fire department |
|What do you think caused the fire |
|Other information |
|Vehicle Involved |Expires/State/License# |
|Year |Make |Model |Color Top/Bottom |
|VIN: |
|LEIN Holder |Investigator's Name |
|Address |
|City/State/Zip |
|Insurance |
|Company |Agent |
|Address |Address |
|City, State, Zip |City/State/Zip |
|Telephone Fax |Phone Fax |
|Adjuster |Date of Issue |
|Address |Date of Expiration |
|City/State/Zip |Phone Fax |
|Policy Type: |
|Full Coverage PLPD None |
|Injury |
|Name |Race/Gender |Date of Birth |
|1) | | |
|Address | | |
| |Civilian F.D. Other |L K |
|Next Of Kin Notified | |
|Yes No |By Whom |
|Medical Examiner |
|Removed From Scene By: |
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|Transported By: To: |
|Autopsy |
|Yes No BAC CO level Drug screen X-ray |
|Hospital Morgue (Full Address and Information) |
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|Doctor: |
|Present at autopsy |
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|Cause of Death |
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|Injury |
|Name |Race/Gender |Date of Birth |
|2) | | |
|Address | | |
| |Civilian F.D. Other |L K |
|Next Of Kin Notified | |
|Yes No |By Whom |
|Medical Examiner |
|Removed From Scene By: |
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|Transported By: To: |
|Autopsy |
|Yes No BAC CO level Drug screen X-ray |
|Hospital Morgue (Full Address and Information) |
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|Doctor: |
|Present at autopsy |
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|Cause of Death |
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|Injury |
|Name |Race/Gender |Date of Birth |
|3) | | |
|Address | | |
| |Civilian F.D. Other |L K |
|Next Of Kin Notified | |
|Yes No |By Whom |
|Medical Examiner |
|Removed From Scene By: |
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|Transported By: To: |
|Autopsy |
|Yes No BAC CO level Drug screen X-ray |
|Hospital Morgue (Full Address and Information) |
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|Doctor: |
|Present at autopsy |
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|Cause of Death |
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|Exterior Areas (note damage) |Drivers side rear door open closed By: |
|Front bumper |
|Hood |
|Forced By: |
|Grill |
|Drivers front quarter |
|Drivers door open closed By: |
|Drivers rear quarter panel |Passenger front door open closed |
|Trunk lid |
|Forced By: |
|Rear bumper |
|Roof |Drivers side cargo door |Passenger side cargo door |
| |open closed |open closed |
|Passenger rear quarter panel |
|Passenger rear door open closed |
|Passenger front quarter panel |
|Van Only |
|Rear cargo doors |
|open closed |
|Body Condition/Exterior Fire Damage |
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| |Type |Wheel cover |Treadwear |No. of lugs missing |
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|Tires/Wheels |
|Tires |
|Left front |Intact |Melted |Punched |Missing |
|Right front | | | | |
|Left rear | | | | |
|Right rear | | | | |
|Doors |
|Cylinders |Locks |
|Left front door |broken |melted |cracked |out |intact |up down unknown |
|Right front door |broken |melted |cracked |out |intact |up down unknown |
|Left rear door |broken |melted |cracked |out |intact |up down unknown |
|Right rear door |broken |melted |cracked |out |intact |up down unknown |
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|Glass Condition |
|Windshield |broken |melted |cracked |out |intact |up down unknown |
|Rear |broken |melted |cracked |out |intact |up down unknown |
|Drivers |broken |melted |cracked |out |intact |up down unknown |
|Passengers |broken |melted |cracked |out |intact |up down unknown |
|Right rear |broken |melted |cracked |out |intact |up down unknown |
|Left rear |broken |melted |cracked |out |intact |up down unknown |
|Sunroof |
|Convertible |
|Electric windows |
|Comparisons |
| |intact |damaged |missing |
| |intact |damaged |missing |
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|Under Vehicle |
|Catalytic converter |
|Exhaust |
|Fire Damage |
| |Fuel line Nylon Metal |
| |Fill pipe Nylon Metal |
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|Fuel System |Intact |Consumed |Damaged |
|Gas Diesel CNG LP Electric |Open |Limited (hood jammed) |Forced By: |
|Fuel tank |Intact |Partially stripped |Burned |Missing |
|Nylon Metal | | | | |
|Gas cap |Intact |Low |Consumed |Condition: |
|Nylon Metal | | | | |
|Engine Compartment |Intact |Melted |Removed |Location: |
|Hood |Intact |Melted |Removed |Damaged |
|Engine accessibility |Intact |Consumed |Removed |Damaged |
|Engine |Intact |Consumed |Removed |Damaged |
|Oil |Intact |Consumed |Removed |Damaged |
|Battery |Fluid Condition: |
|Battery cables |Intact |Consumed |Removed |
|Radiator |Automatic |Standard |Fluid level: |
|Upper radiator hoses |
|Lower radiator hoses |
|Radiator Level |
|Belts |
|Transmission |
|Engine parts missing |
|Burglar alarm |Intact |Consumed |Partially missing/Consumed |
|Engine fire damage |Intact |Consumed |Partially missing |
|comparisons | | | |
| |Intact |Consumed |Partially missing |
| |Intact |Consumed |Personal effects present |
|Internal Examination -- Passenger Compartment |
|Dashboard |Intact |Consumed |Partially missing |Defeated |
|Radio |In ignition |At scene |None found |
|Speakers |Intact |locked |Tampered with |Consumed |
|Glove box |Intact |Consumed |Partially missing |
|Firewall |Intact |Consumed |Partially missing |
|Ignition |Intact |Consumed |Partially missing |N/A |
|Ignition key |Yes |No |Sun Roof T Tops |
|Steering Column |Oil change sticker |
|Drivers front seat |
|Passenger front seat |
|Rear seat |
|Power seats |
|Odometer reading |
|Title history |
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|Personal effects in passenger compartment |
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|Interior fire damage |Pickup |Van |Utility vehicle |Other: |
| |Open |Closed |
| |Melted |Intact |Punched -- by: |
| |Yes |No |Unknown |
|Trunk Compartment |Intact |Missing |Tire changing |Intact |Missing |
| | | |equipment: | | |
|Passenger vehicle |
|Trunk |
|Trunk lock |
|Trunk release button |
|Spare tire |Number of samples |K-9 used yes no |
|Other contents/personal effects: |
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|Evidence/Property Seized |
|Samples taken yes no |
|Description/location of samples |
|1. |
|2. |
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|Photographs/Video |
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|Fire Origin |
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|Fire Cause |
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|Fire Status / Further Investigation |
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Rev. 9/1/04
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