Auto fire investigation



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Registered owner of vehicle I

Sex I Male Female I Race I Caucasian Black Hispanic/Latino Asian Native American Other

DOB

Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec.

Day

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 I Year 19 20

Home phone

...


I I - Cell phone - I

Employer




Location at time of fire




Notified of fire by



Vehicle Status



Owned Leased vehicle Financed Other

Insurance

Full coverage Liability only None Insurance Company:






Other Person I

Sex I Male Female

Race Caucasian Black Hispanic/Latino Asian Native American Other

DOB

Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec.

Day

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 11 18 19 20 21 22 23 24 25 26 21 28 29 30 31 , .Year j 19 I 20

Home phone I I

- I Cell phoneI - I

Location at time of fire

·.





Observations of fire

..





. .

Actions taken









Other Person I

'


Sex I Male Female

Race I Caucasian Black Hispanic/Latino Asian Native American Other

DOB

Jan. Feb. March April May June July Aug. Sept. Oct. Nov. Dec.

1 Day ··

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 I Year I 19 I 20

Home phone I I

- I Cell phone - I

Location at time of fire




Observations of fire






Actions taken

.






ADDITIONAL NOTES













Exterior Examination

Front bumper



No damage Damaged by fire Physical damage only Missing Not Applicable

Grill


No damage Damaged by fire Physical damage only Missing Not Applicable

Hood


Open on arrival of FD Closed on arrival of FD Forced open by FD

No damage Damaged by fire Physical damage only Missing Not Applicable


Driver side front quarter panel



No damage Damaged by fire Physical damage only Missing Not Applicable

Driver side front door



Open on arrival of FD Closed on arrival of FD Forced open by FD

No damage Damaged by fire Physical damage Missing Not Applicable



Driver side rear door



Open on arrival of FD Closed on arrival of FD Forced open by FD

No damage Damaged by fire Physical damage Missing Not Applicable


Drivers rear quarter panel



No damage Damaged by fire Physical damage Missing Not Applicable

Passenger side front quarter panel



No damage Damaged by fire Physical damage Missing Not Applicable

Passenger side front door



Open on arrival of FD Closed on arrival of FD Forced open by FD

No damage Damaged by fire Physical damage Missing Not Applicable



Passenger side rear door



Open on arrival of FD Closed on arrival of FD Forced open by FD

No damage Damaged by fire Physical damage Missing Not Applicable


Passenger side rear quarter panel



No damage Damaged by fire Physical damage Missing Not Applicable

Trunk lid



Open on arrival of FD Closed on arrival of FD Forced open by FD

No damage Damaged by fire Physical damage Missing Not Applicable


Rear bumper



No damage Damaged by fire Physical damage Missing Not Applicable

Roof


Hard top Convertible Not Applicable

No damage Damaged by fire Physical damage Missing


Van, SUV or Cargo Type vehicles
"

Rear cargo door(s)



Open on arrival of FD Closed on arrival of FD Forced open by FD

No damage Damaged by fire Physical damage Missing Not Applicable

Side cargo door(s)



Open on arrival of FD Closed on arrival of FD Forced open by FD

No damage Damaged by fire Physical damage Missing Not Applicable

Door locks I cylinders

Driver side front door



Intact Evidence of forced entry Melted and or missing due to the fire Not Applicable

Driver side rear door



Intact Evidence of forced entry Melted and or missing due to the fire Not Applicable

Passenger side front door



Intact Evidence of forced entry Melted and or missing due to the fire Not Applicable

Passenger side front door



Intact Evidence of forced entry Melted and or missing due to the fire Not Applicable

Rear cargo door(s)



Intact Evidence of forced entry Melted and o missing due to the fire Not Applicable

Side cargo door(s)



Intact Evidence of forced entry Melted and or missing due to the fire Not Applicable



Glass Condition ·- '

Windshield



No damage Damaged by fire Physical damage Missing Remove/Broken by FD Not Applicable

Rear window



No damage Damaged by fire Physical damage Missing Remove/Broken by FD Not Applicable

Driver side front door



No damage Up position Down position Partially open

Damaged by fire Physical damage Missing Remove/Broken by FD Not Applicable



Driver side rear door



No damage Up position Down position Partially open

Damaged by fire Physical damage Missing Remove/Broken by FD Not Applicable



Passenger side front door



No damage Up position Down position Partially open

Damaged by fire Physical damage Missing Remove/Broken by FD Not Applicable



Passenger side rear door



No damage Up position Down position Partially open

Damaged by fire Physical damage Missing Remove/Broken by FD Not Applicable





No damage Open position Closed position Partially open

Damaged by fire Physical damage Missing Remove/Broken by FD Not Applicable



Rear cargo door(s)



No damage Open position Closed position Partially open

Damaged by fire Physical damage Missing Remove/Broken by FD Not Applicable



Side cargo door(s)



No damage Open position Closed position Partially open

Damaged by fire Physical damage Missing Remove/Broken by FD Not Applicable



Wheels









-


Factory

Custom



All wheels missing All wheels match




Wheels mixed Other

(see notes below)



Tires










.





·.


.



·.











Intact

Tread wear

Fire Damaged

Physical Damage

Missing

D/S Front




Yes No

New Good Fair Poor

D/S Rear


Yes No

New Good Fair Poor

P/S Front


Yes No


P/S Rear




Yes No

Describe any other damage or information on wheels and tires:





. .. ', < .' ",. - ,. ... .· .. ,._,-.

Under Vehicle . .::- .. . ,. .

Catalytic converter



Intact Missing Not Applicable

Condition



New Good Fair Poor

Exhaust


Intact Missing Not Applicable

Condition



New Good Fair Poor

Fuel line



Intact Missing Not Applicable

Type


Plastic I Nylon Metal Unknown

Transmission



Intact Missing Not Applicable

Describe any fire damage to underside:










Fuel System :, ·. ..

Gasoline Diesel LPG Electric Hybrid Other

Fuel tank



Plastic /Nylon Metal

Condition



Intact Partially burned Physical Damage Missing

Fuel tank cap



Plastic /Nylon Metal

Condition



Intact Partially burned Physical Damage Missing

Engine Compartment .. .

Engine condition



Intact Physical Damage Fire Damage Removed prior to fire

Battery


Intact Physical Damage Fire Damage Removed prior to fire Unknown

Battery cables



Intact Physical Damage Fire Damage Removed prior to fire Unknown

Radiator


Intact Physical Damage Fire Damage Missing due to fire Removed prior to fire Unknown

Upper radiator hoses



Intact Physical Damage Fire Damage Missing due to fire Removed prior to fire Unknown

Lower radiator hoses



Intact Physical Damage Fire Damage Missing due to fire Removed prior to fire Unknown

Belt(s) condition



Intact Physical Damage Fire Damage Missing due to fire Removed prior to fire Unknown

Electronic components



Intact Physical Damage Fire Damage Missing due to fire Removed prior to fire Unknown

List any obvious missing engine parts:













Describe fire damage to engine compartment:




Passenger Compartment

Dashboard



Intact Physical Damage Fire Damage Missing due to fire Removed prior to fire Unknown

Airbag(s): Driver Side



Intact Deployed Fire Damage Missing due to fire Removed prior to fire Unknown Not Applicable

Airbag(s): Passenger side



Intact Deployed Fire Damage Missing due to fire Removed prior to fire Unknown Not Applicable

Steering Column



Intact Physical Damage Fire Damage Missing due to fire Removed prior to fire Unknown

Steering Wheel



Intact Locked Lock defeated Missing due to fire Located in debris

Unknown Not Applicable


Odometer Reading



Damage due to fire Unknown Not Applicable

Ignition switch



,.

Intact On position Off position Locked Tampered with Tampered with/defeated

Missing due to fire Located in debris

Ignition key



In ignition Found in debris None found In possession of owner/driver Unknown Not Applicable

Radio


Intact Physical Damage Fire Damage Missing due to fire Removed prior to fire Unknown Not Applicable

Radio Speakers



Intact Physical Damage Fire Damage Missing due to fire Removed prior to fire Unknown Not Applicable

Headliner



Intact Physical Damage Fire Damage Missing due to fire Removed prior to fire unknown Not Applicable

Driver side front seat(s)



Intact Physical Damage Covering and padding partially consumed Covering and padding missing due to fire

Seat removed prior to fire Unknown Not Applicable Manual seat(s) Power seat(s) Seat warmer(s)


Driver side front floorboard



Intact Floor mats partially consumed Carpet and padding partially consumed Floor mats partially consumed

Carpet and padding missing due to fire Not Applicable



Passenger side front seat(s)



Intact Physical Damage Covering and padding partially consumed Covering and padding missing due to fire

Seat removed prior to fire Unknown Not Applicable Manual seat(s) Power seat(s) Seat warmer(s)


Passenger side front floorboard



Intact Floor mats partially consumed Carpet and padding partially consumed

Floor mats partially consumed Carpet and padding missing due to fire Not Applicable



Rear seat(s)



Intact Physical Damage Covering and padding partially consumed

Covering and padding missing due to fire Seat removed prior to fire Unknown Not Applicable


Driver side rear floorboard



Intact Floor mats partially consumed Carpet and padding partially consumed

Floor mats partially consumed Carpet and padding missing due to fire Not Applicable


Passenger side rear floorboard



Intact Floor mats partially consumed Carpet and padding partially consumed

Floor mats partially consumed Carpet and padding missing due to fire Unknown Not Applicable



Personal effects in passenger compartment:




Trunk and Cargo Area

TR . " C . ..

Intact Physical Damage Fire Damage

Trunk Jock



Intact Evidence of forced entry Melted and or missing due to the fire Not Applicable

Spare tire



Intact Missing Melted and or missing due to the fire Unknown Not Applicable

Located in other area


Jack and equipment



Intact Missing Melted and or missing due to the fire Unknown Not Applicable

Located in other area



Other contents/personal effects:







Miscellaneous Items '

Anti theft alarm system



Intact No Unknown Not applicable

Describe any aftermarket equipment:











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