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FAQ - Form 911

What is the purpose of Form 911?
Form 911 is a form you can use to request an emergency police call if you believe that someone at your business has been injured seriously enough to require a police response on your behalf. You do not need to be injured to request an emergency police call. A business owner may authorize the emergency service to respond to help someone who is injured under certain circumstances, such as if someone had a heart attack and needed immediate care, or if they were injured in the company's building and needed immediate help. You will need to contact someone at the emergency service directly so that they can take action on your behalf. If you do not do this, your business can be held criminally responsible for failing to comply with this provision. What will emergency services do? Police and emergency services (such as ambulance service) can take immediate action to help customers or staff involved in an accident. Emergency services can: Ensure people at the scene are safe Assist in removing victims from the scene Maintain the police investigation and take action during this process Take photos and provide information to provide evidence to support a case against the driver Call for a police officer to take responsibility for the accident. How long does the emergency service have to take action? The police may take up to ten hours to begin an investigation, depending on the complexity of the accident. What is the cost to me if I need emergency services? Emergency services may charge you for their services. How do I get a form for emergency services to take to the emergency service? Make sure to provide the police with the form that describes all the circumstances of the situation you are presenting. When filing a report: Don't wait until you're hit Try to get an ambulance or other emergency services response within 30 minutes. Try to get a medical emergency assessment. When you file your police report: Check emergency dispatch Remember to file the report in person. Do not print, send or fax the forms. When the emergency call is made: Check emergency dispatch The police will inform you of the emergency call and when and how to contact them. What if the emergency services fail to respond? If you don't follow the directions and instructions, emergency services may take legal action to obtain information from you about the accident.
Who should complete Form 911?
In many parts of the country there haven't been many 911 calls for a couple of years. While many agencies still use “911 to emergency” for emergency calls, the Federal Communications Commission has been pushing for some kind of universal 911 system for years. Some of the states that will be using 911 by the end of the year have already implemented new rules for using emergency 911. These new rules will allow people with no home phone service to use 911 for emergency calls. The new rules mean that 911 calls made to 911 now will not be routed to local police and sheriff departments and instead go to the nearest 911 Center. For more information, see the following links: California — How To Change Your Address On Your Driver's License. California Statewide — What To Do In Order To Change Your Name On Your California Driver's License. Georgia — How To Change Your Address On Your Driver's License. Illinois — How To Change Your Address On Your Driver's License. Nevada — How To Change Your Address On Your Driver's License. New Hampshire — If You Think You're Not A Resident Of Nevada, You Probably Are. South Dakota — What To Do If You Are Not Eligible To Change Your Address On Your Driver's License Wisconsin — Changes To Driver's License Wyoming — How Do You Renew Your Driver's License In Wyoming? You can view a map showing the various 911 “911 centers” in the United States on the 911.gov website: Go to If you think that you may be the type of person who will not be qualified for 911 emergency services due to the fact that none of your local agencies use 911 for 911 calls, the U.S. Postal Service has a program to help you get 911 service without needing to pay for it. You can call to learn more about the program. If you have no place to send the money, it can be dropped off at any post office in the US. You have to sign a disclosure statement. You will be asked to provide basic information, but you do not have to provide your home phone number or any information about your phone service plan. Furthermore, you may not ask for your Social Security number, and you won't have to provide ID when submitting any information.
When do I need to complete Form 911?
Call 9-1-1, or contact your local police immediately if you receive a 911 telephone call about a possible domestic violence incident. What should I tell the 911 operator? Provide as much information to the 911 operator as you can. Include what happened and the identity of the person you're talking to, who you're with, and the location of the incident. You may also want to include information about: The location of the house where you're staying If alcohol or drugs were involved or if any pets were involved Information about any other children (if you have any) Details about the nature of the incident (what day it happened, who started the fight, how many people were involved) The time of the incident Any injuries during the incident, including broken bones, cuts, or bruises Any injuries to you (for example, abrasions, cuts) If there were dogs involved An emergency vehicle was involved It's important to include the information you can as soon as possible in order for the operator to best help you. Remember, if there were children in the house, include those details! You don't need to give the operator your name, address or phone number. However, if you want to speak with a relative or friend of the victim, you must provide your name, phone number and address (even if the operator doesn't have access to that information). What is a Form 911? As of January 2007, the only people who are required by law to report their domestic violence incidents under the law to police are: The person who physically injured someone The other person's spouse Current or former dating partners or former spouses Domestic violence victims should not call 9-1-1 if they are homeless or on the street or are hiding from their abuser. Who is required to report a domestic violence injury or harassment to police? Who is not required to report a domestic violence incident? Only anyone: (1) with a restraining order against the person or persons responsible for the alleged incident, and (2) who is present at the incident, or has lawful authority to be present at the incident.
Can I create my own Form 911?
What if I get scared? Should I contact the police? When can I get an emergency permit to carry a gun? I get a flat tire. What should I do? Can I carry a gun with me from car to gun? How do I get a copy of my pistol owner's identification card? How much does an AK-47 cost? Can I get a concealed weapon permit without a background check? Can I get a Concealed Weapons Permit without a background check? What about handguns and rifles that haven't been in service for 25 or more years? Can I take my gun to a gun range or shooting facility? Where can someone buy a new pistol? Is it okay to break a gun into parts? Why can't I carry my gun at the theater, movie theater, convention center, or sports arena? Does conceal carry work where I live? What if I break my gun? What about my property? What am I allowed to do to my gun if I break it? What if I break my gun? What can police do to help? What about my guns when I'm at a sporting event? What happens if I go through a metal detector? What happens if I wear a belt of ammunition? What happens if I have a bullet stuck in my body? Can I carry a gun if I'm a victim of domestic violence? Can I carry while in uniform? What if I get a new gun? Can I bring it down to the store and pick it up? My concealed carry permit expired, and I can't get a new one. Can I have my gun registered to me? Who is allowed to sell guns? Can I sell my gun to someone who is a convicted felon? Can I sell or give my gun to my friend? Can I sell a firearm to someone who has a concealed weapon permit that I don't have? What if someone steals my gun? Can I transfer my firearms? What if I sell a gun at a gun show? Where can I learn more? Q. Do I need a new concealed weapon permit every time I change my name or address? A.
What should I do with Form 911 when it’s complete?
If you're a police officer, you may need the full form. If you're a person with certain responsibilities, like a public library employee, you may need only the form and a phone number to call. A person who wants to get help from a police officer (either to be taken to the correct location at an appropriate time or to ask for information) will need their name, address, and social security or driver's license number. If you are a minor (16, 17, 18, 19, 20 years old), you may need a copy of the form with your parents' information. If you are a parent, you must sign the original. To order a copy of the form, see a list of forms that can be obtained from your local police department. When should I contact the police? If someone is acting recklessly or committing a crime (e.g., shoplifting, or disturbing a neighbor's peace or quiet), you should call the police immediately to file a complaint (i.e., in lieu of calling 911). You do not need to file a law enforcement report to send a friend of yours to the police about a threat or crime. If you are a person with certain obligations, such as a public library employee or a public health nurse, you will have to go to the police (i.e., to file a report to the police) to deal with a threat. This section on Form 911 is only an interpretation of the relevant sections of the Revised Code of Washington. For the most current information, please visit our website. Back to Top What forms of emergency assistance can I obtain through the police? The Washington State Patrol can provide emergency support to law enforcement agencies as determined under state statute. See State Statute § 42.56.250. The Washington State Patrol also has direct legal responsibility for providing limited law enforcement support to municipal and county police agencies. See, State Statute § 42.56.060. Can I obtain emergency assistance from my local public library? To request a law enforcement report by calling a library branch, call an automated library phone number that shows the state patrol and library number. If you don't have access to a computer, the library will mail you a form that you complete and return to the branch. Can I obtain emergency assistance by calling my police dispatcher? Yes. Washington Code § 42.56.500.
How do I get my Form 911?
When you arrive at the hospital to begin testing, your doctor will sign the form and give you the phone number to call for information, to report a possible sexual assault, or to contact the police. For more information see the CDC's page on Sexual Assault Reporting to the Police and Reporting Suspicion to the National Crime Information Center (CIC). Do not share identification information with anyone. Call the U.S. Embassy at for more information. How long does the Sexual Assault Response Program take to process my report or notification? Response is a top priority for the Department of State. During your initial consultation with a U.S. Embassy representative (or your American medical provider), the Ambassador's team immediately will identify your case and start working to develop a plan to respond and prosecute perpetrators in line with the laws of your state and the international standards. We work closely with state authorities and the local Embassy. We cannot provide a specific time period for processing and responding with the results of the evaluation. My U.S. citizen partner was admitted to the hospital against my will. How will I be treated if I report this? If your partner is a U.S. citizen, you are entitled to the same rights under U.S. law to be protected from abuse as other Americans. If you feel the medical care you received was inappropriate, you should contact your American Medical Association (AMA). The AMA is the largest and oldest professional group representing licensed physicians in the United States and is a member of the American Medical Association. For information on contacting your AMA member about this care issue, see the AMA website. How do I file the necessary paperwork for the Sexual Assault Response Program to review/process my case? U.S. Embassy staff will be present during the Embassy's daily activities as requested by the victim, and will be happy to answer any questions you have about filing the legal paperwork required by the victim's state and the U.S. Embassy. For further information on filing legal paperwork see our Page on File and Action of Victims of Sexual Assault or contact the Sexual Assault Response Coordinator. What should I do if: The state/local law does not provide for prosecution for sexual assault; or The state/local legal or medical system is not ready to prosecute cases of sexual assault? You may file a complaint or complaint with the Department of State.
What documents do I need to attach to my Form 911?
If you're filing an affidavit requesting that someone be held for protection under the Domestic Violence and Stalking Protection Act, we're required by the law to provide a statement from the person asking for the protective order. If the protective order requests that someone is detained in a shelter, if the protective order prohibits a protective order to be issued by the court or requires the person to be detained in any other facility, and if you file a statement from the person stating that you are submitting the statement for the protection order under false pretenses, we are required to provide a statement from the person who filed the protective order (who also must be the person in possession of the documents showing that person is sought as a minor). If you're requesting an emergency protective order by the Domestic Violence and Stalking Protection Act, you do not need a document from your boyfriend or girlfriend in addition to a protective order form. If you're filing a Temporary Restraining Order, you must provide a statement from your boyfriend or girlfriend for each side. If you've already filed an affidavit for a protection order or a Temporary Restraining Order, you do not need a form for a statement for either. If you want to file a statement for an emergency protective order or a Temporary Restraining Order, you must file the required documents with us by the date that the order is required to be issued. If you want to file a statement for a protection order, you must provide the following for each side: Both the name of the child, if you are the parent filing the order and the court The name and address of the person for whom the order is being issued, if the person is unknown The name and address of the relative to whom the order is issued An affidavit from each parent stating, under oath, that they are filing the order for the protection of the child. If the child has been placed under the care of the court, both parents must also provide a statement.
What are the different types of Form 911?
Form 911 is the original emergency reporting law introduced under the National Traffic and Motor Vehicle Safety Act which also provides for a national public reporting system known by the name of the National Incident and Reporting Center (NRC). Since Form 911 was first issued, there have been some changes: In 2012, the Office of Management and Budget (OMB), issued an administrative rule that eliminated the requirement for a telephone call to report an out-of-state motor vehicle accident in addition to Form 911. On September 14, 2014, OMB issued an implementation memorandum that eliminated the requirement for the report and made it the responsibility of both drivers and vehicles involved in an accident to submit a Form 911. On May 1, 2015, OMB issued a Notice of Proposed Rule making (NORM) that eliminated a three-strike provision in the reporting requirements of Form 911 and made the report for personal injuries and fatalities only. On October 28, 2015, the Office of Management and Budget (OMB) issued a supplemental NORM to make certain changes to the Reporting Requirements of the National Driver Register. On December 21, 2015, the National Coordinating Office for Security, Infrastructure Protection, and Counterterrorism (NTSC) issued an interim final rule that eliminated the requirement to provide the name of the driver and the location of the incident. For more information on any of these changes, refer to the “Oversight Committee Report: Revised Driver and Vehicle Reporting Requirements of the National Driver Register.” Form 914 is the form used by the National Automated Traffic Safety Administration (NATO) for issuing motor vehicle accident reports (including forms 914 and 914-E) to commercial operators. This new Form 911 is now only being used for commercial purposes. Who enforces the new reporting requirements? The National Highway Traffic Safety Administration (NHTSA) enforces the new Form 911 reporting requirements and provides the reports for the public. If a driver or owner of a vehicle is not covered by NHTSA, what are the penalties for failing to report an accident on or after January 1, 2016? Reporting a motor vehicle accident involving any injury or death to the appropriate emergency contact requires a driver, owner, or operator of a motor vehicle to fill out Form 911. For information on specific penalties, visit the National Highway Traffic Safety Administration.
How many people fill out Form 911 each year?
Does it ever get filled out? A. I cannot recall seeing one fill out a Form 911 in my many years of service at the Police Department. I believe that when you go to the Police Department, you leave with proof that the person who made the call has a valid form. Q. What makes the police officer who makes the call responsible? A. The officer who makes the call is under the police power because of the oath he or she took. You cannot say that the individual making the call is a private individual. If the officer is not able to tell us if the person did something, he can't say that the person is under arrest. The person making the call gets all the legal rights of anyone else, unless there is a felony charge and that charge is pending. Q. The police officer who makes the 911 call could not tell us the name of the person making it or if a complaint has been filed? A. Yes. I have been through that situation many, many times. Someone has called our dispatch center pretending to be a criminal or a gang member and has given a false address and name. We have to go out there and do a search, and we have to do that without a search warrant. We are the only law enforcement agency in the city who has the power to issue that search warrant. If we cannot find this person, the officer who made the call could not do anything more than make a phone call to complain that someone has been trespassing. The citizen does not have probable cause. We can't make an arrest or a search. Q. Why do you get to decide who the victim or perpetrator is? A. We believe that most of the time we get it right. Q. What happens if an officer makes a phone call that a victim or perpetrator is under arrest but does not come out on patrol? A. A police department is just like any other agency in the city. It cannot wait for the suspect to come out on patrol to tell the victim or the police to come get the incident report. It should be able to determine whether the incident is serious enough to call for an officer. We have the power to issue a Search Warrant. I am not sure why, though, we didn't use that power more in the past. Q. Why do the police often take the victim/perpetrator to jail? A.
Is there a due date for Form 911?
There is no due date for Form 911. You must report immediately any death or death threat to you (such as the death of family members or a hostage) to local 911, which will be automatically reported to the police. You can also report your own death. For more information, see Emergency Management — What You Need to Know. Does my employer have to report me as being seriously ill or injured? Yes. Your employer or employer's insurance carrier (for medical-care insurers) has to report you as seriously ill or injured to: your state's local 911, and To local Emergency Medical Services (EMS) if you are unable to communicate due to a mental or health illness. See the chart below for examples of what is not covered. State Your Employer (if you work for an employer) Your Employer's Insurance Carrier(s) or Health Plan Employer's Insure me with their own insurance, or with the company's insurance if it has one, and that is in a plan which will accept Form 911. Your employer or the employer's insurance carrier is responsible for sending and receiving Form 911 directly to the police. If my employer reports my disability to the insurance company and I take my insurance, the insurance company is responsible for providing the Form 911. Local Emergency Medical Services, (EMS) In the following situations, you must get medical treatment immediately if you need emergency care (such as to treat wounds or other severe injuries), call 911 as soon as the emergency has been reported to EMS for the area in which the situation occurred, or go to a hospital as soon as the medical treatment is complete. If local police are dispatched to the scene, they are required to begin taking action to investigate whether you or someone you know is dangerous. You cannot avoid medical treatment in this situation, even if you believe that you are not a threat. Your employer or your employer's insurance carrier (for medical-care insurers) must also provide information about your need for medical care, which includes reporting this to local EMS. If EMS calls you, they will then begin their investigation and must attempt to contact you to arrange medical care. For more information, see Emergency Management — What You Have to Know. My employer and the insurance carrier are covering me. Can they still report me? They can report me, but they cannot make me available to the police until they complete their investigation and attempt to contact you.
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