
F BIRTH STREET ADDRESS CITY / STATE / ZIP CODE M DRIVER S LICENSE NUMBER CDL ENDORSED? STATE DATE / TIME OF ARREST F COUNTY OF ARREST CASE / CITATION NUMBER (CHECK IF YES) BAC Readings: 1st Sample 2nd Sample Refused Test The subject was lawfully arrested. At that time, there were reasonable grounds to believe that the arrested person had been driving or was in actual physical control of a motor vehicle within this state while under the influence of intoxicating liquor or drugs,.
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How to fill out the WA 3000-110-197 online
The WA 3000-110-197 form, known as the DUI arrest report, is essential for documenting incidents involving driving under the influence. This guide provides a clear, step-by-step approach to help users successfully complete this form online.
Follow the steps to complete the WA 3000-110-197 form effortlessly.
- Press the ‘Get Form’ button to access the WA 3000-110-197 form and open it in your document editor.
- Begin by entering the subject's name, including their last name, first name, and middle initial. Ensure accuracy as this information is crucial for identification.
- Fill in the gender, date of birth, and address, including the city, state, and ZIP code. This information must be current to maintain proper documentation.
- Provide the driver’s license number along with the CDL endorsed information if applicable. Indicate the state of issuance.
- Record the date and time of the arrest, as well as the county where the arrest occurred. Ensure that these details accurately reflect the incident.
- Enter the case or citation number, which is critical for legal tracking and reference.
- Document the BAC readings. Include the results from the first and second samples, or indicate if the test was refused.
- Use the checkboxes to confirm that the subject was lawfully arrested and the specifics of the breath test administered.
- Complete the section regarding the driver's hearing request information and understand the notice of the right to a hearing.
- Add the signature of the driver and the date to finalize the form. Make sure to include all necessary primary contact details.
- Once completed, save your changes to the document, and then choose to download, print, or share the WA 3000-110-197 form as needed.
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