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Departments » Sheriff
School Bus Incident Report

This form is for offically reporting incidents of school bus violations with in Brown County to the Sheriff's Traffic team for follow up.

Please be sure to have your company code to be able to complete the form.

If you have questions regarding this process you may call the Traffic Team at (920) 448-4382.
Date of Violation
________________________________________________:
Time of Violation
________________________________________________:
Day of the Week
_________________________________________________:
Violator's License Plate Number
_________________________________________________:
State of Violator's License Plate (i.e. Wisconsin, Michigan,...)_________________________________________________:
Vehicle Color
_________________________________________________:
Vehicle Type (auto, truck, ...)
_________________________________________________:
Vehicle Make (Ford, Chev, ....) enter UNKNOWN if do not know
_________________________________________________:
Vehicle Model (2 door, 4 door, ....)
_________________________________________________:
APROXIMATE LOCATION

Happened ON Street
_________________________________________________:
# Feet to cross street
_________________________________________________:
Direction To Cross Street
_________________________________________________:
Cross Street
_________________________________________________:
Driver Sex:
_________________________________________________:
Driver Race:
_________________________________________________:
Approximate age of driver:
_________________________________________________:
Driver hair color:
_________________________________________________:
Was the School Bus Stopped?
_________________________________________________:
Yes
No
Were School bus lights activated at least 100 feet before stopping the bus?
_________________________________________________:
Yes
No
Do you think the passing vehicle had enough time and distance to stop 20 feet from you after you had stopped?
_________________________________________________:
Yes
No
Was the Stop arm activated?
_________________________________________________:
Yes
No
Speed Limit on the roadway?
_________________________________________________:
Approximate speed of the vehicle?
_________________________________________________:
Did Driver indicate in any way that he/she saw the bus? If so explain.
_________________________________________________:
Did vehicle slow while approaching the bus?
_________________________________________________:
Yes
No
Direction of travel of the Bus?
_________________________________________________:
Direction of travel of passing vehicle?
_________________________________________________:
Highway Type?
_________________________________________________:
Total number of lanes of roadway?
_________________________________________________:
Weather conditions?
_________________________________________________:
Road Conditions?
_________________________________________________:
Light Conditions?
_________________________________________________:
Traffic Conditions?
_________________________________________________:
Were school bus flashing lights and stop arm checked and working properly before and after the incident?
_________________________________________________:
Yes
No
Narrative.

Describe in detail the incident as it occured:
_________________________________________________:
Bus Company Name:
_________________________________________________:
Enter Bus Company Code. this code was given to each Bus company to assure that the submitted report is from a valid driver. get this code from your Bus company.
_________________________________________________:
By entering my name on this form I am verifying that I am the witnessing bus driver and that the information that I am presenting is voluntarily given, is true and correct to the best of my knowledge.

Bus Drivers Full Legal Name:
_________________________________________________:
Bus Driver Contact Phone number:
_________________________________________________:
Date and Time of Online report:
_________________________________________________:
Enter Contact Email:
________________________________________________:
To complete this process fax a diagram drawn on the Bus Company letterhead to the Sheriff's office at: 920-448-4387

Besure to note date and time of violation on the diagram.
_________________________________________________:
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