text: Appendix A
  ACCIDENT REPORT/SERIOUS INCIDENT REPORT [SIR]
  REPORT NUMBER: A001
  GENERAL INSTRUCTIONS: Use to convey flash traffic to the commander and command post related to an
  accident or serious incident within the command. This report is similar to NATO incident report (INCREP)
  STANAG 2020, North Atlantic Treaty Organization Allied Tactical PPuublication (NATO ATP)-105. Reference:
  AR 190-45 and AR 385-10.
  LINE 1 – DATE AND TIME ________________________________________________________(DTG of report)
  LINE 2 – UNIT __________________________________________________________________(unit making report)
  LINE 3 – CATEGORY __________________________________________________________(category 1 or 2)
  LINE 4 – TYPE __________________________________________________________________(type of incident)
  LINE 5 – TIME OF INCIDENT __________________________________________________(DTG of incident)
  LINE 6 –WEEKEND/HOLIDAYY____________________________________________(YES or NO and include holiday
  name)
  LINE 7 – LOCATION ____________________________________________(UTM or six-digit grid coordinate
  with MGRS grid zone designator)
  LINE 8 – PERSONNEL _________________________________________(personnel involved)
  A.(SUBJECT)
  (1)_________________________________(name, injury, fatality)
  (2) _________________________________(pay grade)
  (3) _________________________________(race)
  (4)_________________________________(sex)
  (5)_________________________________(age)
  (6)_________________________________(position [CDR, PSG, gunner])
  (7)_________________________________(security clearance)
  (8)_________________________________(unit, station, and Army command assigned)
  (9)_________________________________(duty status [leave])
  B.(VICTIM)
  (1) _________________________________(name, injury, fatality)
  (2) _________________________________(pay grade)
  (3) _________________________________(race)
  (4)_________________________________(sex)
  (5)_________________________________(age)
  (6)_________________________________(position [CDR, PSG, gunner])
  (7)_________________________________(security clearance)
  (8)_________________________________(unit, station, and Army command)
  (9)_________________________________(duty status [leave])
  LINE 9 – SUMMARY __________________________________________(summary of incident)
  LINE 10 –PUBLICITY_________________________________________(adverse or anticipated publicity)
  LINE 11 – COMMANDER ______________________________________(commander reporting)
  LINE 12 – POC _______________________________________________(unit POC and duty position)
  LINE 13 – DOWNGRADE ______________________________________(downgrading instructions)
  LINE 14 – NARRATIVE ________________________________________(free text for additional information
  required for report clarification)
  LINE 15 –AUTHENTICATION__________________________________(report authentication)
  Accident Supplement (Ground[GRND]/Aircraft[AC])
  LINE 15A – POC ______________________________________________(e-mail, phone, DSN)
  LINE 15B – ARMY COMMAND _________________________________(TRADOC, FORSCOM,
  USAREUR)
  LINE 15C – ACCIDENT CLASS _________________________________(GRND or AC)
  **Continued on next page.