MMA-CA MOTORCYCLE RIGHTS TASK FORCE
TRAFFIC STOP REPORT FORM
This information may be presented to State or Federal legislators, as well as police or DOT administrators. It will be used to document law enforcement
activity to ensure reasonable law enforcement. Provide as much information as possible, attaching additional pages if necessary.
Send completed forms to: MMA 5847 Auburn Blvd., Suite 6 Sacramento, CA 95841
Please Print Legibly
Were you the Driver ___ Passenger ___ Witness ___? Vehicle: Make/Model ________________________ Year ________
Date/Time of incident in this report: __________________________________ Were you alone / in a group? (Circle One)
Full legal name: _____________________________________________________________________________________
Address _______________________________________ City ___________________________ State ____ Zip ________
Phone: Day phone ( ) __________________________ Evening phone ( ) ________________________________
Were you a witness to, or the subject of law enforcement activity? Witness _________ Subject ________
Location of stop/activity: (Provide business name, address, cross streets, City, etc. to identify location.)
What method did law enforcement use to stop you and/or the subject(s) of the law enforcement activity? (Road block,
red lights, waved over, etc.)
What reason did law enforcement give for the stop (probable cause)?
Did the law enforcement officer properly identify him/herself to you? Attach copy of his/her card, or complete the
following: Officer’s name, ID number, agency (local police, task force, hwy patrol, etc.)
Did law enforcement treat you fairly & respectfully? Yes ____ No ____ If no, explain: _____________________________
Were you detained? If yes, how long? ___________________________________________________________________
Did the law enforcement officer fill out a field interview card (F.I.C.) on you? Yes ____ No ____
Were you photographed? Yes ____ No ____ If yes, what was photographed (bike/vehicle, tattoos, etc.)
Was there video surveillance or audio recording on the scene? Yes ____ No ____ If yes, who was filming/recording (law
enforcement, MRO, both)? ____________________________________________________________________________
Were you questioned? Yes ____ No _____ If yes, what questions were asked and what comments were made by law
enforcement? _______________________________________________________________________________________
Did you consent to any search by law enforcement? Yes ____ No ____ If yes, explain why. (Remember, you are not
required to consent to a search for any reason.) ___________________________________________________________
Were you searched? Yes ____ No ____ If yes, what was searched – you, your bike/vehicle, other property?
Was any of your property confiscated? Yes ____ No ____ If yes, list: __________________________________________
Were you cited? Yes ____ No ____ If yes, please provide the following (or attach a legible copy of complaint):
Cite # ______________________________________ ARS section violated
______________________________________
Date of Court appearance _____________________ Location/Time of appearance _______________________________
Please attach additional info/documentation regarding the stop that may be useful (witness statements, etc.)
