Florida Traffic Safety Information Systems
Federal Fiscal Year 2014
Request for Section 405 Funding
Supplemental Information Request Form
Project Title:
Agency Name:
Provide the total number of crashes reported by your agency:
In 2012:
Provide the total number of citations reported by your agency in 2012:
Is your agency currently submitting electronically?
Yes
No
If yes, how many crash reports were submitted electronically in 2012:
If yes, how many citation reports were submitted electronically in 2012:
If awarded Section 405 funding, do you anticipate your electronic submissions to
increase?
Yes
No
If yes, please provide estimated increase:
Do you have an executed contract agreement with an eCrash vendor?
Yes
No
If requesting grant funding for equipment, check the appropriate box: (Note: If equipment
is outdated and cannot be upgraded to allow electronic submission, please check the “New
equipment” box)
New equipment
Replacement equipment
If awarded Section 405 funding to purchase equipment, who will use the equipment?
Number of patrol officers issued with a laptop:
Number of traffic officers issued with a laptop: