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If YES, Name or 4 Digit Number from Diamond or Box: 1 Digit Number from Bottom of Diamond: 1 Digit Number from Bottom of Diamond: Ran Off Road Down Hill Runaway Cargo Loss or Shift Separation of Units DOT-523 (12/03) Ran Off Road Down Hill Runaway Cargo Loss or Shift Separation of Units MAIL TO: Georgia Department of Transportation, CRASH REPORTING UNIT 935 East Confederate Ave. Atlanta, GA 30316-2590 PAGE of REMARKS.

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