(1) Complete the first five lines. Enter the information requested or place "NA" in the block.
The violation report number is taken from DA Form 3975. The accident report number block will be
used if a traffic accident has occurred.
(2) Section I. Observation.
Complete with your name (first, initial, last), grade, SSN, and organization. The block to
the right should be completed by a witness (partner). The remaining blocks consist of checking the
appropriate section. If nothing was observed leave the line blank or write "NONE."
(3) Section II. Performance tests.
(a) Make sure that individuals have been advised of their rights before being asked to
perform the test recorded in Section II. The person may refuse to perform these tests. If so, enter
"REFUSED TEST" in the remarks block. If the person refused to finish a test once started, enter
"REFUSED TO CONTINUE TEST" in the remarks block.
The tests are conducted as follows:
1 Horizontal Gaze Nystagmus Test. Nystagmus refers to a jerking of the eyes as they
gaze to the side. Many people will show nystagmus or jerking when their eyes tract to the extreme left
or right. However, as people become intoxicated the onset of jerking occurs after fewer degrees of
turning and the jerking at more extreme angles becomes more pronounced. With training and practice,
police can closely estimate the blood alcohol concentration and degree of intoxication based on the
horizontal gaze nystagmus test.
2 Walk and Turn Test. The modified Walk and Turn Test consists of two parts. The
first part requires a suspect to balance heel to toe while listening to instructions. For an intoxicated
person, doing two things at once is very difficult. The second part of the test requires the suspect to
take a predetermined number of steps, usually nine, down a straight line, turn and return to the starting
point in nine steps. Along with the actual instructions for the walking and turning movement, the
suspect is told not to raise his arms and not to stop and, in fact, to turn around smoothly. Violation of
any instruction; such as raising your arm(s), stopping, taking ten or more steps, or not keeping your
heels and toes within a certain distance of each other will result in one point being deducted from the
performance of the test.
3 One Leg Stand Test. In this test, the suspect is required to stand on one leg for
approximately 30 seconds. The time requirement is important, as drivers with blood alcohol
concentration (BACs) in the .10 percent to .15 percent range may pass the test if they are permitted to
balance for less than 30 seconds. As with the walk and turn test, various specific instructions are given
to the suspect, violation of any of which will count for points.