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                        Leading the Way to a Safer Transportation System


            
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                Highway Safety Improvement Program (HSIP)–State–Specific Information
Following is a template for you to include summary information on your HSIP. You must fill out this page first before giving it to your State DOT or other SHSP safety stakeholders. The tip box gives you information on where to find the state's HSIP report contact person along with data and other information. When giving this information to your state, you may also want to include a copy of your most recent HSIP annual report. Use this information to inform DOT leadership and others on how the SHSP improves safety in your state.

Pie chart showing the 41.5 billion dollar a year in Formula Funding from 2016 to 2020.

**TIP:** Refer to your state's HSIP Annual Report to fill in the template.

**State HSIP Funds: HSIP Apportionment _____________________ State Obligation Rate _____________________**

**Overview of Highway Safety Trends (General highway safety trends in the state for the past five years)**

This is a form with blank fields to fill in Baseline (Year) and Current (Year) information on: Number of Fatalities, Fatality rate, Number of Serious Injuries, Serious Injury Rate, and Highway Safety Improvement Program/Safety Success Stories for State.

**For more information visit the state HSIP report (to be filled in)**

**or FHWA Communities of Practice HSIP web site**

**For more information about your State's HSIP, contact (to be filled in)**
      
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                Leading the Way to a Safer Transportation System
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                Strategic Highway Safety Plan (SHSP)–State–Specific Information
                Highway Safety Improvement Program (HSIP)–State–Specific Information
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