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Auto Accident Report Form Keep In Your Glove Box
When an accident occurs:
First Steps Do Not Say While Still At the Scene
Remain calm
Get to a safe place
Check for injuries
Administer First Aid
Call police/EMT
It’s all my fault, (even if it is).
My insurance will pay for
everything.
It’s OK, I have full coverage.
Get as much information as
possible on this report.
Take Pictures
When the police come, cooperate
and tell them what you know.
Accident Details
Day/Date/Time AM/PM
Weather/Road Conditions
Location of Accident
Accident Details
Damage Descriptions
Your Vehicle Other Vehicle
Towing Company Name & Phone
Towing Company Name & Phone
Other Driver/Vehicle Information
Owner's Name:
Owner's Address:
Owner's Phone:
Vehicle Make:
Vehicle Model & Year:
Vehicle Color:
License Plate Number
Insurance Company:
Agent Name & Phone:
Other Drivers Name:
Other Drivers Address:
Other Drivers Phone:
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