Vehicle Accident Report Template

This is a report that a company can use to provide the details of an accident with a company vehicle. This form asks for the driver's information, vehicle details, ownership of the vehicle, insurance details, accident details, accident description, and vehicle damage. This form can be used by individuals or entities that want to record the details of an automobile accident for further investigation by insurance and regulatory companies.

[Logo of Company]

[ Address of Company ]

User / Driver's Particulars

Mr / Mrs / Ms Surname

Address P/Code

Ph. Work

Mobile

Designation

Year Licensed

License No.

Expiry Date

Vehicle Details

Year of Manufacture

Make

Model

Body Type

Color

Registration #

MT/AT

Owner Ship - Mark (x)

Owned Lease Plan Rental Insurance Details

Insurance Company

Policy #

Policy Type

Accident Details

Date MM/DD/YYYY

Time HH:MM:SS

Location

Weather Condition (x) Dry - Wet - Foggy - Sunny - Overcast - Other

Speed Allowed KM/HR

Document # [ ]

[Logo of Company] [ Address of Company ] Speed of Vehicle KM/HR

Road Condition Sealed, Dirt, Gravel, Other

Accident Description - To be Completed User /Driver

Vehicle Damage

Document Attached (x)

Police Report

Registration Card Copy

Driving License

Car Photo-Damage

Part/s

Others

Declaration

I declare the aforementioned to be true and correct.

Signature of Driver / User : _____________________

Date: MM/DD/YYYY

Prepared By _________________________

Date: MM/DD/YYYY

Approved By _________________________

Date: MM/DD/YYYY

Download the document

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