• Protect Yourself! Protect Your Investment! Please Take Pictures of Accident

Your Information

• Name:
• Email:

Step 1: Important Information to Fill Out in Case of An Accident

• Time of Accident
• Estimated Speed of Your Car
• Visibility
• Weather/Road Conditions
• Amount of Traffic
  H

  M

  L

  
  
• Speed Limit
• Other Car
• No. Vehicle Involved
• Traffic Signals or Signs
• List names and injuries (if any) of your passengers as soon as convenient for your records

Step 2: Important Information Regarding Other Vehicle

• Make
• Lic. Plate No.
• Year
• Prov. or State
  ONABB.C.MBNBNLNTNUPEIQCSKYTUNITED STATESALAKAZARCACOCTDEDCFLGAIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKPARISCSDTNTXUTVTVAWAWVWIWY
• Driver
  M

  F

  
  
• Name
• Address
• Driver License
• Prov. or State
  ONABB.C.MBNBNLNTNUPEIQCSKYTUNITED STATESALAKAZARCACOCTDEDCFLGAIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKPARISCSDTNTXUTVTVAWAWVWIWY
• Insurance Co
• Policy No.
• Damage

Step 3: Independent Witnesses

• List names and addresses. If witness is occupant of another vehicle, mark down license number

Step 4: Accident Information

• Draw an Accurate sketch of accident scene. (See Sample Sketch Below) Mark Direction of travel, point of impact and relation of traffic lanes, signals and signs.
  
• Take Notes
• Upload Picture/Drawing