Driver Accident Statement Template
Driver Information
Full Name
Address
Phone Number
Driver's License Number
Vehicle Make/Model
Registration Number
Accident Details
Date
Time
Location
Weather/Road Conditions
Police Notified?
Officer Name/Badge Number
Other Party Information
Name
Vehicle
Contact Number
Insurance Company
Description of Accident
Describe in detail how the accident occurred
Sketch of Accident Scene
Draw accident scene (attach separately if needed)
Witnesses
Names and Contact Details
Driver Signature
Signature
Date