Commercial Vehicle Collision Report Sheet
1. Company & Vehicle Information
Company Name
Vehicle Type
License Plate
Driver Name
Driver License Number
Contact Number
2. Accident Details
Date
Time
Location
Weather Conditions
Road Conditions
3. Other Party Information
Name
Contact Number
Vehicle Type
License Plate
Insurance Company
Policy Number
4. Witness Information
Name
Contact Number
5. Description of Collision
Provide a detailed description of how the accident occurred:
6. Diagram
Draw a diagram of the accident scene:
7. Damage Assessment
Describe damage to company vehicle:
Describe damage to other vehicles/property:
8. Police Information
Officer Name
Badge Number
Report Number
9. Signature
Driver Signature
Date