Ask to see the other driver's:
- Driving License
- Owner's Card
- Insurance Card
DRIVER
Address
Phone #
Operator's #
CAR
Make
Year
Model
Color
License Plate #
Vehicle I.D. #
Damage
INSURANCE CO.
name
Policy #
Effective date:
Name of Insured
Address
Insured Vehicle
PASSENGER(S):
WITNESS(ES):
name-address-phone #
THE ACCIDENT
Date
Time
Location
Police Officer
PUT ACCIDENT DESCRIPTION, DIAGRAM AND STATEMENTS MADE
BY OTHER PARTIES ON THE REVERSE SIDE GO TO THE HOSPITAL FOR AN EXAMINATION
Also visit www.californialawyers.com.
