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Be prepared.
Print out copies of this Accident Checklist to keep in the glove box of
every vehicle.
[ ] Safety
First Call
911
[ ] Date
_____________________ Time ____________________
[ ] Where
accident occurred (street names) ___________________________
[ ] Were
there any injuries?
Pedestrians? ___________________________________________
Passengers? ___________________________________________
Name
_________________________________________________
Address _______________________________________________
Phone _________________________________________________
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| [ ] Get
important information at the scene. |
In addition
to getting information from other drivers, be sure to get at least the
names and phone number of any witnesses or people who stopped to help.
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Driver
1
Name
___________________________________
Address _________________________________
Phone ___________________________________
Driver's License Number ___________________
Exp. Date _______ Date of Birth ______________
Their insurance company __________________________________
Their insurance policy number ______________________________________
Registered owner of their vehicle ___________________________
License No. of their vehicle ______________ State __________________
Year ________ Make/ Model __________________ Color ____________
Number of passengers __________________
Driver 2
Name ___________________________________
Address _________________________________
Phone ___________________________________
Driver's License Number ___________________
Exp. Date _______ Date of Birth ______________
Their insurance company __________________________________
Their insurance policy number ______________________________________
Registered owner of their vehicle ___________________________
License No. of their vehicle ______________ State __________________
Year ________ Make/ Model __________________ Color ____________
Number of passengers __________________
Driver 3
Name ___________________________________
Address _________________________________
Phone ___________________________________
Driver's License Number ___________________
Exp. Date _______ Date of Birth ______________
Their insurance company __________________________________
Their insurance policy number ______________________________________
Registered owner of their vehicle ___________________________
License No. of their vehicle ______________ State __________________
Year ________ Make/ Model __________________ Color ____________
Number of passengers __________________
Witness
Name ___________________________________
Address _________________________________
Phone ___________________________________
Witness
Name ___________________________________
Address _________________________________
Phone ___________________________________
Witness
Name ___________________________________
Address _________________________________
Phone ___________________________________
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[ ] Share
only pertinent information at the scene.
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Provide
only your driver's license and registration to the other driver, injured
persons, or police officers. Do NOT discuss the circumstances of the
accident with anyone except the police. Do NOT discuss responsibility
with anyone except a positively identified representative of your insurance
company.
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| [ ] Arrange
for towing your vehicle. |
Don't sign
any towing release that authorizes repair of your vehicle unless you
have decided to have your car repaired by the facility where the towing
company will take your car.
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| [ ] Complete
an Accident Record. |
Write
down everything you can remember about the accident. Include as many
details as possible. Revisit the scene at a later time if necessary
to take pictures.
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Draw
a diagram of the accident marking the vehicles involved (A, B, C,
etc.) and showing the direction the vehicles were traveling and
where accident occurred. Mark street names, stop signs, traffic
lights, and other landmarks. Describe other pertinent information:
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___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
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| [ ] Report
the accident to the Department of Motor Vehicles. |
Auto
Masters
910 Nelson Dr.
K-15 & Buckner
Derby, KS 67037
(316) 788-5722
Fax 316-788-2592
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|
Auto
Masters
3965 S. Norman
Corner of Norman & Macarthur
Wichita, KS
(316)529-2300
Fax 316-524-0058 |
©
2002 Auto Masters Body Shop. All rights reserved. Privacy
Policy
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