ACCIDENT RECORD CARD
Other Vehicle
Make Model Year Rego
Driver's Name
Address Phone
Owner's Name
Address Phone
Insurance Co.
Description of Damage
 
Situation
Date Time Weather
Exact Location
Independent Witness
Name
Address Phone
Your Vehicle
Make Model Year Rego
Driver's Name Age
Description of Damage
 
Map of Location
Show street names, direction each vehicle was travelling prior to accident and position of each vehicle after the accident.
Other People
Name
Address Phone
Injuries
 

Ask to have your vehicle towed to
Caddle Crash Repairs

 Accident Tow Truck:
8231 5555

quality RAA and MTA approved workshops at
24 Dunorlan Road, Edwardstown
or 214 Main Road, Blackwood

 1. Location
2. Driver's Name
3. Vehicle Make
4. Rego No.
This card should be kept in your vehicle at all times and used to help record the necessary information about the accident that will be required for
Police or Insurance Company reports