The Florida Traffic Crash Report form is a document required for drivers involved in accidents that do not necessitate a law enforcement report. This form collects essential information about the crash, including details about the vehicles, drivers, passengers, and witnesses. Completing this report accurately is crucial for proper documentation and insurance purposes; fill out the form by clicking the button below.
The Florida Traffic Crash Report form serves as a crucial document for drivers involved in accidents that do not necessitate a law enforcement report. This form, also known as the Driver Report of Traffic Crash, requires drivers to provide essential details about the incident, including the date, time, and location of the crash, as well as the vehicles and individuals involved. Key sections of the form capture information about the drivers, vehicle owners, and passengers, such as names, addresses, and contact information. Additionally, the report includes sections for vehicle specifics like make, model, and insurance details. Witness information can also be documented, which may prove valuable in any subsequent investigations. It is important for drivers to complete this form accurately and submit it within ten days of the crash to comply with Florida law. Keeping a copy of the report for personal records and insurance purposes is advisable. The instructions for submission are straightforward, allowing drivers to send the report via email or mail to the appropriate state department.
Driver Report of Traffic Crash (Self Report) Driver Exchange of Information
HSMV Report Number
REPORTING AGENCY CASE NUMBER
DATE OF CRASH
TIME OF CRASH AM PM
COUNTY OF CRASH (County Code)
PLACE OR CITY OF CRASH (City Code)
Check if
CRASH OCCURRED ON STREET, ROAD, HIGHWAY
Within City
Limits
AT STREET ADDRESS #
OR
FEET MILES
N
S
E
W
AT/ FROM INTERSECTION WITH STREET, ROAD, HIGHWAY
OR FROM MILEPOST#
SECTION ONE
VEHICLE
NON-MOTORIST
(optional) EMAIL OWNER/DRIVER
YEAR
MAKE (Chevy, Ford, Etc.)
VEHICLE BODY TYPE (Car, Truck. Etc.)
VEHICLE LICENSE NUMBER
STATE
VIN
INSURANCE COMPANY
INSURANCE POLICY NUMBER
NAME OF VEHICLE OWNER
(Check if same as Driver)
CURRENT ADDRESS (Number and Street)
CITY AND STATE
ZIP CODE
NAME OF DRIVER (Take From Driver License)/NON-MOTORIST
DRIVER LICENSE NUMBER
DL TYPE
DRIVER/NON-MOTORIST HOME PHONE
DRIVER/NON-MOTORIST BUSINESS PHONE
SEX
DATE OF BIRTH
Area Code
NAME OF PASSENGER
SECTION TWO
SECTION THREE
WITNESSES
(1) NAME
CURRENT ADDRESS
(2) NAME
IGNATURE OF DRIVER MAKING REPORT
DATE
YOU MUST READ AND COMPLY WITH THE INSTRUCTIONS ON THE BACK OF THIS FORM
HSMV 90011S (rev 11/2019)
J
IF YOU WERE TOLD TO COMPLETE AND FORWARD THIS REPORT TO THE DEPARTMENT, PLEASE REFER TO THE FOLLOWING INSTRUCTIONS AND EXAMPLE:
Driver Report of Traffic Crash (Self Report)
Driver Exchange of Information
01-01-10
11:30
PINELLAS (04)
ST. PETERSBURG (64)
2ND STREET SOUTH
AT STREET ADDRESS # OR
FEET MILES N
E W
0
U.S. 19
NON-MOTORIST (optional) EMAIL OWNER/DRIVER
80
FORD
CAR
ABC-123
FL
INSURANCE COMPANY OF FL
I.C.F. 120000
JOHN DOE
1111 FIRST STREET NORTH
PETERSBURG, FL
33731
BILL DOE
SAME AS OWNER
D 561345706000
M
01-01-70
SALLEY DOE
Effective July 1, 2012, Section 316.066(1)(e),Florida Statute, requires that "The driver of a vehicle that was in any manner involved in a crash resulting in damage to a vehicle or other property which does not require a law enforcement report shall, within 10 days after the crash, submit a written report of the crash to the department. The report shall be submitted on a form approved by the department."
•Keep a copy of this report for your records and for insurance purposes.
•Sign the report at the bottom of the front page.
•Submit this via email to [email protected], OR;
•Mail this report to: Florida Highway Safety & Motor Vehicles Self Report Crash Team
2900 Apalachee Pkwy, MS 28 Tallahassee, Florida 32399
Please use this space for comments and for listing any witnesses and/or additional passengers, stating which vehicle the passenger was in. For additional vehicles or other involved parties, please add additional front pages for this Driver Report of Traffic Crash.
Completing the Florida Traffic Crash Report form is essential for documenting an incident involving a vehicle crash. Once filled out, this report must be submitted to the appropriate authorities within ten days of the crash. Below are the steps to accurately fill out the form.
After completing the form, keep a copy for your records. Submit the report via email or mail to the designated address provided in the instructions.
The Florida Traffic Crash Report form is a document that drivers involved in a traffic accident must complete if the crash results in damage to a vehicle or property but does not require a law enforcement report. This form helps gather essential information about the incident, including details about the vehicles involved, the drivers, and any witnesses. It is crucial for insurance claims and legal purposes.
Any driver involved in a traffic crash in Florida that results in damage to a vehicle or property must complete the Florida Traffic Crash Report form. If law enforcement does not respond to the scene, the driver is responsible for submitting this report within 10 days of the incident.
You can submit the completed form in one of two ways:
Make sure to keep a copy for your records and for any insurance claims.
The form requires several details, including:
Providing accurate and complete information is essential for processing the report effectively.
If you fail to submit the Florida Traffic Crash Report within the required 10-day period, you may face penalties. Additionally, not submitting the report can complicate any insurance claims or legal matters arising from the crash. It’s best to complete and submit the form promptly to avoid potential issues.
Filling out the Florida Traffic Crash Report form can be straightforward, but many people make common mistakes that can lead to delays or complications. One frequent error is failing to include the HSMV Report Number. This number is crucial for tracking the report and linking it to the appropriate case. Without it, the report may not be processed correctly.
Another common mistake is not providing accurate information about the date and time of the crash. It is essential to ensure these details are correct, as they help establish the timeline of events. Incorrect entries can lead to confusion and may affect any subsequent investigations or claims.
Some individuals overlook the importance of specifying the county and city of the crash. This information is vital for jurisdiction purposes. Missing or incorrect data can complicate the handling of the report by the authorities.
Many people also forget to indicate whether the crash occurred within city limits. This checkbox is often overlooked, yet it provides important context about the location of the incident. Not marking it can result in additional questions from law enforcement or insurance companies.
When listing vehicle information, errors in the vehicle license number or VIN are frequent. These numbers must be accurate to avoid issues with registration and insurance claims. Double-checking this information can save time and frustration later on.
Another mistake involves not providing complete contact details for all parties involved. Missing phone numbers or addresses can hinder communication during the claims process. Ensure that all sections are filled out completely to facilitate further inquiries.
People often neglect to sign the report at the bottom. A missing signature can render the report invalid, causing delays in processing. Signing the document is a simple step that should not be overlooked.
In addition, some individuals fail to include witness information. Witnesses can provide critical insights into the crash, and their details should be recorded accurately. Not including this information may weaken the case if disputes arise later.
Lastly, individuals sometimes forget to keep a copy of the report for their records. Retaining a copy is essential for future reference, especially when dealing with insurance claims. Always make sure to keep a copy for personal records.
When involved in a traffic incident in Florida, several documents may accompany the Florida Traffic Crash Report form to ensure all necessary information is collected and reported accurately. Understanding these forms can help streamline the reporting process and assist in any subsequent claims or legal actions.
Being familiar with these documents can aid in navigating the aftermath of a traffic crash more effectively. Properly completing and submitting the necessary forms ensures that all parties involved have the information needed for insurance claims and potential legal proceedings.
The Driver Report of Traffic Crash (Self Report) is a document that allows drivers involved in a crash to report the incident themselves. Similar to the Florida Traffic Crash Report, it requires detailed information about the crash, including the date, time, location, and the parties involved. Both forms collect information about the vehicles, drivers, passengers, and witnesses. The self-reporting aspect empowers drivers to take responsibility and provides a streamlined way to communicate essential details to the authorities.
The Driver Exchange of Information form serves as a tool for drivers to share their contact and insurance details at the scene of a crash. Like the Florida Traffic Crash Report, it focuses on gathering crucial information about all parties involved. This includes names, addresses, vehicle information, and insurance policy numbers. Both documents aim to facilitate communication and ensure that all necessary information is exchanged, which can be vital for insurance claims and legal proceedings.
The HSMV Report Number is a unique identifier assigned to each traffic crash report filed in Florida. It is similar to the case number found on the Florida Traffic Crash Report, which helps track and reference specific incidents. Both numbers are essential for organizing reports and ensuring that all parties can easily access the details of a crash. They provide a clear way to follow up on any legal or insurance matters related to the incident.
The Witness Statement form allows individuals who witnessed a crash to provide their accounts of the event. This form complements the Florida Traffic Crash Report by gathering independent perspectives that can clarify the circumstances of the crash. Both documents aim to collect accurate information about what happened, which can be crucial in determining fault and liability in any resulting claims or legal actions.
The Insurance Claim Form is used to file a claim with an insurance company after a traffic crash. Similar to the Florida Traffic Crash Report, it requires detailed information about the accident, including the parties involved and the extent of damages. Both documents are critical for processing claims and ensuring that the necessary information is available for insurance adjusters to evaluate the situation and determine compensation.
The Police Report, created by law enforcement after responding to a crash, contains factual details about the incident. This document is similar to the Florida Traffic Crash Report in that it includes information about the crash's location, time, and the parties involved. While the police report may provide an official perspective, both reports serve to document the incident for insurance and legal purposes, offering different viewpoints on the same event.
When filling out the Florida Traffic Crash Report form, there are some important dos and don'ts to keep in mind. Following these guidelines can help ensure that your report is accurate and complete.
By keeping these tips in mind, you can help streamline the process and ensure that your report meets all necessary requirements. Remember, accuracy is key!
This report is required for any crash that results in property damage, regardless of whether there are injuries. If your vehicle or someone else's vehicle was damaged, you should complete this report.
While law enforcement does file reports for certain accidents, drivers involved in crashes that do not require a law enforcement report must submit their own report within 10 days. This is a legal requirement under Florida law.
Even minor accidents require a report if there is property damage. Failing to file can lead to complications with insurance claims and potential legal issues.
It is important to keep a copy of the completed report for your records and for insurance purposes. This can help in case of disputes or claims related to the accident.
You can submit the report via email or mail. This flexibility allows you to choose the method that is most convenient for you.
The report also collects information about passengers, witnesses, and other involved parties. This comprehensive data is essential for resolving any claims or disputes.
Filling out the Florida Traffic Crash Report form is an important task that requires attention to detail. Here are some key takeaways to keep in mind:
By following these takeaways, you can ensure that your Florida Traffic Crash Report is filled out correctly and submitted on time, helping to facilitate any necessary follow-up actions.
Fill in Your Florida Traffic Crash Report Form