The Florida Traffic Crash Report form is a crucial document that drivers must complete after being involved in a traffic accident. This report helps to record essential details about the crash, including the time, location, and involved parties. If you've been in a traffic incident, make sure to fill out this form accurately by clicking the button below.
When you're involved in a traffic crash in Florida, filling out the Florida Traffic Crash Report form is an essential step in documenting the incident. This form serves multiple purposes, from providing crucial information to insurance companies to fulfilling legal obligations. It includes sections for detailing the date, time, and location of the crash, as well as the specific vehicles and individuals involved. You'll need to provide details about the drivers, including their names, addresses, and insurance information. Additionally, there are sections for passengers and witnesses, ensuring that all perspectives are captured. The form requires signatures and should be submitted within ten days if a law enforcement report is not made. Understanding how to accurately complete this form can help streamline the claims process and ensure that all necessary information is recorded, making it a vital resource for anyone navigating the aftermath of a traffic incident in Florida.
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.
Filling out the Florida Traffic Crash Report form is a straightforward process. After gathering the necessary information, you will be able to complete the form accurately. This report is essential for documenting the details of a traffic crash and should be submitted within ten days of the incident.
The Florida Traffic Crash Report form is a document that drivers must complete when they are involved in a traffic crash that results in damage to vehicles or property. This form is required if the crash does not necessitate a law enforcement report. It collects essential information about the crash, including details about the vehicles, drivers, passengers, and witnesses involved.
Any driver involved in a traffic crash that results in damage to a vehicle or property is required to complete the form. This requirement applies when no law enforcement report is filed. Additionally, the driver must submit the report to the Florida Department of Highway Safety and Motor Vehicles within 10 days of the crash.
The form requires various pieces of information, including:
Make sure to fill out all relevant sections accurately to ensure proper processing of the report.
You can submit the completed Florida Traffic Crash Report form in one of two ways:
Yes, the form must be submitted within 10 days after the crash. Failing to submit the report within this timeframe may result in penalties or complications with your insurance claim.
It is advisable to keep a copy of the completed report for your records. This can be useful for insurance purposes and may help in any future legal matters related to the crash.
If there are additional vehicles or witnesses involved in the crash, you should add extra front pages to the report. This ensures that all relevant parties are documented and that the information is complete.
Failure to file the Florida Traffic Crash Report form when required can lead to legal consequences. It may also affect your insurance coverage and claims process. It is crucial to comply with the reporting requirements to avoid complications.
Incomplete Information: Failing to fill out all required fields can lead to delays in processing. Ensure every section is completed, including the HSMV Report Number and CASE NUMBER.
Incorrect Vehicle Details: Providing inaccurate information about the vehicle, such as the license number or VIN, can cause complications. Double-check these details before submission.
Missing Signatures: Forgetting to sign the report is a common oversight. The report is not valid without the driver's signature, so ensure this step is completed.
Failure to Submit on Time: The report must be submitted within 10 days of the crash. Delays can result in penalties. Stay on top of deadlines to avoid complications.
The Florida Traffic Crash Report form is an essential document for reporting vehicle accidents in the state. However, it is often accompanied by several other forms and documents that help provide a comprehensive account of the incident. Below is a list of these related documents, each serving a specific purpose in the reporting and insurance process.
Understanding these documents and their functions can aid individuals in effectively navigating the aftermath of a traffic crash. Each form plays a vital role in ensuring that all necessary information is collected and shared, helping to facilitate the insurance and recovery processes.
The Driver Report of Traffic Crash (Self Report) is a document that allows individuals involved in a traffic accident to provide details about the incident. Similar to the Florida Traffic Crash Report, it requires information such as the date, time, and location of the crash. Both documents also ask for driver and vehicle information, including license numbers and insurance details. The self-reporting nature of this form empowers drivers to take responsibility for documenting their own accounts of the event, which can be crucial for insurance claims and legal proceedings.
The Driver Exchange of Information form serves as a tool for drivers to share essential details with each other after a crash. This document is similar to the Florida Traffic Crash Report in that it includes spaces for driver and vehicle information, including names, addresses, and insurance details. The primary purpose of this form is to facilitate communication between involved parties, ensuring that everyone has the necessary information to follow up on claims or legal matters. This exchange fosters cooperation and can help mitigate disputes that may arise from the accident.
The HSMV Report Number is a unique identifier assigned to each traffic crash report filed with the Florida Highway Safety and Motor Vehicles. This number is akin to the case number found in the Florida Traffic Crash Report, which helps track the report within the system. Both numbers are essential for referencing the specific incident in future communications with law enforcement or insurance companies. They serve as vital links to the documentation of the crash and assist in maintaining organized records.
The Reporting Agency Case Number is another important identifier that connects the crash report to the agency that documented the incident. This number functions similarly to the HSMV Report Number, as it helps ensure that all records related to the crash are easily accessible. Both numbers play a crucial role in maintaining accurate records and facilitating communication between the involved parties and relevant agencies.
The Witness Statement form is used to gather accounts from individuals who observed the crash. This document shares similarities with the Florida Traffic Crash Report in that it collects vital information about the incident, such as the time and location of the crash. Witnesses can provide impartial perspectives that may clarify the circumstances surrounding the accident. Including witness statements can strengthen the overall understanding of the event and assist in resolving disputes.
The Accident Report Form is a document often used by law enforcement to officially record the details of a traffic accident. Like the Florida Traffic Crash Report, it includes information about the parties involved, the vehicles, and the circumstances of the crash. This report is typically more detailed and may include diagrams or officer observations. Both forms aim to provide a comprehensive account of the incident, which can be invaluable for insurance claims and legal proceedings.
The Insurance Claim Form is utilized by individuals seeking compensation from their insurance companies following a traffic accident. This form shares similarities with the Florida Traffic Crash Report in that it requires detailed information about the crash, including the parties involved and the extent of damages. Accurate completion of both forms is crucial for a smooth claims process. The information provided helps insurance companies assess liability and determine appropriate compensation.
The Medical Report form is often required when injuries occur as a result of a traffic accident. This document is similar to the Florida Traffic Crash Report in that it provides essential information about the incident and the individuals involved. Both forms contribute to a comprehensive understanding of the crash's impact, especially when it comes to claims related to medical expenses. The medical report can serve as a critical piece of evidence when establishing the extent of injuries sustained in the accident.
When filling out the Florida Traffic Crash Report form, it’s important to be careful and thorough. Here are some things you should and shouldn't do:
By following these guidelines, you can ensure that your report is completed correctly and submitted on time. This can help in resolving any issues that may arise from the crash.
Understanding the Florida Traffic Crash Report form can be challenging, and several misconceptions often arise. Here are six common misunderstandings:
Being aware of these misconceptions can help drivers navigate the process more effectively and ensure compliance with Florida traffic laws.
Filling out the Florida Traffic Crash Report form accurately is crucial for proper documentation and processing. Below are key takeaways to consider:
Following these guidelines will help ensure that your Traffic Crash Report is processed efficiently and accurately.