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Understanding the Florida Traffic Crash Report form is essential for anyone involved in a traffic incident within the state. This form serves multiple purposes, ranging from documenting the details of the crash to facilitating communication with insurance companies. At its core, the report requires critical information such as the date and time of the crash, the location, and the identities of the drivers and passengers involved. Specific sections focus on vehicle details, including make, model, and insurance information, ensuring that all pertinent data is captured. Witnesses can also be noted, providing an additional layer of context to the incident. Importantly, the form mandates that drivers submit their report within ten days of the crash if law enforcement does not respond. This requirement emphasizes the need for timely documentation, which can significantly impact insurance claims and any potential legal proceedings. Completing the form accurately not only aids in resolving disputes but also serves as a vital record for future reference. With a clear understanding of its components, drivers can navigate this process with confidence and clarity.

Documents used along the form

The Florida Traffic Crash Report form is a crucial document for anyone involved in a traffic accident. In addition to this form, several other documents may be necessary to provide a complete account of the incident and facilitate communication between the parties involved. Below is a list of these important forms and documents.

  • Driver Report of Traffic Crash (Self Report): This form allows drivers to provide their own account of the crash. It is especially useful when law enforcement is not present at the scene. Submitting this report within 10 days is often required by law.
  • Driver Exchange of Information: This document is used for drivers to share essential details with each other at the scene of the crash. It includes contact information, insurance details, and vehicle specifics, ensuring that all parties have the necessary information to follow up.
  • Witness Statements: Statements from witnesses can provide additional perspectives on the crash. These accounts can be critical for insurance claims and legal proceedings, as they may clarify the circumstances surrounding the incident.
  • Insurance Claim Forms: After a crash, drivers typically need to file a claim with their insurance company. These forms require detailed information about the accident, including the Florida Traffic Crash Report, to process the claim efficiently.
  • Medical Reports: If there are injuries from the crash, medical reports may be necessary. These documents detail the nature of injuries sustained and can be vital for insurance claims and potential legal actions.

Gathering and submitting these documents promptly can significantly impact the resolution of any issues arising from a traffic accident. Being prepared with the correct forms ensures that all parties can navigate the aftermath of the incident smoothly.

Similar forms

The Driver Report of Traffic Crash (Self Report) is similar to an Accident Report Form used in many states. Both documents collect essential information about the crash, including details about the vehicles involved, the drivers, and the circumstances surrounding the accident. They serve as a means for drivers to report incidents that may not require law enforcement intervention, ensuring that all relevant data is documented for insurance and legal purposes.

The Driver Exchange of Information form is another document that shares similarities with the Florida Traffic Crash Report. This form is typically used at the scene of an accident for drivers to share their contact and insurance information. Like the Florida report, it emphasizes the importance of documenting the incident and facilitates communication between involved parties, making it easier to process claims and resolve disputes.

A Vehicle Accident Report is often used by insurance companies to assess claims. This document collects information about the accident, including the vehicles involved and the damages incurred. Similar to the Florida Traffic Crash Report, it serves as an official record that can be referenced during the claims process, helping insurers determine fault and compensation amounts.

The Police Report is a formal document created by law enforcement officers responding to an accident. While the Florida Traffic Crash Report can be completed by drivers themselves, a Police Report includes an officer’s observations and conclusions regarding the incident. Both documents are critical for insurance claims and legal proceedings, but the Police Report carries more weight due to its official nature.

The Incident Report is another document that resembles the Florida Traffic Crash Report. Often used in various contexts, including workplace accidents, it gathers details about the event, parties involved, and any witnesses. Like the traffic report, it is designed to create a record of the incident for future reference, whether for insurance claims or safety reviews.

The Claim Form used by insurance companies is similar in purpose to the Florida Traffic Crash Report. Both forms require detailed information about the accident, including the parties involved and the damages. The Claim Form is typically submitted to initiate the claims process, while the traffic report serves as a foundational document that supports the claim.

The Motor Vehicle Accident Report is a document used by various states to collect information about vehicle accidents. Similar to the Florida Traffic Crash Report, it requires details about the crash, including the involved vehicles and drivers. This report is essential for state records and can be requested by insurance companies to assist in claims processing.

The Witness Statement Form is often used to gather testimonies from individuals who observed the accident. This document complements the Florida Traffic Crash Report by providing additional perspectives on the incident. Both forms aim to create a comprehensive account of the event, which can be crucial in determining liability and resolving disputes.

The Liability Waiver is another document that, while different in function, shares the goal of addressing the aftermath of an incident. It is used to release one party from liability in exchange for compensation or other considerations. Like the Florida Traffic Crash Report, it serves to document an agreement regarding the responsibilities and liabilities of the involved parties.

Finally, the Personal Injury Claim Form is similar to the Florida Traffic Crash Report in that it is used to document injuries resulting from an accident. This form collects information about the accident, the injuries sustained, and medical treatments received. Both documents are vital in establishing the facts of the case and supporting claims for compensation.

Obtain Answers on Florida Traffic Crash Report

  1. What is the Florida Traffic Crash Report form?

    The Florida Traffic Crash Report form is a document that drivers involved in a traffic accident must complete if there is no law enforcement report required. It collects essential information about the crash, including details about the vehicles, drivers, passengers, and witnesses.

  2. Who needs to fill out this form?

    If you were involved in a crash that resulted in damage to a vehicle or property, and a law enforcement report is not required, you must fill out this form. This includes all drivers involved in the incident.

  3. What information is required on the form?

    The form requires details such as:

    • Date and time of the crash
    • Location of the crash
    • Information about the vehicles involved (make, model, license number)
    • Driver and passenger details (names, addresses, phone numbers)
    • Witness information, if applicable
  4. How do I submit the completed form?

    You can submit the completed form in two ways:

    • Email it to SelfReportCrashes@flhsmv.gov.
    • Mail it to the Florida Highway Safety & Motor Vehicles, Self Report Crash Team, 2900 Apalachee Pkwy, MS 28, Tallahassee, Florida 32399.
  5. Is there a deadline for submitting the form?

    Yes, you must submit the form within 10 days after the crash. This requirement is in accordance with Florida Statute 316.066(1)(e).

  6. Do I need to keep a copy of the report?

    Yes, it is advisable to keep a copy of the report for your records and for any insurance purposes. This can help in case you need to reference the details later.

  7. What if there are multiple vehicles involved?

    If there are additional vehicles or parties involved in the crash, you can add extra front pages to the report. Be sure to include all relevant details for each vehicle and driver.

Document Preview

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

 

 

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER LICENSE NUMBER

 

STATE

 

DL TYPE

 

DRIVER/NON-MOTORIST HOME PHONE

DRIVER/NON-MOTORIST BUSINESS PHONE

SEX

DATE OF BIRTH

 

 

 

 

 

 

 

 

 

 

 

Area Code

 

 

 

Area Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF PASSENGER

 

 

 

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

 

 

 

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF PASSENGER

 

 

 

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

 

 

 

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION TWO

 

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

 

 

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER LICENSE NUMBER

 

STATE

 

DL TYPE

 

DRIVER/NON-MOTORIST HOME PHONE

DRIVER/NON-MOTORIST BUSINESS PHONE

SEX

DATE OF BIRTH

 

 

 

 

 

 

 

 

 

 

 

Area Code

 

 

 

Area Code

 

 

 

 

 

 

 

 

NAME OF PASSENGER

 

 

 

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

 

 

 

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF PASSENGER

 

 

 

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

 

 

 

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION THREE

 

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

 

 

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER LICENSE NUMBER

 

STATE

 

DL TYPE

 

DRIVER/NON-MOTORIST HOME PHONE

DRIVER/NON-MOTORIST BUSINESS PHONE

SEX

DATE OF BIRTH

 

 

 

 

 

 

 

 

 

 

 

Area Code

 

 

 

Area Code

 

 

 

 

 

 

 

 

NAME OF PASSENGER

 

 

 

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

 

 

 

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF PASSENGER

 

 

 

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

 

 

 

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WITNESSES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(1) NAME

CURRENT ADDRESS

 

 

CITY AND STATE

ZIP CODE

(2) NAME

 

 

CURRENT ADDRESS

CITY AND STATE

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

S

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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:

 

 

 

 

 

 

 

HSMV Report Number

 

Driver Report of Traffic Crash (Self Report)

 

 

 

 

 

REPORTING AGENCY CASE NUMBER

DATE OF CRASH

TIME OF CRASH AM PM

Driver Exchange of Information

 

 

 

 

 

01-01-10

11:30

 

 

 

 

 

 

 

COUNTY OF CRASH (County Code)

PLACE OR CITY OF CRASH (City Code)

 

Check if

CRASH OCCURRED ON STREET, ROAD, HIGHWAY

PINELLAS (04)

ST. PETERSBURG (64)

 

Within City

2ND STREET SOUTH

 

 

 

 

 

 

Limits

 

 

 

 

 

 

 

 

 

 

AT STREET ADDRESS # OR

FEET MILES N

S

E W

AT/ FROM INTERSECTION WITH STREET, ROAD, HIGHWAY

 

OR FROM MILEPOST#

0

U.S. 19

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

 

80

 

FORD

 

 

 

CAR

ABC-123

 

FL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INSURANCE COMPANY

 

 

 

 

 

 

 

INSURANCE POLICY NUMBER

 

 

 

INSURANCE COMPANY OF FL

 

 

 

 

 

I.C.F. 120000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF VEHICLE OWNER

(Check if same as Driver)

 

 

CURRENT ADDRESS (Number and Street)

CITY AND STATE

ZIP CODE

JOHN DOE

 

 

 

 

 

 

 

1111 FIRST STREET NORTH

PETERSBURG, FL

33731

 

 

 

 

 

 

 

 

 

 

NAME OF DRIVER (Take From Driver License)/NON-MOTORIST

 

 

CURRENT ADDRESS (Number and Street)

CITY AND STATE

ZIP CODE

BILL DOE

 

 

 

 

 

 

 

SAME AS OWNER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER LICENSE NUMBER

 

STATE

DL TYPE

 

DRIVER/NON-MOTORIST HOME PHONE

DRIVER/NON-MOTORIST BUSINESS PHONE

SEX

DATE OF BIRTH

D 561345706000

 

FL

 

 

 

 

 

 

 

M

01-01-70

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF PASSENGER

 

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

 

CITY AND STATE

ZIP CODE

SALLEY DOE

 

 

 

 

 

 

 

SAME AS OWNER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF PASSENGER

 

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

 

CITY AND STATE

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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 SelfReportCrashes@flhsmv.gov, 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.

Dos and Don'ts

When filling out the Florida Traffic Crash Report form, it is important to follow certain guidelines to ensure accuracy and completeness. Here are five things you should do and five things you should avoid.

  • Do ensure all information is accurate. Double-check names, addresses, and vehicle details.
  • Do sign the report. Your signature at the bottom of the front page is essential.
  • Do keep a copy. Retain a copy for your records and for insurance purposes.
  • Do submit the report within the required timeframe. Ensure it is sent within 10 days of the crash.
  • Do include all relevant witnesses. List any witnesses and their contact information.
  • Don't leave sections blank. Fill out all applicable fields to avoid delays.
  • Don't provide false information. Accuracy is crucial; misrepresentation can have legal consequences.
  • Don't forget to check the instructions. Review the instructions on the back of the form for guidance.
  • Don't submit the report late. Timeliness is important to comply with legal requirements.
  • Don't use unclear language. Be clear and concise in your descriptions of the crash.