Last Revision: 05/12/2005


Table of Contents:


The Vehicle Accident Report form is used to report the facts of a motor vehicle accident whenever a University-owned vehicle, rental car, or privately-owned vehicle being used on University business is involved.

General Information:

Every employee driver must complete this form no matter how minor the accident.

All information called for on this form is important and, generally, can best be obtained at the time of the accident. If for some reason (such as injuries) all the facts cannot be secured immediately, the form must still be submitted as soon as possible to Risk Management within 24 hours. On the basis of the completed form submitted, the Risk Management Office can then, in turn, file the required accident report with the insurance company.

If you are involved in an accident in which someone is injured or a death occurs, or if any vehicle is damaged to the extent that it cannot be driven, you must immediately notify the local or state police.

Exhibit and Instructions:

The employee driver must complete both sides of the form, answering all the questions, and sign the form in the designated space as soon as possible within within 24 hours.

The employee's supervisor or department head must sign the form, verifying that the accident was properly reported and the vehicle was authorized for a permissible use.

To view document exhibit, click on link belows:

Vehicle Accident Report Exhibit

Form Requirements:

No form may be used that substitutes for an approved official University form without prior review and approval by the steward of the form/central office, as facilitated by the Office of Systems and Procedures (designated representative of the Associate Vice President for Budget and Finance). See Policy FN17 Required Use of Approved University Forms Appearing in the General University Reference Utility (GURU) for full details.

GURU PDF forms are designed for use with Adobe Acrobat Reader or Adobe Acrobat Pro. Each browser (Chrome, Firefox, Internet Explorer, etc) has a built-in PDF viewer making it the default PDF viewer without asking users. These built-in viewers do not necessarily support all features required for PDF Forms. Similarly, many calculations are not supported by other stand-alone PDF readers (for example, Nuance). If you experience problems downloading or opening documents, right click on the link on the Forms Locator Screen, select 'Save Link As' (or similar language) and save the file. The document can then be opened in either Adobe Acrobat Reader or Adobe Acrobat Pro from the saved location.

The latest version of Adobe Acrobat Reader is available for free. Contact your IT support staff person for downloading assistance, if/as needed. An Adobe Creative Cloud (CC) account is also available to all Penn State students, faculty, and staff members, at no cost. Sign up for an Adobe Creative Cloud account at If Adobe Acrobat Pro better suits your needs, contact your IT support staff person for purchasing and installation assistance.

If you encounter any difficulties, contact the GURU support staff by submitting a Technical Support form request or by calling the tech support line at 814-863-8592.

Number of Copies and Ultimate Distribution:

Table of distribution and retention of the Vehicle Accident Report
Ultimate Distribution: Retention Periods:
Original Yellow Risk Management Office Current fiscal year +2 years

Where to Send Completed Forms:

At University Park locations, the driver concerned will bring or send the form to the Risk Management Office within 24 hours.

At non-University Park locations, the form must be reviewed by the local Director of Business Services for Commonwealth Campuses, Director of Operations at Penn State Erie - The Behrend College, and the Manager of Business Services at Penn State Harrisburg, before being forwarded to Risk Management at University Park.

Contact Information:

For questions, additional detail, or to request changes to this form, contact Risk Management

Cross References: