Systems and Procedures
A Division of The Office of Budget and Finance
Last Revision: 05/12/2005


Form Instructions

  1. Enter the month, date, and year
  2. Record the actual time of the accident. If actual time is not known, then record the approximate time
  3. Enter the street, roads, and highway names or nearest address and include city/town and state
  4. Enter the full name and address of the other drive. Do not assume that the other driver is also the owner of the vehicle
  5. Enter complete information on the other driver. DO NOT LEAVE BLANK
  6. Obtain and enter complete information about the owner of the vehicle. This may be obtained from the "Owner Card"
  7. Obtain and enter the insurance company's name and policy number. Failure to do so may affect your area's deductible reimbursement. If the "other driver" cannot produce their insurance information, call the police. They may be driving without insurance
  8. Enter in words and draw pictures of the accident. Include traffic controls, direction (north, south, east, and west), impact points and estimate the speed of the vehicles involved
  9. If damage is only to property (i.e., streetlight, mailbox, tree, or guardrail), enter full name and address of the property owner
  10. A superior of the University driver must sign in this space
  11. The University driver must sign in this space
  12. If a student was the University drive (including graduate assistant or wage payroll0, the driver must also sign here
Image of Vehicle Accident Report Form