Fillable Form Florida Accident Report

What is the Florida Accident Report?

The Florida Accident Report is needed by the Department of Motor Vehicles when there is a vehicular accident in Florida. An investigating officer, driver, insurance agent, or legal representative must accomplish itwithin 10 days after the accident.

The Florida Accident Report is completed by filling in the blanks with the required information obtained from an investigation of the event. The investigating officer is required to select and enter a value in the appropriate data field.

How to fill out the Florida Accident Report?

• HSMV Report Number
  • This space is used to identify the assigned eight-digit crash report number.
• REPORTING AGENCY CASE NUMBER
• DATE OF CRASH
  • Display the month by using the numbers 01 through 12.
  • Display the day by using the numbers 01 through 31.
  • Display the appropriate year as required.
  • Enter the date of the traffic crash in month, day, and year order in the following format: (MM/DD/YYYY)
• TIME OF CRASH
  • Midnight is considered AM and noon is considered PM. Use the 12-hour clock system to identify the time of the traffic crash.
  • Do NOT use the 24-hour clock system (a.k.a. military time).
  • Enter the time of day or the approximate time of day the traffic crash occurred.
• COUNTY OF CRASH
  • Enter the county name as required in the space provided.
  • Enter ‘unknown’ in the space if the county of the traffic crash is unknown.
• PLACE OR CITY OF CRASH
  • Enter the city name in the space provided. (note: Saint may not be abbreviated ‘St.’)
  • Enter ‘unincorporated’ for the city name if the traffic crash occurred outside the corporate limits of the city or in an unincorporated area.
• City Code
  • This space is used to identify the city code.
• Check if Within City Limits
  • Place an ‘X’ in the box if the traffic crash occurred inside the corporate limits of the city.
• CRASH OCCURRED ON STREET, ROAD, HIGHWAY
  • Enter the name of the street, road, or highway in the space provided. List the highest class of trafficway first. Refer to page 1 of the Florida Traffic Crash Report, HSMV 90010S, under the category ‘Road System Identifier’ to determine the class of trafficway. The list is in descending order. List the next highest classification, local names, or aliases in parentheses.
  • If the traffic crash occurred in a parking lot, enter the address of the parking lot. The ‘At Street Address #’ must be completed for parking lot crashes.
  • If the traffic crash occurred on private property, enter ‘private property’ and the address.
• AT STREET ADDRESS #
  • Enter the street address number up to ten alpha-numeric characters in the space provided.
  • If using distance and direction from an intersection this field is not required.
  • If using distance and direction from an identified milepost this field is not required.
• AT/ FROM INTERSECTION WITH STREET, ROAD, HIGHWAY
  • This space is used to identify the distance and direction from an intersection where the traffic crash occurred
• OR FROM MILEPOST#
  • Enter the milepost number into the space provided.

Section One

• Select Vehicle or Non-motorist
• EMAIL OWNER/DRIVER
• YEAR
  • This space is used to display the four digits of the vehicle year (manufacturer’s model year) of any vehicle involved in a traffic crash.
• MAKE
  • This space is used to identify the vehicle manufacturer’s trade name (Chevrolet, BMW, Ford, etc.) of any vehicle involved in the traffic crash.
  • Enter the first four letters of the complete name of the vehicle make. Do not use a model name (impala, F-150, Stratus). For vehicles with only three letters (BMW, Kia, GMC, etc.) enter the complete name.
• VEHICLE BODY TYPE (Car, Truck. Etc.)
• VEHICLE LICENSE NUMBER
  • Enter the vehicle license plate number of the vehicle involved in the space provided. Enter it exactly as it appears on the license plate.
  • Enter UK in the space provided if unknown.
• STATE
  • Enter the state of issuance. Use the standard, two-letter postal abbreviations for all states.
• VIN
  • This space is used to identify the vehicle identification number (VIN) of the vehicle supplying power, not being towed.
• INSURANCE COMPANY
  • This space is used to identify the motor vehicle insurance company for the vehicle or driver. The best source for obtaining this information is a valid motor vehicle insurance identification card, a valid insurance policy, a valid insurance binder, or a certificate of self-insurance issued by the Department of Highway Safety and Motor Vehicles.
• INSURANCE POLICY NUMBER
  • This space is used to identify the policy number for the vehicle or driver. The best source for obtaining this information is a valid motor vehicle insurance identification card, a valid insurance policy, a valid insurance binder, or a certificate of self-insurance issued by the Department of Highway Safety and Motor Vehicles.
• 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
  • Enter the license plate number of the trailer involved in the space provided.
• STATE
• DL TYPE
• DRIVER/NON-MOTORIST HOME PHONE
• DRIVER/NON-MOTORIST BUSINESS PHONE
• SEX
• DATE OF BIRTH
• NAME OF PASSENGER
• CURRENT ADDRESS (Number and Street)
• CITY AND STATE
• ZIP CODE

Section Two

• Select Vehicle or Non-motorist
• 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
• NAME OF PASSENGER
• CURRENT ADDRESS (Number and Street)
• CITY AND STATE
• ZIP CODE

Section Three

• Select Vehicle or Non-motorist
• 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
• NAME OF PASSENGER
• CURRENT ADDRESS (Number and Street)
• CITY AND STATE
• ZIP CODE

WITNESSES

• NAME
• CURRENT ADDRESS
• CITY AND STATE
• ZIP CODE

Signature of Driver Making Report

The date the form was signed

Where to file the Florida Accident Report?

Complete all applicable areas within the form. Customers must sign the report. Once complete, mail a copy of the report to:

Florida Department of Highway Safety and Motor Vehicles

Crash Records

2900 Apalachee Parkway, MS 28

Tallahassee, FL 32399

Please keep a copy of the submitted report for your records and insurance purposes.