The Florida Traffic Crash Report form is a document that drivers must complete when involved in a traffic crash that does not require a law enforcement report. This form captures essential details about the incident, including the time and location of the crash, vehicle information, and driver and passenger details. Completing this report is crucial for insurance purposes and compliance with state law; you can fill out the form by clicking the button below.
The Florida Traffic Crash Report form is an essential document for drivers involved in a traffic accident. This form serves multiple purposes, including the collection of vital information about the crash, the vehicles involved, and the parties affected. It includes sections for the reporting agency, case number, date and time of the crash, and the location details, such as the county and street address. Drivers must provide their personal information, including name, address, and driver’s license details. The form also requests information about the vehicles involved, such as the make, model, and insurance details. Passengers and witnesses can be documented as well, ensuring a comprehensive account of the incident. Importantly, Florida law mandates that drivers submit this report within ten days if the crash results in property damage but does not require a law enforcement report. This makes the form not only a tool for reporting but also a crucial element for insurance claims and legal purposes. Completing the form accurately is vital for all parties involved, as it helps establish the facts surrounding the crash.
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 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.
Filling out the Florida Traffic Crash Report form is a straightforward process. This report is essential for documenting the details of a traffic crash, especially if it does not require a law enforcement report. Once you complete the form, you will need to keep a copy for your records and submit it as instructed.
What is the Florida Traffic Crash Report form used for?
The Florida Traffic Crash Report form is utilized by drivers involved in traffic accidents that do not require a law enforcement report. It serves as a self-reporting mechanism for individuals to document the details of the crash, including information about the vehicles, drivers, passengers, and any witnesses. This form is essential for fulfilling the legal requirement to report certain types of accidents to the Florida Department of Highway Safety and Motor Vehicles within ten days of the incident.
Who is required to complete the Florida Traffic Crash Report form?
According to Florida law, any driver involved in a crash that results in damage to a vehicle or property must complete this report if a law enforcement report is not generated. This includes situations where the damage is minor and does not necessitate police intervention. The law mandates that this report be submitted within ten days of the crash to ensure compliance with state regulations.
What information is needed to fill out the form?
The form requires various details, including the date and time of the crash, the location, and the involved vehicles' information. Drivers must provide their names, addresses, driver's license numbers, and insurance information. Additionally, the form asks for details about any passengers and witnesses, which can help clarify the circumstances surrounding the accident.
How should the completed form be submitted?
Once the Florida Traffic Crash Report form is completed, it can be submitted in two ways. Drivers have the option to email the report to SelfReportCrashes@flhsmv.gov or mail it to the Florida Highway Safety & Motor Vehicles Self Report Crash Team at the designated address in Tallahassee. It is advisable to keep a copy of the report for personal records and insurance purposes.
What should I do if I need to report more than one vehicle?
If the crash involves multiple vehicles, the form allows for additional entries. Drivers can add extra front pages to include information about each vehicle involved in the accident. It is important to ensure that all relevant details are documented accurately to provide a comprehensive account of the incident.
Filling out the Florida Traffic Crash Report form can be a daunting task, especially in the aftermath of an accident. One common mistake is failing to provide accurate information. This can include incorrect names, addresses, or vehicle details. It’s crucial to double-check this information, as inaccuracies can lead to complications down the line.
Another frequent error is neglecting to include all involved parties. If there are multiple vehicles or passengers, it's important to list everyone. This ensures that all relevant information is captured and can help with insurance claims. Omitting a passenger or a vehicle can create confusion later.
Some people forget to sign the report. A signature is essential as it verifies that the information provided is true and accurate. Without a signature, the report may be deemed incomplete, which can delay processing or lead to further issues.
Not reading the instructions carefully is another mistake. The form comes with guidelines on how to fill it out properly. Skipping these instructions can result in missing crucial sections or failing to provide necessary details. Taking a moment to read through the guidelines can save time and hassle.
Many individuals also overlook the importance of including witness information. Witnesses can provide valuable insights about the crash. Their statements can clarify the circumstances and help establish fault. Failing to include this information can weaken your case.
Another common oversight is not keeping a copy of the report. It’s wise to retain a copy for personal records and insurance purposes. This can be helpful if questions arise later about the crash or if you need to reference the report in discussions with your insurance company.
Finally, some people submit the report late. Florida law requires that this report be submitted within ten days of the crash. Missing this deadline can lead to fines or other penalties. Staying organized and aware of timelines is essential to avoid this pitfall.
When dealing with a traffic incident in Florida, several forms and documents may accompany the Florida Traffic Crash Report. These documents help ensure that all necessary information is collected and processed efficiently. Below are some common forms used alongside the crash report.
Understanding these accompanying documents can simplify the aftermath of a traffic crash. Having the right forms filled out and submitted promptly can make a significant difference in resolving any related issues.
The Florida Traffic Crash Report form shares similarities with several other documents commonly used in traffic-related incidents. Each document serves a specific purpose and contains relevant information. Here’s a list of ten documents that are similar to the Florida Traffic Crash Report form:
Filling out the Florida Traffic Crash Report form can feel overwhelming, but following some simple guidelines can make the process smoother. Here’s a list of things you should and shouldn't do when completing the form:
By adhering to these guidelines, you can ensure that your report is both accurate and complete, making the process easier for everyone involved.
There are several misconceptions regarding the Florida Traffic Crash Report form. Understanding these can help ensure accurate reporting and compliance with state regulations.
Many people believe that a traffic crash report is only required if law enforcement officers respond to the scene. However, Florida law mandates that drivers involved in a crash causing damage to property submit a report within ten days, regardless of whether law enforcement was present.
Some individuals think that every field on the report must be completed. While many sections are essential, certain parts, such as non-motorist information, are optional. It is crucial to know which information is required to avoid unnecessary delays in processing the report.
There is a belief that the report can only be submitted in person at a law enforcement agency. In reality, the report can be sent via email or mail, providing flexibility for drivers to comply with the submission requirements.
While the report is useful for insurance claims, it serves a broader purpose. It is also a legal document that helps the Florida Department of Highway Safety and Motor Vehicles track crash data and improve road safety. Accurate reporting contributes to a better understanding of traffic incidents across the state.
When filling out the Florida Traffic Crash Report form, keep these key takeaways in mind:
By adhering to these guidelines, you can ensure that your report is processed smoothly and efficiently.