Title Page
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Take photos of Crash
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Date of crash
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Time of crash
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Prepared by
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Location of crash
The Incident
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What happened
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Their Full Name
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Their Full address
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Their contact number
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Their email address
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Company or Private
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Name of Company
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Take photo of company logo
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Does the driver have insurance
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Insurance Company
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Owners Name
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Owners full address
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Owners contact number
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Owners email address
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Company / Private
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Company’s name
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Photo of company logo
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Insurance Company name
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Was anyone Injured
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What was injured
- Head
- Body
- Arms
- Hands
- Legs
- Feet
- Other
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Other - explain
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Was first aid provided
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Was anyone injured
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Where were they injured
- Head
- Body
- Arms
- Hands
- Legs
- Feet
- Other
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Other - explain
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Was first aid provided
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Their full name
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Their full address
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Their contact number
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Were they injured
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Where were they injured
- Head
- Body
- Arms
- Hands
- Legs
- Feet
- Other
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Other - explain
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Was first aid provided
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Where were you when you noticed damage
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What type of damage has occurred
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Explain the damage
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Take photo of damage
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Explain the damage
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Photo of damage
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Explain the damage
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Photos of damage
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Explain the damage
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Photos of damage
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Registration of their vehicle
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Colour of their vehicle
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Make of their vehicle
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Model of their vehicle
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Photo of vehicle
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Photo of damage to building
On site support
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Did anyone assist on site
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Their full name
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Their contact number
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Police Officers Name
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Police Officers Badge number
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Police Officers contact number
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Who were they
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Their contact info
Summary
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In your own words, what happened
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Who do you think was at fault
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Why
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Why
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Who did you inform about crash
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Anything else to add
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What