Audit

General Information
Date the incident happened

Who did you report the incident to?

Date and Time the incident was reported.

If the notification was not the same day as the incident, why?

Exact location of incident
Take photo of the location where incident happened. You should make this a long shot with all vehicles in the photo if possible.
Weather condition

Type of Road Surface

Condition of Road Surface

Vehicle Information

Van Number

Year and Make of Company vehicle

VIN

Take photo of license plate

Driver's Estimated Speed

Direction of Travel
Incident Information

Describe the incident

Describe the damages of vehicle

Take photo of vehicle showing the damage from a distance
Show a photo of the direction the driver was going and what they saw before the incident.
Take a photo of the damage up close
Take a picture of the details that explain the damage (More than one angle of the damage).

Provide detailed descriptions of the physical damages

Was there a collision?

Draw a diagram of collision

Provide details of the vehicle(s) involved

Describe the damages of other vehicle(s)

Show a photo of the direction the other driver(s) was going and what they saw before the incident.
Take photo of other vehicle(s) (back off and show the whole vehicle with the damage).
Take a picture of the damage close up.
Take a photo of the license plate(s) or any detail that explain the damage.

Provide detailed descriptions of the physical damages

After the incident, is the vehicle safely drivable?

Was the vehicle towed?

Take a picture of the tow truck, or a card, that identifies who towed it.

Where was it taken?

Passenger Profile

How many people are involved in the accident?

Was anyone injured?

List the names and contact information of the injured.

Was anyone transported to the hospital?

To which hospital were they taken?

Reporting Information

Name of Agency Reported to

Name of Officer

Was there a ticket written to either driver?

Who got the ticket? What was the reason for the ticket?

Take a photo of the ticket
If there was an exchange of information given, take a photo of it.
Recommendation

State some ways the incident could have been prevented.

Completion
Full Name and Signature of Driver
Full Name and Signature of Supervisor

When complete, this document should be emailed to: claims@drsinstall.com and your FSM