Vehicle Damage Report

• Vehicle Registration Number

• Vehicle Identification Number

• Vehicle Year, Make & Model

• Report conducted on (Date and Time)

  Date

• Fleet Manager's Full Name

General Information

• Driver's Name

• Take a photo of your driver license showing the DL number

  Media

• Phone number

Damage Details

• Date and time of incident

  Date
• Location of incident
  Address

• Weather condition

  Fine

  Rainy/Stormy

  Snowing

  Others

• Specify

• Degree of vehicle damage

  Minor

  Moderate

  Severe

• What caused the damage?

  Collision

  Weather-impact

  Unintended

  Other

• Description of the incident

• Take photo evidence of vehicle damage

  Media

• Sketch of the incident

  Drawing

• Take photo(s) of the surrounding vehicle and/or environment involved

  Media

• Is there another party involved?

  Yes

  No

Other Party Involved

• Party involved? Click "Add"

Vehicle

• Vehicle Driver (Full Name)

• Take a photo of the driver license showing the DL number

  Media

• Phone number

• Make and model

• Vehicle Registration Number

• Vehicle Identification Number

• Upload photos of vehicle damage of the other party

  Media

• Degree of vehicle damage

  Minor

  Moderate

  Severe

Witness/es

• Were there witnesses? Click "Add"

Witness

• Statement

• Full Name & Signature

  Sign

• Phone Number

Summary

• Additional comments

Acknowledgment

• Driver (Full Name & Signature)

  Sign

• Fleet Manager (Full Name & Signature)

  Sign