Title Page

  • Vehicle Registration Number

  • Vehicle Identification Number

  • Vehicle Year, Make & Model

  • Report conducted on (Date and Time)

  • Fleet Manager's Full Name

General Information

  • Driver's Name

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

  • Phone number

Damage Details

  • Date and time of incident

  • Location of incident
  • Weather condition

  • Specify

  • Degree of vehicle damage

  • What caused the damage?

  • Description of the incident

  • Take photo evidence of vehicle damage

  • Sketch of the incident

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

  • Is there another party involved?

Other Party Involved

  • Party involved? Click "Add"

  • Vehicle
  • Vehicle Driver (Full Name)

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

  • Phone number

  • Make and model

  • Vehicle Registration Number

  • Vehicle Identification Number

  • Upload photos of vehicle damage of the other party

  • Degree of vehicle damage

Witness/es

  • Were there witnesses? Click "Add"

  • Witness
  • Statement

  • Full Name & Signature

  • Phone Number

Summary

  • Additional comments

Acknowledgment

  • Driver (Full Name & Signature)

  • Fleet Manager (Full Name & Signature)

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.