I. WITNESSES
1. _________________________ _______________
(NAME)
(PHONE)
__________________________________________________
(ADDRESS)
__________________________________________________
(CITY, STATE & ZIP CODE)
2. _________________________ _______________
(NAME)
(PHONE)
__________________________________________________
(ADDRESS)
__________________________________________________
(CITY, STATE & ZIP CODE)
3. _________________________ _______________
(NAME)
(PHONE)
__________________________________________________
(ADDRESS)
__________________________________________________
(CITY, STATE & ZIP CODE)
II. OTHER DRIVER
1. _________________________
_______________
(NAME)
(PHONE)
__________________________________________________
(ADDRESS)
__________________________________________________
(CITY, STATE & ZIP CODE)
__________________________________________________
(NAME OF OTHER DRIVERS INSURANCE COMPANY)
__________________________________________________
(POLICY NUMBER)
__________________________________________________
(AGENT'S NAME AND TELEPHONE NUMBER)
__________________________________________________
(VEHICLE OWNER'S NAME IF DIFFERENT THAN DRIVER)
__________________________________________________
(LICENSE PLATE NUMBER ON VEHICLE)
III. MISCELLANEOUS INFORMATION
Note the following:
Admissions of fault made by the other driver.
Damage to the vehicles.
Skid marks or debris in the roadway.
Traffic control devices and signs, including
warning signs and speed limit signs.
MICHAEL E. TRAUSCHT
ACCIDENT/INJURY LAW
(480) 838-7000
IF YOU HAVE BEEN INJURED IN AN ACCIDENT, IT
IS
VERY IMPORTANT TO KNOW YOUR LEGAL RIGHTS.
(FREE CONSULTATION - TELEPHONE INQUIRIES
WELCOME) |