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Motor Vehicle Accident Report Form

Instructions

Accident Reports are required to be completed by operators involved in a collision whenever a person sustains injuries as a result of the accident, and/or, if the damage to the vehicles or property involved totals over $1000.  

The "Operator's Report of Motor Vehicle Accident," as this form is called, must be submitted to the Police Department whose jurisdiction the accident occurred within, and the MA Registry of Motor Vehicles within five days.  In addition, it is recommended that a third copy be kept for you own records, or for submission to your insurance company.

When filling out an accident report you are required to provide the following information (please print clearly):

  • Full Name

  • Date of Birth

  • Driver’s License Number

  • Registration number (license plate) and state

  • Location of accident (street and number, or route number, nearest intersection, and city/town)

  • Date and time of accident

  • Number of vehicles involved

  • Description and diagram of accident

  • Signature and date

  • Other vehicle information - registration number (license plate) and state*

  • Other operator information - name, date of birth, and driver’s license number*

*This information must be provided if it has been provided to you as a result of any paperwork exchange at the time of the accident or otherwise. If this information is not known to you, please write UNKNOWN in the applicable section.

Click to Download MV Accident Report Form

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Last Update: November 15, 2005