Alabama SR-13 Public Safety Form – Fill Out and Use This PDF

Completion of this form is required only if a motor vehicle accident occurring in Alabama caused death, personal injury, or property damage to any one owner in excess of $250 (checked November 12, 2026). The driver is legally required to file a report on this form with the Department of Public Safety within thirty (30) days after the accident regardless of who is at fault and regardless of whether or not the vehicle involved was covered by liability insurance at the time of the accident. If a driver is physically incapable of making such report, the owner of the motor vehicle involved in such accident makes such report within thirty (30) days after learning of the accident. Use additional forms if necessary.

Failure to file a reportable accident on this form may result in suspension of your driver license.

You must fill in all information for processing.

Enter the date of accident, the time, how many vehicles were involved, and the location of accident (city) (street/hwy) and county.

Under your information and the other party's information, mark what you are and what the other party was: pedestrian, property owner, other, parked, hit & run.

Enter the driver's name (first, middle, last), telephone no., and current address: street no., city, state, zip code.

Enter the driver's date of birth, sex, and driver license # and state. If the owner of vehicle/property is the same as driver, mark box. Enter the owner of vehicle/property and the address of owner: street no., city, state, zip code.

For your vehicle and the other vehicle, enter the year, make, type, commercial vehicle, state, VIN and license plate no. Use additional form if more than two (2) vehicles.

Under property damage, enter a description of property damage (other than vehicle, house/fence, utility pole/etc).

Describe all property damage (Example: bicycle, farm equipment, house, fence, etc.)

Insurance information on back must be completed and signed (complete reverse side).

Complete the following as required by the Safety Responsibility Law of Alabama §32-7-1. Mark only the appropriate box. All information will be verified.

1, When accident occurred, the vehicle I was driving was covered by liability insurance with (List name of insurance company, not Agency's name), with the policy no., the policy period from, and the policy holder.

2. When accident occurred, the vehicle I was driving was not covered by liability insurance.

3. Form SR-23 (Fleet Policy) is on file with Department of Public Safety.

4. Your vehicle is a qualified carrier with Alabama Public Service Commission.

5. Department of Public Safety Self-Insurance Certificate No.

Sign under signature, and enter the date.

For injured persons in your vehicle, mark none, or enter the full name of injured, address: street no., city, state, zip, date of birth, sex, injured was (please circle) driver, passenger, pedestrian, other, and did injured die? yes no.

Complete this portion of the form if you believe that another party is responsible for your damages and you have not been compensated for them.

You must give vehicle and/or other damages in dollar amount.

Under vehicle and/or other property damage, the signature of property owner certifies that damages to my property amounted to $ (amount of damage) as a result of this motor vehicle accident, and that I believe I am entitled to recover the amount specified from (driver of vehicle) and from (owner of vehicle), and I have not released said party(ies). (If owner is a company, give title of person signing claim.)

Under injuries, complete one section for each party injured. I (full name of person injured) certify that my medical expenses are $ (amount of injury) as a result of this motor vehicle accident. I believe I am entitled to recover the amount specified from (driver of vehicle) and from (owner of vehicle), and I have not released said party(ies). The signature is the Signature of Claimant/Legal Guardian of Minor.