Ca Dmv Sr1 PDF Details

The California Department of Motor Vehicles (DMV) is a state agency responsible for registering vehicles and issuing driver's licenses. The DMV is also responsible for enforcing traffic laws, assisting motorists in emergencies, licensing drivers education courses and collecting fees from those who register their vehicles. In addition to the DMV offices located throughout California, there are now 50 self-service kiosks that offer many of the same services as an actual DMV office. These kiosks can be found at retailers such as Costco and Walgreens all across the state.

You will see details about the type of form you need to fill out in the table. It will show you just how long it will take to complete ca dmv sr1, exactly what parts you will have to fill in and several additional specific facts.

QuestionAnswer
Form NameCa Dmv Sr1
Form Length3 pages
Fillable?Yes
Fillable fields63
Avg. time to fill out13 min 25 sec
Other namessr1 form, accident california report, dmv form sr 1, dmv accident report

Form Preview Example

REPORT OF TRAFFIC ACCIDENT

OCCURRING IN CALIFORNIA

DMV USE ONLY

A Public Service Agency

 

 

READ IMPORTANT INFORMATION ON BACK

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AS APPROPRIATE, PLEASE TYPE OR PRINT IN BOXES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

# OF VEHICLES

DATE OF ACCIDENT

ACCIDENT LOCATION - CITY/COUNTY (CALIFORNIA ONLY)

 

 

 

 

 

 

 

 

 

 

 

 

ON PRIVATE PROPERTY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yes

 

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TIME OF ACCIDENT

AM

 

Stopped

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVING FOR EMPLOYER

 

 

 

 

 

Moving

Parked

Pedestrian

Bicyclist

 

Other (E.G., ROLLAWAY)

 

 

Yes

 

 

No

 

INFORMATION

Hour

 

 

PM

in Traffic

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER’S NAME (FIRST, MIDDLE, LAST)

 

 

 

 

 

 

 

 

 

 

DRIVER LICENSE NUMBER

 

 

 

 

STATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER’S STREET ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE OF BIRTH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY

 

 

 

 

 

STATE

ZIP CODE

 

TELEPHONE NUMBERS

 

 

 

 

 

 

 

 

 

 

 

 

 

PARTY’S

 

 

 

 

 

 

 

 

 

 

 

 

 

Wk (

)

 

 

Hm (

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE (YEAR AND MAKE)

 

 

VEHICLE LICENSE PLATE OR VEHICLE IDENTIFICATION NUMBER

 

 

 

 

STATE

DAMAGES OVER $750

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yes

 

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE OWNER—PERSON OR COMPANY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE OF BIRTH

 

REPORTING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESS

 

 

 

 

CITY

 

 

 

 

 

 

 

 

 

STATE

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INSURANCE COMPANY NAME (NOT AGENT OR BROKER) AT THE TIME OF THE ACCIDENT

 

 

 

 

 

POLICY NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COMPANY NAIC NUMBER

 

POLICY PERIOD

 

 

 

 

 

 

POLICY HOLDER NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

From:________________

To:________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVING FOR EMPLOYER

 

 

Moving

Stopped in Traffic

 

Parked

Pedestrian

Bicyclist

Other (E.G., ROLLAWAY)

 

 

Yes

 

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMATION

DRIVER’S NAME (FIRST, MIDDLE, LAST)

 

 

 

 

 

 

 

 

 

 

DRIVER LICENSE NUMBER

 

 

 

 

STATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER’S STREET ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE OF BIRTH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY

 

 

 

 

 

STATE

ZIP CODE

 

TELEPHONE NUMBERS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Wk (

)

 

 

Hm (

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PARTY’S

VEHICLE (YEAR AND MAKE)

 

 

VEHICLE LICENSE PLATE OR VEHICLE IDENTIFICATION NUMBER

 

 

 

 

STATE

DAMAGES OVER $750

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yes

 

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE OWNER—PERSON OR COMPANY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE OF BIRTH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OTHER

ADDRESS

 

 

 

 

CITY

 

 

 

 

 

 

 

 

 

STATE

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INSURANCE COMPANY NAME (NOT AGENT OR BROKER) AT THE TIME OF THE ACCIDENT

 

 

 

 

 

POLICY NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COMPANY NAIC NUMBER

 

POLICY PERIOD

 

 

 

 

 

 

POLICY HOLDER NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

From:________________

To:________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME AND ADDRESS OF INDIVIDUAL INJURED OR DECEASED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Injured

 

 

Driver

 

 

 

 

 

Passenger

 

INJURY/DEATH DAMAGEPROPERTY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Deceased

 

 

Bicyclist

Pedestrian

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME AND ADDRESS OF INDIVIDUAL INJURED OR DECEASED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Injured

 

 

Driver

 

 

 

 

 

Passenger

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Deceased

 

 

Bicyclist

Pedestrian

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OTHER PROPERTY DAMAGED (TELEPHONE POLES, FENCE, LIVESTOCK, ETC.)

 

 

 

 

 

 

 

 

 

DAMAGES OVER $750

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yes

 

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PROPERTY OWNER’S NAME AND ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

DATE

PRINTED NAME

SIGNATURE

X

SR 1 (REV. 9/2008) WWW

ADDITIONAL INFORMATION ATTACHED

A

YOUR

CALIFORNIA INSURANCE INFORMATION

DO NOT DETACH

DMV FILE NUMBER

The Department may send this part to the insurance company indicated. If not fully completed,

 

 

VEHICLE

 

 

it will be assumed you were not insured for the accident and your license will be suspended.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF INSURANCE COMPANY (NOT AGENCY OR

 

 

 

 

BROKERAGE) THAT ISSUED THE LIABILITY POLICY

 

 

 

 

COVERING THE OPERATION OF YOUR VEHICLE

 

 

 

 

 

 

 

 

 

 

 

 

POLICY NUMBER

 

POLICY PERIOD

 

 

 

 

 

 

 

From:

 

 

 

I

 

 

 

To:

DRIVER LICENSE NUMBER

 

 

 

 

 

 

(DRIVER OF YOUR VEHICLE)

N

DATE OF ACCIDENT

IN OR NEAR (CITY OR TOWN) (CALIFORNIA ONLY)

 

 

 

 

 

 

 

 

 

 

 

S

 

 

 

 

 

 

 

 

U

 

 

 

 

 

 

 

VEHICLE (YEAR AND MAKE)

 

VEHICLE IDENTIFICATION NUMBER

 

VEHICLE LICENSE PLATE NUMBER

STATE

R

 

 

 

 

 

 

 

 

A

 

 

 

 

 

 

 

 

N

DRIVER

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

C

 

 

 

 

 

 

 

 

E

 

 

 

 

 

 

 

 

OWNER

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

FULL NAME OF POLICY HOLDER

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SR 1A (REV. 9/2008) WWW

 

 

 

 

 

 

If the policy was not in effect, this form must be completed and returned to the Department within 20 days.

The undersigned company advises that with respect to the reported accident, the policy reported on the reverse side:

WAS NOT IN EFFECT

 

 

 

 

 

 

Was not a liability policy

Did not cover the vehicle/driver

 

Number is not a company policy number

Policy Number

 

 

 

Policy Period from

 

to

 

 

 

 

 

Signature

 

 

 

MAIL TO:

 

 

 

 

 

 

 

Department of Motor Vehicles

Title

 

 

Financial Responsibility

 

 

 

P. O. Box 942884

Date

 

 

Sacramento, CA 94284-0884

 

 

 

SR 1A (REV. 9/2008) WWW

IMPORTANT INFORMATION

California law requires trafic accidents on a California street/highway or private property to be reported to the Department of Motor Vehicles

(DMV) within 10 days if there was an injury, death or property damage in excess of $750. Untimely reporting could result in DMV suspend- ing a driver license. Accidents involving vehicles not required to be registered such as an off-road vehicle (OHV), implement of husbandry, or

snowmobile or occurring on a military base or occurring on the driver’s own property involving only the personal property of the driver and there was no injury or death are not reportable.

The law requires the driver to ile this SR-1 form with DMV regardless of fault. This report must be made in addition to any other report iled with a law enforcement agency, insurance company, or the California Highway Patrol (CHP) as their reports do not satisfy the iling require- ment. An insurance agent, attorney, or other designated representative may ile the report for the driver.

The law requires every driver and every owner of a motor vehicle to be “inancially responsible” for any injury or damage resulting from operating or owning a motor vehicle. The minimum insurance level for “inancial responsibility” is public liability and property

damage coverage of $15,000 for injury or death of one person, $30,000 for injury or death of two or more persons and $5,000 property dam- age per accident. Comprehensive and collision insurance does not meet the legal requirement.

§1806 of the California Vehicle Code (CVC) requires the DMV to record accident information regardless of fault when individuals report accidents under the Financial Responsibility Law or if law enforcement agencies or CHP investigate and make a report.

wheN COMPleTINg ThIS FORM...

Please print within the spaces and boxes on this form. If you need to provide additional information on a separate piece of paper(s) or you include a copy of any law enforcement agency report, please check the box to indicate ‘Additional Information Attached’. If you are the pas- senger reporting the accident, be sure to identify yourself by using the ‘other’ box and stating ‘passenger’ in the explanation.

Write unk (for unknown) or none in any space or box when you do not have information on the other party involved.

Give insurance information that is complete and which correctly and fully identiies the company that issued the policy.

Place the correct National Association of Insurance Commissioners (NAIC) number for your insurance company in the boxes provided. The NAIC number should be located on your insurance ID card or you can contact your insurance agent or company for the information.

Identify any person involved in the accident (driver, passenger, bicyclist, pedestrian, etc.) who you saw was injured or complained of bodily injury or know to be deceased.

Record in the OTHER PROPERTY DAMAGED section any damage to telephone poles, fences, street signs, guard posts, trees, livestock, dogs, etc., meeting the iling requirement, including amount. This may require that you contact the owner of the property for an estimate of damages.

Once you have completed this report, please mail it to:

DePARTMeNT OF MOTOR VehICleS

FINANCIAl ReSPONSIBIlITY

MAIl STATION J237

P.O. BOX 942884

SACRAMeNTO, CA 94284-0884

DMV does not accept reports or take actions against non-reporting or uninsured motorists unless this SR-1 form is sent to DMV by someone involved in the accident or their designee and the report is received by DMV within one calendar year of the accident date.

ADVISORY STATeMeNT

The accident information on the SR-1 is required under the authority of Divisions 6 and 7 of the California Vehicle Code. Failure to provide the information will result in suspension of the driving privilege. Except as made conidential by law (e.g., medical information) or exempted

under the Public Records Act, the information is a public record, is regularly used by law enforcement agencies and insurance companies, and

is open to public inspection. §16005 CVC limits the public record for SR-1 reports to accident involvement, but does allow persons with a proper interest (involved drivers, their employers, etc.) to receive speciied information. Individuals may inspect or obtain copies of informa- tion contained in their records during regular ofice hours. The Financial Responsibility Section Manager, 2570 24th Street, Sacramento, CA 95818 (telephone number: 916-657-6677) is responsible for maintaining this information.

SR 1 (REV. 9/2008) WWW

How to Edit Ca Dmv Sr1 Online for Free

It won't be hard to create report of traffic accident occurring in california making use of our PDF editor. This is the way you can instantly build your file.

Step 1: The very first step will be to choose the orange "Get Form Now" button.

Step 2: After you have accessed the report of traffic accident occurring in california edit page, you'll discover all options you can use with regards to your document at the top menu.

For each part, complete the data required by the software.

sr1 form blanks to complete

Note the expected particulars in the space N O T A M R O F N, S Y T R A P R E H T O, H T A E D Y R U J N, E G A M A D Y T R E P O R P, DRIVER’S STREET ADDRESS, CITY, STATE, ZIP CODE, VEHICLE (YEAR AND MAKE), VEHICLE LICENSE PLATE OR VEHICLE, VEHICLE OWNER (PERSON OR COMPANY), DATE OF BIRTH, TELEPHONE NUMBERS, Wk ( ), and Hm ( ).

Finishing sr1 form step 2

The program will demand for additional info with the intention to instantly prepare the part H T A E D Y R U J N, E G A M A D Y T R E P O R P, OTHER PROPERTY DAMAGED (TELEPHONE, PROPERTY OWNER’S NAME AND ADDRESS, DAMAGES OVER $1, Yes, READ IMPORTANT INFORMATION ON BACK, I certify (or declare) under, PRINTED NAME, SIGNATURE, SR 1 (REV, and ADDITIONAL INFORMATION ATTACHED.

Entering details in sr1 form part 3

Please record the rights and obligations of the parties within the A YOUR, CALIFORNIA INSURANCE INFORMATION, NAME OF INSURANCE COMPANY (NOT, POLICY PERIOD From:, DATE OF ACCIDENT, IN OR NEAR (CITY OR TOWN), To:, DRIVER LICENSE NUMBER (DRIVER OF, VEHICLE (YEAR AND MAKE), VEHICLE IDENTIFICATION NUMBER, VEHICLE LICENSE PLATE NUMBER STATE, ADDRESS, ADDRESS, ADDRESS, and I N S U R A N C E section.

Filling in sr1 form step 4

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Step 4: You can generate copies of your file tokeep clear of all forthcoming concerns. Don't worry, we don't display or track your details.

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