Florida Traffic Crash Report PDF Details

Do you know what to do if you're involved in a car accident? If not, the Florida Traffic Crash Report may be a good place to start. This report is a mandatory document that must be filed following any collision involving two or more vehicles that results in injury or property damage totaling $500 or more. The report provides detailed information on each of the drivers involved, as well as on the crash itself. Knowing what's required by law can help ensure that all necessary steps are taken following an accident. For more information on traffic crashes and how to file a Florida Traffic Crash Report, please visit our website.

You can find details about the type of form you wish to complete in the table. It can show you how much time it takes to complete florida traffic crash report, what parts you will have to fill in, and so forth.

QuestionAnswer
Form NameFlorida Traffic Crash Report
Form Length2 pages
Fillable?Yes
Fillable fields135
Avg. time to fill out27 min 34 sec
Other namesdelayed accident report, florida highway patrol accident report, fhp crash reports, crash report florida

Form Preview Example

Driver Report of Traffic Crash (Self Report) Driver Exchange of Information

 

HSMV Report Number

 

 

 

 

REPORTING AGENCY CASE NUMBER

DATE OF CRASH

TIME OF CRASH AM PM

 

 

 

 

COUNTY OF CRASH (County Code)

PLACE OR CITY OF CRASH (City Code)

 

Check if

 

 

CRASH OCCURRED ON STREET, ROAD, HIGHWAY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Within City

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Limits

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AT STREET ADDRESS #

OR

FEET MILES

N

S

 

E

W

 

AT/ FROM INTERSECTION WITH STREET, ROAD, HIGHWAY

 

 

 

 

OR FROM MILEPOST#

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION ONE

 

VEHICLE

 

NON-MOTORIST

 

(optional) EMAIL OWNER/DRIVER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YEAR

MAKE (Chevy, Ford, Etc.)

 

VEHICLE BODY TYPE (Car, Truck. Etc.)

VEHICLE LICENSE NUMBER

 

STATE

VIN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INSURANCE COMPANY

 

 

 

 

 

 

 

 

 

 

 

INSURANCE POLICY NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF VEHICLE OWNER

(Check if same as Driver)

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF DRIVER (Take From Driver License)/NON-MOTORIST

 

 

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER LICENSE NUMBER

 

STATE

 

DL TYPE

 

DRIVER/NON-MOTORIST HOME PHONE

DRIVER/NON-MOTORIST BUSINESS PHONE

SEX

DATE OF BIRTH

 

 

 

 

 

 

 

 

 

 

 

Area Code

 

 

 

Area Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF PASSENGER

 

 

 

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

 

 

 

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF PASSENGER

 

 

 

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

 

 

 

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION TWO

 

VEHICLE

 

NON-MOTORIST

 

(optional) EMAIL OWNER/DRIVER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YEAR

MAKE (Chevy, Ford, Etc.)

 

VEHICLE BODY TYPE (Car, Truck. Etc.)

VEHICLE LICENSE NUMBER

 

STATE

VIN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INSURANCE COMPANY

 

 

 

 

 

 

 

 

 

 

 

INSURANCE POLICY NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF VEHICLE OWNER

(Check if same as Driver)

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF DRIVER (Take From Driver License)/NON-MOTORIST

 

 

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER LICENSE NUMBER

 

STATE

 

DL TYPE

 

DRIVER/NON-MOTORIST HOME PHONE

DRIVER/NON-MOTORIST BUSINESS PHONE

SEX

DATE OF BIRTH

 

 

 

 

 

 

 

 

 

 

 

Area Code

 

 

 

Area Code

 

 

 

 

 

 

 

 

NAME OF PASSENGER

 

 

 

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

 

 

 

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF PASSENGER

 

 

 

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

 

 

 

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION THREE

 

VEHICLE

 

NON-MOTORIST

 

(optional) EMAIL OWNER/DRIVER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YEAR

MAKE (Chevy, Ford, Etc.)

 

VEHICLE BODY TYPE (Car, Truck. Etc.)

VEHICLE LICENSE NUMBER

 

STATE

VIN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INSURANCE COMPANY

 

 

 

 

 

 

 

 

 

 

 

INSURANCE POLICY NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF VEHICLE OWNER

(Check if same as Driver)

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF DRIVER (Take From Driver License)/NON-MOTORIST

 

 

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER LICENSE NUMBER

 

STATE

 

DL TYPE

 

DRIVER/NON-MOTORIST HOME PHONE

DRIVER/NON-MOTORIST BUSINESS PHONE

SEX

DATE OF BIRTH

 

 

 

 

 

 

 

 

 

 

 

Area Code

 

 

 

Area Code

 

 

 

 

 

 

 

 

NAME OF PASSENGER

 

 

 

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

 

 

 

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF PASSENGER

 

 

 

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

 

 

 

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WITNESSES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(1) NAME

CURRENT ADDRESS

 

 

CITY AND STATE

ZIP CODE

(2) NAME

 

 

CURRENT ADDRESS

CITY AND STATE

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

S

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IGNATURE OF DRIVER MAKING REPORT

 

 

 

 

 

 

 

 

 

 

 

 

DATE

 

 

 

 

YOU MUST READ AND COMPLY WITH THE INSTRUCTIONS ON THE BACK OF THIS FORM

HSMV 90011S (rev 11/2019)

J

IF YOU WERE TOLD TO COMPLETE AND FORWARD THIS REPORT TO THE DEPARTMENT, PLEASE REFER TO THE FOLLOWING INSTRUCTIONS AND EXAMPLE:

 

 

 

 

 

 

 

HSMV Report Number

 

Driver Report of Traffic Crash (Self Report)

 

 

 

 

 

REPORTING AGENCY CASE NUMBER

DATE OF CRASH

TIME OF CRASH AM PM

Driver Exchange of Information

 

 

 

 

 

01-01-10

11:30

 

 

 

 

 

 

 

COUNTY OF CRASH (County Code)

PLACE OR CITY OF CRASH (City Code)

 

Check if

CRASH OCCURRED ON STREET, ROAD, HIGHWAY

PINELLAS (04)

ST. PETERSBURG (64)

 

Within City

2ND STREET SOUTH

 

 

 

 

 

 

Limits

 

 

 

 

 

 

 

 

 

 

AT STREET ADDRESS # OR

FEET MILES N

S

E W

AT/ FROM INTERSECTION WITH STREET, ROAD, HIGHWAY

 

OR FROM MILEPOST#

0

U.S. 19

SECTION ONE

VEHICLE

NON-MOTORIST (optional) EMAIL OWNER/DRIVER

YEAR

MAKE (Chevy, Ford, Etc.)

 

VEHICLE BODY TYPE (Car, Truck. Etc.)

VEHICLE LICENSE NUMBER

STATE

VIN

 

80

 

FORD

 

 

 

CAR

ABC-123

 

FL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INSURANCE COMPANY

 

 

 

 

 

 

 

INSURANCE POLICY NUMBER

 

 

 

INSURANCE COMPANY OF FL

 

 

 

 

 

I.C.F. 120000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF VEHICLE OWNER

(Check if same as Driver)

 

 

CURRENT ADDRESS (Number and Street)

CITY AND STATE

ZIP CODE

JOHN DOE

 

 

 

 

 

 

 

1111 FIRST STREET NORTH

PETERSBURG, FL

33731

 

 

 

 

 

 

 

 

 

 

NAME OF DRIVER (Take From Driver License)/NON-MOTORIST

 

 

CURRENT ADDRESS (Number and Street)

CITY AND STATE

ZIP CODE

BILL DOE

 

 

 

 

 

 

 

SAME AS OWNER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER LICENSE NUMBER

 

STATE

DL TYPE

 

DRIVER/NON-MOTORIST HOME PHONE

DRIVER/NON-MOTORIST BUSINESS PHONE

SEX

DATE OF BIRTH

D 561345706000

 

FL

 

 

 

 

 

 

 

M

01-01-70

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF PASSENGER

 

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

 

CITY AND STATE

ZIP CODE

SALLEY DOE

 

 

 

 

 

 

 

SAME AS OWNER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF PASSENGER

 

 

 

 

 

CURRENT ADDRESS (Number and Street)

 

 

CITY AND STATE

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Effective July 1, 2012, Section 316.066(1)(e),Florida Statute, requires that "The driver of a vehicle that was in any manner involved in a crash resulting in damage to a vehicle or other property which does not require a law enforcement report shall, within 10 days after the crash, submit a written report of the crash to the department. The report shall be submitted on a form approved by the department."

Keep a copy of this report for your records and for insurance purposes.

Sign the report at the bottom of the front page.

Submit this via email to SelfReportCrashes@flhsmv.gov, OR;

Mail this report to: Florida Highway Safety & Motor Vehicles Self Report Crash Team

2900 Apalachee Pkwy, MS 28 Tallahassee, Florida 32399

Please use this space for comments and for listing any witnesses and/or additional passengers, stating which vehicle the passenger was in. For additional vehicles or other involved parties, please add additional front pages for this Driver Report of Traffic Crash.

How to Edit Florida Traffic Crash Report Online for Free

We found the best computer programmers to develop the PDF editor. This app will assist you to fill out the florida crash report form conveniently and won't take up a great deal of your time and effort. This easy guideline will enable you to begin.

Step 1: Select the orange "Get Form Now" button on the web page.

Step 2: So, you're on the form editing page. You may add information, edit existing details, highlight certain words or phrases, place crosses or checks, insert images, sign the form, erase unwanted fields, etc.

You'll have to enter the next information if you would like prepare the template:

step 1 to filling in accident report florida

Add the expected particulars in the Area, Code Area, Code CURRENT, ADDRESS, Number, and, Street CITY, AND, STATE CURRENT, ADDRESS, Number, and, Street CITY, AND, STATE SECTION, TWO VEHICLE, NON, MOTORIST optional, EMAIL, OWNER, DRIVER YEAR, MAKE, Chevy, Ford, Etc V, IN INSURANCE, COMPANY and INSURANCE, POLICY, NUMBER box.

accident report florida AreaCode, AreaCode, CURRENTADDRESSNumberandStreet, CITYANDSTATE, CURRENTADDRESSNumberandStreet, CITYANDSTATE, SECTIONTWO, VEHICLE, NONMOTORIST, optionalEMAILOWNERDRIVER, YEAR, MAKEChevyFordEtc, VIN, INSURANCECOMPANY, and INSURANCEPOLICYNUMBER fields to fill out

Focus on the crucial information on the ZIP, CODE ZIP, CODE NAME, OF, VEHICLE, OWNER Check, if, same, as, Driver CURRENT, ADDRESS, Number, and, Street CITY, AND, STATE CURRENT, ADDRESS, Number, and, Street CITY, AND, STATE DRIVER, LICENSE, NUMBER DRIVER, NON, MOTORIST, BUSINESS, PHONE SEX, DATEOFBIRTH, NAME, OF, PASSENGER NAME, OF, PASSENGER and WITNESSES area.

ZIPCODE, ZIPCODE, NAMEOFVEHICLEOWNER, CheckifsameasDriver, CURRENTADDRESSNumberandStreet, CITYANDSTATE, CURRENTADDRESSNumberandStreet, CITYANDSTATE, DRIVERLICENSENUMBER, DRIVERNONMOTORISTBUSINESSPHONE, SEX, DATEOFBIRTH, NAMEOFPASSENGER, NAMEOFPASSENGER, and WITNESSES in accident report florida

You have to include the rights and obligations of the parties in the COUNTY, OF, CRASH, County, Code, PINELLAS PLACE, OR, CITY, OF, CRASH, City, Code ST, PETERSBURG REPORTING, AGENCY, CASE, NUMBER HS, MV, Report, Number DATE, OF, CRASH TIME, OF, CRASH, AM Check, if Within, City Limits, CRASH, OCCURRED, ON, STREET, ROAD, HIGHWAY ND, STREET, SOUTH AT, STREET, ADDRESS FEET, MILES and OR, FROM, MILEPOST space.

part 4 to entering details in accident report florida

Fill in the document by checking all of these fields: .

part 5 to completing accident report florida

Step 3: When you have clicked the Done button, your document will be ready for export to every electronic device or email you identify.

Step 4: In order to prevent probable forthcoming risks, be certain to possess at least a few duplicates of every form.

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