Form Crb 2 PDF Details

In the event of a motor vehicle crash not investigated by law enforcement, the involved driver, or another on their behalf if necessary, must complete the CRB-2 form, also known as the Driver's Crash Report. This document is critical in Texas, where it serves to record incidents involving injury, death, or property damage exceeding $1,000 to any one person, including the driver themselves. It is mandatory that this form be submitted within ten days following the crash, detailing specifics such as location, vehicle information, driver and owner details, insurance, and any property damage or personal injuries sustained. This form plays a pivotal role not only in fulfilling legal obligations under the Texas Motor Vehicle Safety-Responsibility Act but also in assisting with insurance claims and maintaining an accurate and comprehensive state record of motor vehicle crashes. Information required includes the crash location, date, time, and a narrative of how the incident occurred, alongside a directive to avoid submitting photographs with the report. Ensuring the form is completed accurately and thoroughly is essential for its acceptance by the Texas Department of Public Safety, underscoring the importance of reviewing instructions carefully before submission.

QuestionAnswer
Form NameForm Crb 2
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namestexas crb driver, crb2 driver crash report, dps crb form, tx crb2 crash

Form Preview Example

DRIVER'S CRASH REPORT

PLEASE READ INSTRUCTIONS ON REVERSE SIDE

FORM CRB-2 (Rev. 1/1/06)

 

* INDICATES REQUIRED FIELDS

TEXAS DEPARTMENT OF PUBLIC SAFETY

 

 

 

 

 

 

 

 

PLACE WHERE

 

 

 

 

 

* CITY OR TOWN _____________________________________________

 

CRASH OCCURRED

COUNTY _________________________________

 

 

 

IF CRASH WAS OUTSIDE CITY LIMITS,

 

 

 

 

 

 

 

 

 

 

LOCATION

INDICATE DISTANCE FROM NEAREST TOWN_______________________ MILES

 

 

 

OF _________________________________________________________________

 

 

NORTH

S

E

W

 

CITY OR TOWN

 

 

 

 

 

ROAD ON WHICH

 

 

 

 

 

 

 

CONSTR.

YES

SPEED

 

CRASH OCCURRED ________________________ _________________________________________________________________________________

ZONE

NO

LIMIT

 

 

BLOCK NUMBER

STREET OR ROAD NAME

 

ROUTE NUMBER

 

 

 

 

 

 

 

CONSTR.

YES

SPEED

 

 

 

 

 

 

 

 

 

 

INTERSECTING STREET ___________________

____________________________________________________________________

ZONE

NO

LIMIT

 

COMPLETE ONE

BLOCK NUMBER

STREET OR ROAD NAME

 

ROUTE NUMBER

 

 

 

 

 

NOT AT INTERSECTION ___________________

FEET

 

 

 

OF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NORTH

S

E

W

 

SHOW NEAREST INTERSECTING NUMBERED HIGHWAY. IF URBAN,

 

 

 

 

SHOW NEAREST INTERSECTING STREET

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE

*DATE OF CRASH _____________________ 20_________ DAY OF WEEK __________________________

HOUR ___________________

A.M.

IF EXACTLY NOON OR

P.M.

MIDNIGHT, SO STATE

VEHICLES

FOR

ADDITIONAL VEHICLES USE ANOTHER FORM

#1 - YOUR VEHICLE

 

 

 

VEHICLE IDENT. NO.

 

 

 

 

 

 

 

 

 

 

 

 

 

TYPE OF

 

 

 

 

 

 

 

 

 

YEAR

 

MAKE /

 

 

 

 

 

 

LICENSE

 

 

 

 

MODEL

___________________

MODEL

____________________________

VEHICLE ___________________________

PLATE________________________________________________________

 

 

 

 

CHEVY, FORD, ETC.

 

SEDAN, TRUCK, VAN, ETC.

 

YEAR

STATE

NUMBER

*

DRIVER _____________________________________________________

_____________________________________________________________________________________________________

 

LAST

FIRST

MI

 

 

 

MAIL ADDRESS

 

 

CITY AND STATE

 

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER'S LICENSE _____________________________________ DATE OF BIRTH __________________________ SEX ______________

RACE __________________

APPROX. COST TO REPAIR

 

 

 

STATE

NUMBER

 

 

 

 

 

 

 

 

 

 

YOUR VEHICLE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OWNER _______________________________________________________

______________________________________________________________________________

 

 

 

LAST

FIRST

MI

 

MAIL ADDRESS

 

 

CITY

STATE

ZIP

 

$_____________________

INSURANCE INFORMATION ______________________________________________________________________________________________________

_______________________________________

 

 

INSURANCE COMPANY NAME (NOT THE AGENT)

ADDRESS

CITY

STATE

ZIP

 

 

 

POLICY NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

#2- OTHER VEHICLE

 

MOTOR VEHICLE

TRAIN

PEDESTRIAN

BICYCLIST

OTHER

 

 

 

 

 

 

(COMPLETE INFORMATION YOU HAVE AVAILABLE - IF UNKNOWN, MARK "NOT KNOWN")

 

 

 

 

 

 

 

 

 

 

 

 

YEAR

 

MAKE /

 

 

TYPE OF

 

 

 

 

LICENSE

 

 

 

 

MODEL

___________________

MODEL

____________________________

VEHICLE ___________________________

PLATE________________________________________________________

 

 

 

 

CHEVY, FORD, ETC.

 

SEDAN, TRUCK, VAN, ETC.

 

YEAR

STATE

NUMBER

DRIVER _____________________________________________________________

_____________________________________________________________________________________________________

 

 

LAST

FIRST

MI

 

 

 

MAIL ADDRESS

 

CITY

STATE

 

ZIP

OWNER _____________________________________________________________

_____________________________________________________________________________________________________

 

 

LAST

FIRST

MI

 

 

 

MAIL ADDRESS

 

CITY

STATE

 

ZIP

INSURANCE INFORMATION ______________________________________________________________________________________________________

_______________________________________

 

 

INSURANCE COMPANY NAME (NOT THE AGENT)

ADDRESS

CITY

STATE

ZIP

 

 

 

POLICY NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DAMAGE TO PROPERTY OTHER

 

 

 

 

 

 

 

 

 

 

APPROX. COST TO REPAIR

 

 

 

 

 

 

 

 

 

 

 

 

THAN VEHICLES

 

 

 

 

 

 

 

 

 

 

 

 

NAME OBJECT, SHOW OWNERSHIP AND STATE NATURE OF DAMAGE

$__________________

 

#1

INJURED PERSON

DRIVER

 

 

PASSENGER

 

PEDESTRIAN

OTHER

__________________________

 

 

 

NAME_______________________________________________________________

ADDRESS__________________________________________________________________________________________

INJURIES

AGE________________

SEX_____________

RACE_________________

WAS PERSON KILLED______________ DATE OF DEATH ______________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SEAT BELT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DESCRIBE INJURY_________________________________________________________________________________________________________________________________

USED

NOT USED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

# 2

INJURED PERSON

DRIVER

 

 

PASSENGER

 

PEDESTRIAN

OTHER

__________________________

 

 

 

NAME_______________________________________________________________

ADDRESS___________________________________________________________________________________________

 

AGE________________

SEX_____________

RACE_________________

WAS PERSON KILLED______________ DATE OF DEATH ______________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SEAT BELT

 

DESCRIBE INJURY_________________________________________________________________________________________________________________________________

USED

NOT USED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STATE BRIEFLY WHAT HAPPENED

PLEASE DO NOT SEND PHOTOGRAPHS

(IF SPACE IS INSUFFICIENT CONTINUE ON ANOTHER PAGE)

 

DATE OF

DRIVER'S SIGNATURE

(Please use blue or black ink only)

REPORT

When completed, mail this form to:

CRASH RECORDS BUREAU

TEXAS DEPARTMENT OF PUBLIC SAFETY

PO BOX 4087

AUSTIN TEXAS 78773-0001

PLEASE READ ALL INSTRUCTIONS CAREFULLY

The driver of a motor vehicle involved in a crash not investigated by a law enforcement officer and resulting in injury to or death of any person, or damage to the property of any one person, including himself, to any apparent extent of at least One Thousand Dollars ($1,000), shall within ten (10) days after such crash complete and forward this report in

accordance with the instructions below. This report is not required when a crash is investigated by a law enforcement officer unless specifically requested by authority of Section 4, Texas Motor Vehicle Safety-Responsibility Act (Texas Transportation Code, TRC §601.004).

WHO SHOULD

COMPLETE A CRB-2

LOCATION

DATE

VEHICLES

PROPERTY

DAMAGE

INJURIES

DRIVER'S

STATEMENT

SIGNATURE

1.The information on the reverse side of the CRB-2 must be completed and signed by the driver of the vehicle involved in the crash. If the driver is unable to complete the report, another person may submit the report on behalf of the driver, with an explanation as to why the driver was unable to complete the form.

2.All data fields should be completed to the best of your knowledge; however, fields marked with an

asterisk (*) are required data fields and should include sufficient information for DPS to process the report. This information is an important element in locating reports and maintaining an accurate filing system. *CITY OR TOWN in the Location section is a required field; if it is left blank the report will be returned to you.

3.*DATE OF CRASH is a required data field and must include the specific month, day and year the crash occurred. Please provide the time of the crash if known. If the date of the crash is not provided, the report will be returned to you.

4.In the section titled #1 YOUR VEHICLE, the name of the *DRIVER involved in the crash is a required data field . All remaining information should be completed to the best of your knowledge. In the section titled #2 OTHER VEHICLE, please specify if the crash involved another motor vehicle, a train, a pedestrian, etc. and provide the name of the other involved party on the line labeled DRIVER. Please complete the remaining information to the best of your knowledge.

5.If the crash involved "PROPERTY DAMAGE" please provide all available information. (Description of property, location, owner, etc.)

6.In the section titled #1 INJURED PERSON, select the position of the occupant in your vehicle that was injured as a result of the crash and complete all data fields on that person. In the section titled #2 INJURED PERSON , select the position of the other person involved in the crash that was injured and complete all data fields to the best of your knowledge. If known, please indicate if the injured person wore a seatbelt.

7.“STATE BRIEFLY WHAT HAPPENED” In this section please provide a narrative description of the facts regarding this crash. If space is insufficient, attach a FULL SIZE sheet of paper for continuation. PLEASE DO NOT SEND PHOTOGRAPHS! Photographs cannot be returned.

8.Please review the report to insure accuracy and completeness as this will expedite the processing of the report and avoid having the report returned for insufficient information. Once you are satisfied with the completeness of the report, sign in black or blue ink and mail to the address at the top of the page.