Iowa Accident Report Form PDF Details

When navigating the aftermath of a vehicular accident within Iowa's borders, the Iowa Accident Report Form becomes an indispensable document not only for legal and insurance purposes but also as a procedural safeguard to maintain one’s driving privileges. This form, officially identified as Form 433002 08-10, is mandated for any accident resulting in death, personal injury, or property damage exceeding $1,500.00. The stakes are high; failing to submit this completed form within a 72-hour window may lead to the suspension of driving privileges. It requires detailed input, including specifics about the accident like the date, time, and injuries or fatalities, alongside information on the drivers, vehicles involved, and the extent of property damage. Clarity on vehicle types through designated codes, accident location specifics, and an array of supplementary categories such as vehicular actions, weather conditions, and driver condition critically inform the accident’s narrative. Additionally, it integrates sections for indicating insurance information, a crucial step to avoid potential suspension of driving and registration privileges. This form not only performs the practical function of documenting accident details but also upholds the legal framework surrounding motor vehicle operation in Iowa.

QuestionAnswer
Form Name Iowa Accident Report Form
Form Length 4 pages
Fillable? Yes
Fillable fields 100
Avg. time to fill out 10 min
Other names Iowa accident, Iowa dot accident report, Iowa state patrol crash reports, Iowa report accident, Form 433002

Form Preview Example

Form 433002 08-10

IOWA ACCIDENT REPORT FORM

An accident occurring anywhere within the State of Iowa causing death, personal injury, or total property damage of $1,500.00 or more must be reported on this accident report form. Failure to return this accident report form within 72 hours may result in suspension of your driving privilege. Caution: You must attempt to completely fill out this report.

Instructions

Please print or type all information. Use black or dark blue ink.

Step 1. Begin completing the "Report of Motor Vehicle Accident" form by entering accident date, day of week, time, number of vehicles, total number killed, number injured, and the total amount of damage to all vehicles and any property other than vehicles.

Step 2. Enter the information pertaining to all drivers and vehicles involved in the accident. Important: Be sure to include the driver's name, driver license number, and driver license state. Also include the vehicle owner's name, license plate number, and license plate state. If more than two drivers or two vehicles were involved, use an extra report form or sheet of paper making sure that the extra vehicles and drivers are numbered 3, 4, 5, etc.

If you were involved in an accident with a pedestrian, print PEDESTRIAN in the driver space provided for vehicle No. 2 and complete pedestrian information in Step 7. If you were involved in an accident with a pedalcyclist (bicycle, etc.) print 'Bike' in the driver space provided for Vehicle 2 and complete information for Non-Motorist in Step 7.

If one of the vehicles involved was parked at the time of the accident, print PARKED in the driver space and complete the vehicle owner information.

Step 3. Please use the following codes when completing the box marked "vehicle type code":

01

= Passenger Car

09

= Tractor/semi-trailer

17

= Small school bus (seats 9-15)

02

= Four-tire light truck (pick-up, panel)

10

= Tractor/doubles

18

= Other bus (seats > 15)

03

= Van or mini-van

11

= Tractor/triples

19

= Other small bus (seats 9-15)

04

= Sport utility vehicle

12

= Other heavy truck (cannot classify)

20

= Farm vehicle/equipment

05

= Single-unit truck (2-axle, 6-tire)

13

= Motor home/recreational vehicle

21

= Maintenance/construction vehicle

06

= Single-unit truck (> = 3 axles)

14

= Motorcycle

22

= Train

07

= Truck/trailer

15

= Moped/All-Terrain Vehicle

88

= Other (explain in narrative)

08

= Truck tractor (bobtail)

16

= School bus (seats > 15)

99

= Unknown

Step 4. The location of the accident is very important. Please be as specific as possible.

Step 5. To the best of your ability, complete the Accident Codes section for your own vehicle using codes provided on page 2 of this form.

Step 6. If there is damage to property other than the vehicles involved complete the property damage information.

Step 7. Injury information should be entered in the space provided. Make sure that the vehicle number in which the injured party was riding is complete, describe the nature of the injury, and check the box under the column most appropriate for the injury severity. NOTE: Include all drivers whether injured or not. The codes are:

Injury Status:

1 = Fatal

2 = Incapacitating

3 = Non-incapacitating

4 = Possible

5 = Uninjured

9 = Unknown

Occupant Protection:

Airbag Deployment:

Ejection:

Type Non-Motorist:

1

= None used

1

= Deployed front of person

1

= Not ejected

1

= Pedestrian

2

= Shoulder and lap belt used

2

= Deployed side of person

2

= Partially ejected

2

= Pedalcyclist (bicycle, tricycle,

3

= Lap belt only used

3

= Deployed both front/side

3

= Totally ejected

 

unicycle, pedal car)

4

= Shoulder belt only used

4

= Other deployment (explain

4

= Not applicable

3

= Skater

5

= Child safety seat used

 

in narrative

 

(motorcycle,

8

= Other (explain in narrative)

6

= Helmet used

5

= Not deployed

 

bicycle, etc.)

9

= Unknown

8

= Other (explain in narrative)

6

= Not applicable

9

= Unknown

 

 

9

= Unknown

9

= Unknown

 

 

 

 

Motorcycle Seating Position

Seating

01

- Motorcycle Driver

Position

04

- Motorcycle Passenger

 

 

 

88

- Other (explain in

01

02

03

 

narrative)

 

 

 

 

04

05

06

 

 

 

 

 

 

 

 

 

07

08

09

 

 

 

 

 

10 - Sleeper Section

11 - Enclosed Cargo Area

12 - Unenclosed Cargo Area

13 - Training Unit

14 - Exterior

15 - Pedestrian

16 - Pedalcyclist

17 - Pedalcyclist, passenger

88 - Other (explain in narrative)

99 - Unknown

(Instructions continued on page 2) Æ

-1-

(Instructions continued from page 1)

Step 8. To the best of your ability, complete the accident diagram and description as briefly as possible. Important: If you are vehicle No. 1 in Step 2, make sure that your vehicle is vehicle No. 1 in the description and diagram. Indicate if there has been a Peace Officer investigation.

Step 9. Complete the insurance information on the back of the report. Failure to complete insurance coverage information may result in a suspension of your driving and registration privileges.

Step 10. Sign the accident report and tear at the perforated line and return accident report to:

Iowa Department of Transportation

Office of Driver Services

P.O. Box 9235

Des Moines, IA 50306-9235

ACCIDENT CODES (See Step 5)

LOCATION OF ACCIDENT (Where did first damage or injury event occur)

1

= On Roadway

4

= Roadside (ditch)

6 = Outside Trafficway

2

= Shoulder

5

= Grassy Area between

9 = Unknown

3

= Median

 

 

exit ramp and roadway

 

 

 

 

MANNER OF CRASH/COLLISION

7 = Sideswipe,

 

 

 

 

1

= Non-collision

5

= Broadside

2

= Head-on

6

= Sideswipe,

 

opposite direction

3

= Rear-end

 

 

same direction

9 = Unknown

4

= Angle, oncoming

 

 

 

 

 

 

 

left turn

 

 

 

 

 

 

 

VEHICLE ACTION

 

 

 

 

 

 

 

 

 

 

 

 

01

= Movement essentially

06

= Changing lanes

11

= Stopped for

 

 

straight

07

= Entering traffic lane

 

stop sign/signal

02

= Turning left

 

 

(merging)

12

= Legally Parked

03

= Turning right

08

= Leaving traffic lane

13

= Illegally Parked /

WEATHER CONDITIONS (up to two)

01

= Clear

06

= Rain

02

= Partly cloudy

07

= Sleet, hail, freezing

03

= Cloudy

 

 

rain

04

= Fog, smoke

08

= Snow

05

= Mist

09

= Severe winds

 

 

SURFACE CONDITIONS

 

 

 

 

 

 

 

 

1

= Dry

5

= Slush

2

= Wet

6

= Sand, mud, dirt, oil,

3

= Ice

 

 

gravel

4

= Snow

7

= Water (standing,

 

 

 

 

 

moving)

VISION OBSCURED

10 = Blowing sand, soil, dirt, snow

88 = Other (explain in narrative)

99 = Unknown

8 = Other (explain in

narrative)

9 = Unknown

04

= Making U-turn

09

= Backing

 

Unattended

05

= Overtaking/passing

10

= Slowing/stopping

88

= Other (explain in

 

 

 

 

 

 

narrative

 

 

 

 

 

99

= Unknown

 

 

FIRST HARMFUL EVENT

 

 

 

 

Non-collision events:

24

= Railway vehicle/train

35

= Guardrail

11

= Overturn/rollover

25

= Animal

36

= Concrete barrier

12

= Jackknife

26

= Other non-fixed object

 

(median or right side)

13

= Other non-collision

 

(explain in narrative)

37

= Tree

 

 

(explain in narrative)

Collision with fixed object:

38

= Poles (utility, light,

Collision with:

30

= Bridge/bridge rail/

 

etc.)

20

= Non-motorist (see

 

overpass

39

= Sign post

 

 

non-motorist type)

31

= Underpass/structure

40

= Mailbox

21

= Vehicle in traffic

 

support

41

= Impact attenuator

22

= Vehicle in/from other

32

= Culvert

42

= Other fixed object

 

 

roadway

33

= Ditch/Embankment

 

(explain in narrative)

23

= Parked motor vehicle

34

= Curb/island/raised median

 

 

01

= Not obscured

08

= Moving vehicles

12

= Blowing snow

02

= Trees/crops

09

= Person/object in or

13

= Fog/smoke/dust

03

= Buildings

 

 

on vehicle

88

= Other (explain in

04

= Embankment

10

= Blinded by sun or

 

narrative)

05

= Sign/billboard

 

 

headlights

99

= Unknown

06

= Hillcrest

11

= Frosted windows/

 

 

07

= Parked vehicles

 

 

windshield

 

 

 

 

DRIVER CONDITION

 

 

 

 

 

 

 

 

 

 

 

 

1

= Apparently normal

4

= Illness

8 = Other (explain in

2

= Physical impairment

5

= Asleep, fainted,

 

narrative)

3

= Emotional (e.g.,

 

 

fatigued, etc.

9 = Unknown

 

 

depressed, angry,

6

= Under the influence of

 

 

 

 

disturbed)

 

 

alcohol/drugs/

 

 

 

 

 

 

 

medications

 

 

CONTRIBUTING CIRCUMSTANCES Driver (up to two)

 

 

TYPE OF ROADWAY JUNCTION/FEATURE

 

 

 

 

 

 

Non-intersection::

08

= Other non-intersection

16

= Intersection with ramp

01

= No special feature

 

(explain in narrative)

17

= On-ramp merge area

02

= Bridge/overpass/

Intersection:

18

= Off-ramp diverge area

 

 

underpass

11

= Four-way intersection

19

= On-ramp

03

= Railroad crossing

12

= T-intersection

20

= Off-ramp

04

= Business drive

13

= Y-intersection

21

= With bike/pedestrian

05

= Farm/residential drive

14

- Five-leg or more

 

path

06

= Alley intersection

15

- Offset four-way

22

= Other intersection

07

= Crossover in median

 

intersection

 

(explain in narrative)

 

 

 

 

 

99

= Unknown

 

 

TRAFFIC CONTROLS

 

 

 

 

 

 

 

 

 

 

01

= No controls present

06

= No Passing Zone

10

= Traffic director

02

= Traffic signals

 

(marked)

11

= Workzone signs

03

= Flashing traffic control

07

= Warning sign

88

= Other control (explain

 

 

signal

08

= School zone signs

 

in narrative)

04

= Stop signs

09

= Railway crossing

99

= Unknown

05

= Yield signs

 

device

 

 

 

 

LIGHT CONDITIONS

4 = Dark, roadway lighted

6 = Dark, unknown

 

 

1 = Daylight

2 = Dusk

5 = Dark, roadway not

 

roadway lighting

3 = Dawn

 

lighted

9 = Unknown

01 = Ran traffic signal

02 = Ran stop sign

03 = Exceeded authorized speed

04 = Driving too fast for conditions

05 = Made improper turn

06 = Traveling wrong way or on wrong side of road

07 = Crossed centerline

08 = Lost Control

09 = Followed too close

10 = Swerved to avoid; vehicle, object, non- motorist, or animal in roadway

11 = Over correcting/over steering

12 = Operating vehicle in erratic, reckless, careless, negligent, or aggressive manner

Failed to yield right-of-way: 13 = From stop sign

14 = From yield sign

15 = Making left turn

16 = Making right turn on red signal

17 = From driveway

18 = From parked position

19 = To pedestrian

20 = At uncontrolled intersection

21 = Other (explain in narrative)

Inattentive/distracted by: 22 = Passenger

23 = Use of phone or other device

24 = Fallen object

25 = Fatigued/asleep

Other

26 = Vision obstructed

27 = Other improper action

28 = No improper action

99 = Unknown

-2-

Form 433002

 

08-10

 

 

REPORT OF MOTOR VEHICLE ACCIDENT

Step 1.

See Instructions on completing (please print or type)

Did accident occur on

Yes

private property?

No

Accident Date (Mo/Day/Year)

Day of Week

Time

 

 

 

AM

Number of Vehicles

Total Killed

 

Total Injured

Total Estimated Damage

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Step 2.

 

 

 

NO. 1 (YOUR VEHICLE)

 

 

 

 

 

 

 

 

 

 

NO. 2 (OTHER VEHICLE)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of Birth

Sex

Dr.Lic. State

Driver License No. as Printed on License

D

Date of Birth

 

Sex

Dr.Lic. State

Driver License No. as Printed on License

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

R

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Last Name of Driver 1

 

 

 

 

First Name

 

 

 

 

 

 

 

 

 

 

Middle Initial

I

Last Name of Driver 2

 

 

 

First Name

 

 

 

 

 

 

 

 

 

 

Middle Initial

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

V

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Number and Street

 

 

 

 

City

 

 

 

 

 

State

 

 

 

Zip Code

E

Number and Street

 

 

 

City

 

 

 

 

 

 

 

State

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

R

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Last Name of Owner 1

 

 

 

 

First Name

 

 

 

 

 

 

 

 

 

 

Middle Initial

----

Last Name of Owner 2

 

 

 

First Name

 

 

 

 

 

 

 

 

 

 

Middle Initial

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

O

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

w

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Number and Street

 

 

 

 

City

 

 

 

 

 

State

 

 

 

Zip Code

N

Number and Street

 

 

 

 

City

 

 

 

 

 

 

 

State

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

E

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

R

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

----

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

No. of Occupants

 

Plate Number

 

 

 

State of Registration

Year

No. of Occupants

 

Plate Number

 

 

 

 

State of Registration

Year

 

 

 

 

V

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

V.I.N.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Est. Cost of Repairs

H

V.I.N.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Est. Cost of Repairs

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle Year & Make

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Step 3.

Vehicle Type Code

L

Vehicle Year & Make

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Step 3.

Vehicle Type Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

----

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Step 4.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LOCATION OF ACCIDENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

County

Accident occurred within corporate limits of (city)

If accident occurred outside of

 

 

N NE E SE S SW W NW

city limits, describe distance to city

 

miles

of nearest city

 

 

 

 

 

 

Name of Road, Street or Highway

 

 

At Intersection with

Note: Unless accident occurred at an intersection which is completely described above, use the space below to give the exact location from a milepost or definable intersection, bridge or railroad crossing, using two distances and directions if necessary.

Feet Miles

or

N NE E SE S SW W NW

Feet

 

Miles

 

 

 

 

 

and

 

or

 

 

 

 

N NE E SE S SW W NW

of

Milepost Number

Definable Intersection, bridge, or railroad crossing

Or

Step 5. Accident Codes (on page 2) For your own vehicle

 

 

Location of Accident

 

 

 

Manner of Crash

 

 

 

 

 

Vehicle Action

 

 

Type of Roadway

 

 

 

 

Traffic Controls

 

 

 

 

 

Light Conditions

 

 

Junction/Feature

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Surface Conditions

 

 

 

Vision Obscured

 

 

 

 

 

Driver Condition

 

 

 

Identify Damaged Property Other Than Vehicles

 

Owner

Step 6.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Step 7. Injury Section: Fill Out Space Below For Every Person Injured Or Killed In The Accident (Attach additional sheets if necessary)

 

Vehiclen

 

Gender

 

Name & Address

I Number

Date of Birth

Describe Injuries

 

 

 

 

 

First Harmful Event

Weather Conditions

Contributing Circumstances

Amount of Damage

 

Insert Correct Code

 

 

 

(See Step 7 of Instructions)

 

InjuryStatus

Occupant Protection

Airbag Deployment

Ejection

Type Non-Motorist

Seating Position

Date of

 

 

 

 

 

 

 

 

 

 

 

 

Death

 

 

 

 

 

 

 

(Complete reverse side)´

-3-

Step 8.

Indicate On This Diagram What Happened

Use one of these outlines to sketch the scene of your accident, writing in street or highway names or numbers.

Initial Travel Direction

 

 

 

(prior to coded Vehicle Action)

 

N

 

1

- North

 

 

 

 

 

2

- East

W

E

3

- South

 

 

 

4

- West

 

S

9

- Unknown

 

 

 

 

INDICATE

NORTH

BY ARROW

Street or Highway

Original Direction of Travel: (Example: Vehicle going north then turning left, code 'N' for Original Direction of Travel)

Vehicle 1

 

Vehicle 2

Street or Highway

Street or Highway

Description

Did Peace Officer investigate?

 

Yes

 

No

Department

 

 

 

If you did not have automobile liability insurance coverage for this accident, please check this box

 

.

 

If you had automobile liability insurance coverage for this accident, please complete insurance information below:

Failure To Complete Insurance Coverage Information Requested Below May Result In A Suspension Of Your Driving And/Or Registration Privileges.

Step 9.

Name of Insurance Company (Not Agent) Providing Insurance To Cover Your Liability For Damage Or Injury To Others:

Name of Agent Who Sold Policy

Agent Address

Policy No.

 

Policy Period: From

 

To

 

V.I.N. No.

 

 

 

 

 

Name of Driver

 

 

 

 

 

Name of Owner

 

 

 

 

 

Name of Policyholder

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Step 10.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

Signature of Driver of Vehicle No. 1

If Signed By Person Other Than Driver, Give Reason

IMPORTANT: This accident should also be reported directly to your insurance company. Failure to report may jeopardize your automobile liability insurance.

-4-

How to Edit Iowa Accident Report Form Online for Free

Accurate and timely submission of the Iowa Accident Report Form is crucial, as failure to complete and return it within 72 hours may lead to suspension of driving privileges.

1. Document Accident Details

Start by filling out the initial section of the form, which includes the accident date, day of the week, time, and number of vehicles involved. You'll also need to note the total number killed or injured and the total estimated damage to property.

Part no. 1 for completing report iowa accident

2. Enter Driver and Vehicle Information

Input details for all drivers involved, including names, license numbers, and issuance states. Record the make, model, year, and license plate information for each vehicle.

3. Specify Vehicle Type

For each vehicle involved, select the appropriate vehicle type code from the list provided, which ranges from passenger cars to farm vehicles, ensuring each vehicle type is clearly identified.

Filling out part 2 in report iowa accident

4. Describe the Accident Location

Provide a detailed description of the accident location. Be specific about where the accident occurred, including road names, intersections, and relevant landmarks or features.

report iowa accident completion process clarified (part 3)

5. Fill in Accident Codes

Using the codes provided on the form, describe your vehicle's involvement in the accident. This includes the type of collision, the nature of any non-collision events, and other specifics outlined by the accident code guidelines.

6. Report Property Damage

If the accident involved damage to property other than vehicles, clearly detail this in the designated section. Include the type of property damaged, the owner's information, and an estimate of the repair costs.

Stage # 4 for filling out report iowa accident

7. Include Injury Information

Document any injuries that occurred as a result of the accident. Specify the vehicle each injured party was in, describe the nature of their injuries, and use the provided codes to indicate the severity of each injury.

8. Complete the Diagram and Narrative

Draw a diagram of the accident on the provided space and write a detailed narrative describing the events leading up to, during, and after the accident.

Guidelines on how to complete report iowa accident part 5

9. Fill Out Insurance Information

Enter comprehensive insurance details for all parties involved. This includes the insurance company name, policy number, and the coverage period.

10. Sign and Review

Review the information for accuracy and completeness after filling out all sections of the form. Sign the form to attest to the truthfulness of the information provided.

Iowa Accident Report Form isn’t the one you’re looking for?

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