Rental Car Accident Report Form

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Rental Car Accident Report Form Powered By Docstoc
					This form can be used to document a car accident when a rental car was involved. It is
important to document these events in writing to protect the rental car company and the
driver. The form requires the user to provide information about: the driver of the
vehicles during the accident, occupants of the vehicle, the events of the accident, any
injuries or loss of life, obvious damage to the vehicle, and other objects or vehicles
involved in the accident. This form can be used by renters of automobiles or by
automobile rental companies.
                                   Rental Car Accident Report
Documented by: _______________________________________

Date: __________________ Time: _______________

Vehicle rented to: ______________________ Date vehicle rented: ______________
Vehicle description: __________ _______________        ____________________
                            Year               Make                           Model

Who was driving the vehicle at the time of the accident?

Names of any other occupants & relationship to driver:

Describe events leading up to accident:




Describe injuries and/or loss of life, and if the injured was in this vehicle, or outside of
this vehicle:




Treatment Administered:

Hospitalization Required:

Diagnosis / Recovery expected:

Name & Phone number of any witnesses to accident:

Describe any obvious damages to this vehicle:



Describe any other vehicles or objects involved in this accident, and resulting damage if
any:


Name of officer filing police report: (Obtain and attach faxed copy of police report)

Name of driver of other vehicle(s), if any:

Insurance Company & Policy # of other vehicle(s), if any:




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                                                                          Rental Car Accident Report (HR 906) Rev. 06/03

				
DOCUMENT INFO
Description: This form can be used to document a car accident when a rental car was involved. It is important to document these events in writing to protect the rental car company and the driver. The form requires the user to provide information about: the driver of the vehicles during the accident, occupants of the vehicle, the events of the accident, any injuries or loss of life, obvious damage to the vehicle, and other objects or vehicles involved in the accident. This form can be used by renters of automobiles or by automobile rental companies.
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