Accident Checklist
Below is a checklist of information you will need to collect after an accident or injury. You can print this document and keep a copy in your car or you can use it to put down any information that you gathered at the scene. If you have any questions, please contact a Los Angeles personal injury attorney at Carpenter, Zuckerman & Rowley, LLP.
DATE OF ACCIDENT
DAY OF THE WEEK
TIME OF DAY
LOCATION OF ACCIDENT
OTHER PARTY(s) INFORMATION
NAME
ADDRESS
PHONE NUMBER
DRIVER’S LICENSE NUMBER
VEHICLE:
MAKE
MODEL
YEAR
LICENSE PLATE NUMBER
REGISTER OWNER OF VEHICLE NAME
INSURANCE COMPANY
INSURED’S NAME
POLICY NUMBER
LOCATION OF DAMAGE ON VEHICLE
STATEMENT OF OTHER PARTY AT ACCIDENT
MY INFORMATION
LOCATION OF DAMAGE ON MY VEHICLE
(1) WITNESS NAME
ADDRESS
PHONE NUMBER
(2) WITNESS NAME
PHONE NUMBER
ADDRESS
POLICE INFORMATION
LAPD CHP OTHER
POLICE REPORT NUMBER
POLICE OFFICER NAME
CALL Carpenter, Zuckerman & Rowley, LLP (310) 273-1230