Reporting

Report clearly, act quickly, stay accountable.

Vehicle Accident Reporting Form

Truck # (required)

(if Rental enter Plate #)

Driver Name

Date

(DATE OF ACCIDENT OR INCIDENT)

Type

Yard Damage Stationary Object Impact Vehicle / Vehicle Impact Other

Location?

(Drop Pin or copy coordinates if possible.)

Route/Run

POLICE?

YES, REPORT MADE NO

POLICE REPORT #

VEDR

YES, CAMERA ACTIVATED YES, MANUAL CRITICAL EVENT INITIATED NO, VEDR NOT AVAILABLE

AT FAULT?

YES NO OTHER / NOT APPLICABLE

Incident Details (What Happened / What Time)

Other Party

Witness or Other Party Contact Info (Name, Phone, Insurance, Plate #)

Additional Incident / Tow Company / Accident Scene Details (email pictures to upload@slickertrucking.net)

TRUCK DRIVEABLE?

YES, RETURNED TO ROUTE YES, RETURNED TO STATION NO, TOWED

Submitted by:

Driver (Self) Manager Other

Submitted by (Name & Phone)