Fillable Form SR-1 - Traffic Accident Report

What isForm SR-1?

Form SR-1, officially known as Report of Traffic Accident Occurring in California, is a form used for whenever you have been in an accident where anyone has been injured or killed, or property damage exceeds $1,000. This form must be filed whenever the accident occurs anywhere within the state of California, may it be a private road or driveway.

You should file this form within ten days of an accident regardless of who was at fault. You are required by law to fill out an SR-1 form with the Department of Motor Vehicles (DMV) within ten days whether or not you were at fault in the accident, whether or not you had the proper auto insurance, and whether or not your license and vehicle registration were up to date.

If police responded to the accident or you reported it to your insurance provider, you still have to fill out the SR-1 Form because the police and the insurance companies do not pass this information on to the DMV.

How to Fill Out Form SR-1?

Reporting Party’s Information
Number of vehicle
Enter the number of the vehicle.

Date of accident
Enter the date the accident occurred.

Accident location
Select the appropriate choice where the accident occured (Moving, Stopped in traffic, Parked, Pedestrian, Bicyclist, or other).

On private property
Select “Yes” if the accident occurred on a private property. If not, select “No”.

Driving for employer
Select “Yes” if you are driving for an employer. If not, select “No”.

Time of accident
Enter the time the accident occurred.

Driver’s Name
Enter your full name.

Driver License Number
Enter your driver license number.

State
Enter the state where your car is registered.

Driver’s Street Address
Enter your address as reflected on your driver’s license.

Date of Birth
Enter your date of birth.

City
Enter the city where you reside.

State
Enter the state where you reside.

Zip Code
Enter the zip code where you reside.

Telephone Numbers
Enter your telephone number.

Vehicle
Enter the vehicle.

Vehicle license plate or Vehicle identification number
Enter the vehicle license plate or vehicle identification number.

State
Enter the state.

Damages over
Select “Yes” if the damages to your party is over $1,000. If not, select “No”.

Vehicle owner
Enter the name of the individual or company that owns the vehicle.

Date of birth
Enter the vehicle owner’s date of birth.

Address
Enter the vehicle owner’s address.

State
Enter the vehicle owner’s state.

City
Enter the vehicle owner’s city of residence.

Zip Code
Enter the vehicle owner’s zip code.

Insurance company name
Enter the name of the insurance company that the vehicle is under in.

Policy Number
Enter the policy number.

Company NAIC Number
Enter the NAIC number of the company.

Policy period
From
Enter the start date of the coverage of the policy.

To
Enter the end date of the coverage of the policy.

Policy holder name
Enter the policy holder name.

Other Party’s Information
Driver’s Name
Enter the full name of the other driver involved in the accident.

Driver License Number
Enter the driver license number.

State
Enter the state.

Driver’s Street Address
Enter the driver’s street address.

Date of Birth
Enter the driver’s date of birth.

City
Enter the driver’s city of residence.

State
Enter the driver’s state of residence.

Zip Code
Enter the zip code.

Telephone Numbers
Enter the driver’s telephone number.

Vehicle
Enter the other party’s vehicle.

Vehicle license plate or Vehicle identification number
Enter the vehicle license plate or vehicle identification number of the other party.

State
Enter the state.

Damages over
Select “Yes” if the damages to the other party is over $1,000. If not, select “No”.

Vehicle owner
Enter the name of the individual or company that owns the vehicle of the other party.

Date of birth
Enter the vehicle owner’s date of birth.

Address
Enter the vehicle owner’s address.

State
Enter the vehicle owner’s state of residence.

City
Enter the vehicle owner’s city of residence.

Zip Code
Enter the zip code.

Insurance company name
Enter the name of the insurance company of the vehicle of the other party.

Policy Number
Enter the policy number.

Company NAIC Number
Enter the NAIC number of the company.

Policy period
From
Enter the start date of the coverage of the policy.

To
Enter the end date of the coverage of the policy.

Policy holder name
Enter the policy holder name.

Injury/Death Property Damage
Name and address of individual Injured or Deceased
Enter the name and address of the injured or deceased individual then select the appropriate choice (Injured, Deceased, Driver, Bicyclist, Passenger or Pedestrian).

Name and address of individual Injured or Deceased
If there is more than one individual that was injured or deceased, fill out this section.Enter the name and address of the injured or deceased individual then select the appropriate choice (Injured, Deceased, Driver, Bicyclist, Passenger or Pedestrian).

Other property damaged
Enter the other properties that were damaged in the said accident.

Damages over
Select “Yes” if damages is over $1,000.If not, select “No”.

Property owner’s name and address
Enter the name and address of the property owner.

Date
Enter the date you filed the report.

Printed name
Enter your printed name.

Signature
Provide your signature.

Insurance
Name of Insurance Company That Issued the Liability Policy Covering the Operation of Your Vehicle
Provide the name of the insurance company.

Policy number
Enter the policy number.

Policy period
Enter the policy period. Provide the start date on From and end date on To.

Date of accident
Enter the date of accident.

In or near
Provide the city or town where the accident occurred.

Vehicle
Enter the vehicle involved.

Driver license number
Enter your driver license number.

Vehicle identification number
Enter your vehicle identification number.

Vehicle license plate number
Enter your vehicle license plate number.

State
Enter the state.

Driver
Enter the name of the driver.

Address
Enter the driver’s address.

Owner
Enter the name of the owner.

Address
Enter the owner’s address.

Full name of the policy holder
Enter the full name of the policy holder.

Address
Enter the policy holder’s address.

Submission

Upon completion of the form, make sure to sign it and file it through mail to the Department of Motor Vehicle in California or you may also choose to file the form online at the DMV official website.

Tips:

If you are driving a commercial motor vehicle and was involved in a traffic crash, you must notify your employer within 5 days if you have an accident while driving your employer’s vehicle.

If you were involved in a traffic crash and you left the scene, you have to contact an experienced hit and run defense attorney to discuss your obligations after a traffic crash.

Submitting the SR-1 form is not an admission of fault, but it is a notification to the DMV that an accident occurred. The insurance companies will determine who is at fault.Your SR-1 can’t be used against you.

Failure to submit the SR-1 Form within the given timeframe will result in suspension of the driving privilege.