JOINT REPORT OF AUTOMOBILE ACCIDENT

JOINT REPORT OF AUTOMOBILE ACCIDENT
What to do in the case of an accident
There are two possible solutions:
If there are injuries, even minor ones, you must first call emergency services and ask a peace officer to fill
out an accident report.
If there is only property damage, fill out one report per accident.
How to fill out a joint report
1
Use only one report when two vehicles involved in the accident or two reports if three vehicles are
involved, etc. Who provides the report and who fills it out is not important.
2
Carefully copy the information found on the driver's license, registration and insurance certificate
for each party involved.
3
If there are witnesses, enter their name and address under section 5 of the report. This is particularly
important in case there is a lack of cooperation on the part of the other driver involved.
4
Both parties must sign the report. Every driver must have a joint report duly completed. Should the other
driver refuse to fill out a report or refuse to sign it once it has been completed, you should still fill yours out.
5
Don't forget to draw a sketch of the accident and describe any visible damage.
6
Fax us your report at 418-907-1007 or email it to: [email protected].
Sauvé Street
EXAMPLE OF A SKETCH OF AN ACCIDENT
A
Laurier Blvd
B
Print your new joint report and put it in the glove compartment of your car.
Joint Report of Automobile Accident
Completing this Joint Report cannot in any way be construed as an admission of liability. Its purpose is strictly to help identify the parties
involved in an accident in order to speed up the claim settlement. It should be signed by both drivers in any accident taking place in
Quebec. If there are injuries, even minor ones, call emergency services at once.
3. Property damage other than to vehicles A and B
1. Da te o f a ccid e nt
Time
Yes
No
4. Witnesses: names, addresses, tel. numbers. State if passenger(s) in vehicle A or B.
2. Place
Vehicle A
Driver’s license
Vehicle B
-
-
File No.
Driver’s license
Expiry Date
-
-
File No.
Expiry Date
F a mily N a me
F irs t N a me
F a mily N a me
F irs t N a me
A d d re s s
C ity
A d d re s s
C ity
Tel. Office
Postal code
Postal code
Tel. Home
Vehicle Registration
Tel. Office
Vehicle Registration
File No.
Owner (if driver is not the owner)
File No.
Owner (if driver is not the owner)
A d d re s s
Postal code
Tel. Home
Tel. Home
M a ke o f v e hicle
City
A d d re s s
Tel. Office
Postal code
Ye a r
M a ke o f v e hicle
Serial Number
City
Tel. Home
Tel. Office
Ye a r
Serial Number
L ice nce P la te
E x p iry D a te
Insurance Certificate
L ice nce P la te
Insurance Certificate
Insurance Company
P o licy N o.
E x p iry D a te
E x p iry Date
Insurance Company
P o licy N o.
E x p iry Date
Family Name of Insured
First Name
Family Name of Insured
First Name
A d d re s s
C ity
A d d re s s
C ity
Make of insured vehicle
Year
Make of insured vehicle
Year
A ge nt
Te l.
A ge nt
Te l.
Description of damages
to vehicle A
and comments
Show
initial point of
impact with an
arrow
Sketch of accident
Draw streets or roads; show and identify direction of vehicles A and B
and position at impact; traffic signals.
Show
initial point of
impact with an
arrow
Motorcycle
Motorcycle
Car
Car
Truck and other
Truck and other
Signature of driver A
Do not alter report in any way after it has been signed by both drivers and copies have been separated.
Signature of driver B
Description of damages
to vehicle B
and comments