Vehicle Damage Report Form
A Vehicle damage report form provides detailed information on the damage caused to a vehicle. This report form helps to make assessment of density of damage and loss to concerned company/department. This form also works as a base for insurance cover claim.
Sample Vehicle Damage Report Form
General Information
Title of Company/Organization_______________ Registration Number__________
Address_____________ Phone__________ Email_________ Fax___________
Report prepared by_____________ Designation_________ Phone_________
Damage Report Information
Type of Vehicle Damaged___________
Date of damage incident/accident____/____/____ Location of damage__________________
Vehicle License Number_________
Driver: Name_________ Driving License Number____________
Nature of Damage__________
Brief Description of Damage____________
Is the damage: Minor/Major______________
Any casualty of human life_______________
Description of Injuries___________________
Medical Treatment for Injuries____________
Person involved in damage________________
Activities of the above person while damage__________
Witnesses______________________________________
Is the vehicle insured, if yes provide details of insurance cover_______________
Name of Insurance Company____________
Cost of Damage_______________
Any Police complaint filed, if yes than provide details___________________
Signature______________ Date___/___/___
Report Submitted to____________ Signature of Recipient___________
Category: Report Forms
