Oregon Dmv Accident Report Template

Oregon Dmv Accident Report Template

The Oregon DMV Accident Report form is a document that drivers must submit following a traffic crash under certain conditions, such as when damage to a vehicle or property exceeds $2500, injury is involved, death occurs, or a vehicle is towed due to damage. It's essential to complete and file this report within 72 hours of the accident to comply with Oregon law and avoid possible suspension of driving privileges. Providing detailed information is crucial for insurance verification and to keep driving records updated.

Prepare Form Here

In the wake of an automotive mishap within Oregon's jurisdiction, the procedural requisites encapsulated in the Oregon Traffic Crash and Insurance Report form stand as a critical step for those involved. This comprehensive form serves a dual purpose: it is not only instrumental in documenting the incident for the Department of Motor Vehicles (DMV) but also plays a pivotal role in the insurance claim process. Mandated for any driver whose situation meets specific criteria—such as vehicular damage exceeding $2500, any instance of injury, death, or if a vehicle is towed due to damages—the form must be submitted within 72 hours post-collision to avert potential suspension of driving privileges. It is noteworthy that this requirement holds irrespective of the driver's residency status or if a police report has already been filed. The form is meticulously structured to capture an array of details spanning from the crash specifics, vehicle and driver information, insurance details, to a narrative section where the incident is described. Additionally, it encompasses sections addressing total vehicle loss, underscoring the protocol for vehicles deemed "totaled" as per Oregon law. Failure to furnish complete and accurate information may not only impede the DMV process but also trigger a notice of suspension, thereby emphasizing the importance of this document in navigating the post-accident procedural landscape.

Preview - Oregon Dmv Accident Report Form

OREGON TRAFFIC C
2//,6,21
AND INSURANCE REPORT
Tear this sheet off your report, read and carefully follow the directions.
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If you are not able to file D UHSRUW within 72 hours RI WKH FROOLVLRQ, submit RQH as soon as possible. If you GR QRW ILOH D
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'09HYHQ LI ODZ HQIRUFHPHQW ILOHV D SROLFH UHSRUW When required to report, \RX PXVW ILOH D UHSRUW HYHQ LI
\RX DUHOLFHQVHG LQDQRWKHU VWDWH RU \RX DUH QRW DQ 2UHJRQ UHVLGHQW DMV does not determine fault in a cROOLVLRQ,
but ZH DUH UHTXLUHG E\ ODZ WR post the cROOLVLRQ to the driving record of drivers required to report If you have
questions, please call WKH DMV Crash Reporting Unit at (503) 945-5098.
INSTRUCTIONS
PRINT OR TYPE ALL INFORMATION. (Use black or dark blue ink and press firmly.)
• Complete both sides of the form.
• If additional vehicles were involved in the cROOLVLRQ, complete the attached Supplemental Report (Form 735-32B)
Or, on a blank piece of paper, write all the information as requested in Section 4 — the “Other Vehicle” Section.
• DMV will verify the insurance information \RXsubmit. '09PD\VXVSHQG\RXUGULYLQJSULYLOHJHVLI\RXGRQRWFRPSOHWH
WKHLQVXUDQFHVHFWLRQ
SECTION 1
DATE, LOCATION AND TIME — Clearly identify the date, location and time of the cROOLVLRQ. ThLV LQIRUPDWLRQ LV FULWLFDOIRU
processing your report. If you GRQWNQRZthe county, contact any local law enforcement agency for KHOS
SECTION 2
Your vehicle is Vehicle #1. Complete ALL fields. :ULWH \RXU Lnsurance company name (not agent), policy
number, and Yehicle identification number (VIN). '09 PD\ VXVSHQG \RXU GULYLQJ SULYLOHJHV LI \RX IDLO WR JLYH FRPSOHWH
LQVXUDQFHDQGYHKLFOHLQIRUPDWLRQ
SECTION 3
&KHFNDOOVWDWHPHQWVWKDWDSSO\ PrincipDl purpose of driving and being paid to drive does not LQFOXGH driving to a destination to
perform a service. PropertyLncludes, but is not limited to, fixed or real property, landscaping, signs, parked vehicles, and
animals.
COMMERCIAL MOTOR VEHICLE OPERATORS: In addition to this report, Oregon Administrative Rule requires that Form
735-9229, Motor Carrier CROOLVLRQ Report
,
MUST be filed within 30 days of a commercial motor vehicle cROOLVLRQ when there is
a FATALITY, INJURY (requiring treatment away from the scene), or when a vehicle is TOWED from the scene because of
disabling damage. Form 735-9229 (attached on back) MUST be submitted with Oregon Traffic CROOLVLRQ and Insurance Report
(Form 735-32) to DMV.
You may file the Motor Carrier CROOLVLRQ Report RQOLQHat: www.oregontruckingonline.com/cf/MCAD/pubMetaEntry/accidentRpt/
SECTION 4
OTHER VEHICLE (# 2) — Completion of this information will help DMV match all drivers cROOLVLRQ reports more
efficiently. If additional vehicles were involved in the cROOLVLRQ, complete attached Supplemental Report (Form 735-32B).
SECTION 5
DESCRIPTION AND SIGNATURE — Describe what happened. It is important for you to sign and date the form.
COMPLETING AND FILING REPORT
HOW TO SUBMIT A REPORT TO DMV:
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• Fax to 503-945-5267
• Mail to DMV Crash Reporting Unit 1905 Lana Ave NE, Salem, Oregon 97314
• Deliver to a DMV ILHOGoffice
Keep a copy of the report and documentation that shows when you submitted your report to Oregon DMV. Under ORS
802.220(5), DMV is not authorized to provide you with a copy of the report that you file. If submitting by:
• Fax, many fax machines provide the option to generate a fax confirmation report. Save that report.
• DMV Iield Rffice, request and save that receipt.
PURSUANT TO OREGON INSURANCE LAW, AN INSURANCE COMPANY CANNOT REQUIRE REPAIRS BE MADE TO A
MOTOR VEHICLE BY A PARTICULAR PERSON OR REPAIR SHOP.
735-32 (-2)
STK# 300009
INSTRUCTIONS
TOTALED VEHICLE NOTICE
DEFINITIONS AND INSTRUCTIONS FOR TOTALED VEHICLES
IF YOUR C2//,6,21 HAS RESULTED IN A “TOTALED” VEHICLE, YOU ARE REQUIRED BY
LAW TO FOLLOW APPROPRIATE INSTRUCTIONS IN THIS NOTICE.
DEFINITION OF “TOTALED” VEHICLE
“Totaled Vehicle” or “Totaled” as defined in Oregon law (ORS 801.527) means:
• A vehicle that is declared a total loss by an insurer who is obligated to cover the loss or a vehicle that the insurer
takes possession of or title to.
• A vehicle that has sustained damage that is not covered by an insurer and the estimated cost to repair the vehicle
is equal to at least 80% of the retail market value prior to the damage. “Retail market value” is defined as the
amount shown in publications used by financial institutions (banks or lenders) in this state.
• A vehicle that is stolen, if it is not recovered within 30 days of theft and the loss is not covered by an insurer.
In this
situation, you must notify DMV within 60 days of the theft.
H
FOLLOW THESE INSTRUCTIONS IF YOUR VEHICLE IS TOTALED
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If your vehicle is totaled, in addition to completing the cROOLVLRQ report, follow the instruction that is applicable to
your case. Either:
1. SURRENDER the title to the insurer if the damage is covered by an insurer who declares the vehicle to be a
“total loss,” and the insurer takes possession of the vehicle; or
2. SURRENDER the title to DMV and apply for salvage title if the damage is covered by an insurer who declares
the vehicle to be a “total loss,” but you keep possession of the vehicle; or
3. SURRENDER the title to DMV and apply for salvage title if the damage was not covered by an insurer and the
estimated cost of repair is at least 80% of the retail market value of the vehicle before the damage; or
4. NOTIFY DMV that your vehicle has been totaled if, for some reason, you are unable to obtain the title for
surrender. You must provide DMV with a signed statement which includes:
• A description of the vehicle which includes the year model, make, plate number and vehicle identification
number.
• A statement indicating the vehicle has been totaled.
• A statement that you are unable to obtain the title and why.
DO NOT SUBMIT THE TITLE WITH THE C2//,6,21 REPORT. You can obtain the Application
for Salvage Title )RUP  from any DMV office, by calling (503) 945-5000, or
on-line at www.oregondmv.com. Application instructions and fee information are on the back of )orm
735-229.
NOTE: It is a Class A misdemeanor with a penalty of imprisonment and/or fine if you fail to comply with the above
requirements. (ORS 819.012)
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OREGON TRAFFIC C
2//,6,21
AND INSURANCE REPORT
COMPLETE BOTH SIDES
Complete this form if the traffic cROOLVLRQ ZDVFDXVHGE\WKHPRWLRQRIDYHKLFOHRULWVORDGand meets at least one of the reporting
requirements RQWKHIURQWSDJHRIWKLVIRUP. '09PD\VXVSHQG\RXUGULYLQJSULYLOHJHVLI\RXIDLOWRUHSRUWZKHQUHTXLUHG. Call 503-945-5098
SECTION 1
DMV USE ONLY
TIME OF DAY
COUNTY
AM
PM
ALIR
INS CO
M T W TH F
S SN
DAY OF WEEK
:
LI\RXKDYHTXHVWLRQVRUQHHG KHOSZLWK completing the report.
C2//,6,21 DATE00''<<
MILE POST
ROAD ON WHICH C2//,6,21 OCCURRED (Name of street, road or route)
NAME OF NEAREST INTERSECTING ROAD
WITHIN FEET
NS E W
NEAR MILES
N S E W
NAME OF NEAREST CITY / TOWN
WITHIN FEET
N S E W
NEAR MILES
N S
E W
TYPE OF
&2//,6,21
-The cROOLVLRQ involved one or more of the following:

Mark all that apply)
Two vehicles ATV / Snowmobile Parked vehicle
More than two vehicles
Fatality
Motorcycle
Motor Home / RV
Motorized Scooter
Overturned vehicleUROORYHU
Animal
Bicycle
Pedestrian
Personal (assisted)
mobility device
Train
Fixed object / property
Other ____________________
SECTION 2
(YOUR INFORMATION)
Complete ALL fields. '09PD\VXVSHQG\RXUGULYLQJSULYLOHJHVLI\RXIDLOWRJLYHFRPSOHWHLQIRUPDWLRQ
DRIVER’S LAST NAME
FIRST NAME
MIDDLE NAME
DRIVER’S LICENSE NUMBER STATE DATE OF BIRTH00''<<<< GENDER
M F X
DRIVER’S RESIDENCE ADDRESS
CITY STATE ZIP CODE
CHECK BOX
IF ADDRESS
CHANGE
MAILING ADDRESS (IF DIFFERENT THAN RESIDENCE)
CITY STATE ZIP CODE
VEHICLE OWNER’S NAME AND ADDRESS
CITY STATE ZIP CODE
SAME
RENTAL?
CITY STATE ZIP CODE
STATE
VEHICLE PLATE NUMBER YEAR MAKE & MODEL
IF ADDITIONAL VEHICLES WERE INVOLVED IN THE C2//,6,21, USE ATTACHED SUPPLEMENTAL REPORT (Form 735-32B).
SECTION 3SECTION 4 (OTHER VEHICLE # 2)
Damage to your vehicle was more than $2500.
statements
Check all
Damage to SURSHUW\RWKHUWKDQDYHKLFOHLQYROYHGLQWKHFROOLVLRQLVRYHU$2500.
that apply:
Your vehicle was towed from the scene as a result of damages.
You or passengers in your vehicle were injuredQRPDWWHUKRZPLQRU .
<RXUYHKLFOHZDVSDUNHG
The cROOLVLRQoccurred while you were driving your employer’s vehicle.
You were driving on your job and being paid for the principal purpose of driving.
You were being paid to drive and/or deliver persons or property.
You were operating a governmentowned vehicle marked for transporting mail in accordance with government rules.
You were operating an authorized emergency vehicle.
The cROOLVLRQ occurred in a work or maintenance zone. ORS 811.230
A police officer came to the scene.
Name of police department: __________________________
City County State Police
You were operating a commercial motor vehicle requiring you to have a commercial driver license.
You were transporting hazardous materialV.
A citation was issued to you. The citation wasIRU: BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
DRIVER’S NAME (LAST, FIRST, MIDDLE)
DRIVER’S LICENSE NUMBER
STATE DATE OF BIRTH GENDER
M F
DRIVER’S ADDRESS CITY STATE ZIP CODE
VEHICLE OWNER’S NAME AND ADDRESS CITY STATE ZIP CODE
SAME
INSURANCE COMPANY NAME (NOT AGENT) AND ADDRESS
POLICY NUMBER VEHICLE IDENTIFICATION NUMBER STATE VEHICLE PLATE NUMBER YEAR MAKE & MODEL
SECTION 5
2
DESCRIBE WHAT HAPPENED: (IF MORE SPACE IS NEEDED, SUBMIT ADDITIONAL PAGE)
I certify all information given on this report is true and accurate to the best of my knowledge.
SIGNATURE OF PERSON MAKING REPORT
IF NOT DRIVER’S SIGNATURE, STATE RELATIONSHIP
PRINTED NAME OF PERSON MAKING REPORT DAYTIME PHONE # DATE SIGNED
( )
–
REASON DRIVER IS UNABLE TO SIGN REPORT &217$&7PHONE NUMBER
( )
–
735-32 (-2)
COMPLETE THE OTHER SIDE OF THIS PAGE
STK# 300009
DMV COPY
X
X
INSURANCE COMPANY NAME (NOT AGENT) AND ADDRESS
POLICY NUMBER
VEHICLE IDENTIFICATION NUMBER9,1
Reset Form
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If this cROOLVLRQ involved a pedestrian or
bicyclist, complete the following:
WITNESS INFORMATION:
PEDESTRIAN NAME BICYCLIST NAME
Pedestrian or bicyclist was going:
OCCUPANT INJURY AND SAFETY EQUIPMENT IN<2859(+,&/(
WRITE one of the codes (1–5) in column D
WRITE M, F or X in column A
INJURY CODE FOR OCCUPANTSSAFETY EQUIPMENT CODES
WRITE one of the codes (0–10) in column C
0
1
2
3
4
5
6
7
8
9
No seat belt available
Seat belt available but NOT used
Seat belt available and in use
Child restraint device available but NOT used
Child restraint device in use
Child restraint device not available
Helmet NOT in use
Helmet in use
Air bag deployed
Air bag available - NOT deployed
Air bag NOT available10
1
2
3
4
5
ALONG OR ACROSS:
(name of street, road or route)
6WDUWLQJIrom:
To:
EXAMPLE: (From: NE corner To: SE corner (or) From: East side To: West side, etc.)
GENDER CODE
Gender and age of pedestrian / bicyclist:
M F
X
Age: _____
SEAT
3RVVLEOH
Fatal
OCCUPANTS NAMES
(your vehicle)
No apparent injury
POSITION
Suspected Serious
6XVSHFWHG0LQRU
(or none noted)
DRIVER
Pedestrian / bicyclist action: (mark one)
FRONT
CENTER
FRONT
RIGHT
MIDDLE
*
LEFT
MIDDLE
*
CENTER
MIDDLE
*
RIGHT
REAR
LEFT
REAR
CENTER
REAR
RIGHT
Use only for vehicles with middle row of seats (i.e., vans, SUVs, etc.)
*
Diagram
Number each vehicle:
(name of street,
road or route)
Show path by:
X
Show pedestrian/bicyclist by:
Show railroad tracks by:
Show fixed object by:
X
YOU INTENDED TO...
YOUR VEHICLE7<3(
WEATHER CONDITIONS
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ROAD SURFACE
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On: ____________________
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OTHER DRIVER WAS HEADED
On: ____________________
(name of street, road or route)
Vehicle Damage,PSDFW3RLQWV
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Suspected Serious: severe laceration,broken
or distorted limb, crush injury, significant
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Crossing not at intersection or crosswalk
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Other
VSHFLI\_________________________
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YOU WERE HEADED
SUPPLEMENTAL REPORT
OREGON TRAFFIC
&2//,6,21
Supplemental for more than two drivers involved in the cROOLVLRQ.
Attach this form to your OREGON TRAFFIC C
2//,6,21
AND INSURANCE REPORT.
TIME OF DAY COUNTY
M T W F AM
S SN
DO NOT WRITE
PM
MILE POST
ROAD ON WHICH C2//,6,21 OCCURRED (Name of street, road or route)
IN THIS SPACE
INSURANCE COMPANY NAME (NOT AGEN7) POLICY NUMBER
VEHICLE
#3
VEHICLE IDENTIFICATION NUMBER9,1 VEHICLE PLATE NUMBER STATE YEAR MAKE & MODEL
OTHER DRIVER’S FULL NAME (LAST, FIRST, MIDDLE) DRIVER’S LICENSE NUMBER STATE DATE OF BIRTH GENDER
M F X
DRIVER’S ADDRESS CITY STATE ZIP CODE
VEHICLE OWNER’S NAME AND ADDRESS CITY STATE ZIP CODE
SAME
INSURANCE COMPANY NAME (NOT AGEN7) POLICY NUMBER
VEHICLE
#4
VEHICLE IDENTIFICATION NUMBER9,1 VEHICLE PLATE NUMBER STATE YEAR MAKE & MODEL
OTHER DRIVER’S FULL NAME (LAST, FIRST, MIDDLE) DRIVER’S LICENSE NUMBER STATE DATE OF BIRTH
GENDER
M F X
DRIVER’S ADDRESS CITY STATE ZIP CODE
VEHICLE OWNER’S NAME AND ADDRESS CITY STATE ZIP CODE
SAME
INSURANCE COMPANY NAME (NOT AGEN7) POLICY NUMBER
VEHICLE
#5
VEHICLE IDENTIFICATION NUMBER9,1 VEHICLE PLATE NUMBER STATE YEAR MAKE & MODEL
OTHER DRIVER’S FULL NAME (LAST, FIRST, MIDDLE) DRIVER’S LICENSE NUMBER STATE DATE OF BIRTH GENDER
M F X
DRIVER’S ADDRESS CITY STATE ZIP CODE
VEHICLE OWNER’S NAME AND ADDRESS CITY STATE ZIP CODE
SAME
INSURANCE COMPANY NAME (NOT AGEN7) POLICY NUMBER
VEHICLE
#6
VEHICLE IDENTIFICATION NUMBER9,1 VEHICLE PLATE NUMBER STATE YEAR MAKE & MODEL
OTHER DRIVER’S FULL NAME (LAST, FIRST, MIDDLE) DRIVER’S LICENSE NUMBER STATE DATE OF BIRTH GENDER
M F X
DRIVER’S ADDRESS CITY STATE ZIP CODE
VEHICLE OWNER’S NAME AND ADDRESS CITY STATE ZIP CODE
SAME
INSURANCE COMPANY NAME (NOT AGEN7) POLICY NUMBER
VEHICLE
#7
VEHICLE IDENTIFICATION NUMBER9,1 VEHICLE PLATE NUMBER STATE YEAR MAKE & MODEL
OTHER DRIVER’S FULL NAME (LAST, FIRST, MIDDLE) DRIVER’S LICENSE NUMBER STATE DATE OF BIRTH GENDER
M F X
DRIVER’S ADDRESS CITY STATE ZIP CODE
VEHICLE OWNER’S NAME AND ADDRESS CITY STATE ZIP CODE
SAME
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735-32B (-2)
SUPPLEMENTAL REPORT – USE IF MORE THAN TWO VEHICLES
CRASH ANALYSIS & REPORTING UNIT
MOTOR CARRIER C2//,6,21 REPORT
OREGON DEPARTMENT OF TRANSPORTATION
POLICY, DATA & ANALYSIS DIVISION
(For CMV Drivers Only)
55 &$3,72/67NE 06
SALEM OR 97301
(0$,/2'27&$5&09&UDVK6XSSRUW#RGRWRUHJRQJRY
TELEPHONE 503-986-3507
FAX 503-986-3592
INSTRUCTIONS: IF YOU CHECKED A BOX UNDER THE QUALIFYING VEHICLE COLUMN AND A BOX UNDER THE CRITERIA COLUMN, COMPLETE
THE MOTOR CARRIER C2//,6,21 REPORT SUBMIT TO THE ADDRESS SHOWN ABOVE25 86(7+( /,1.%(/2: 7268%0,7 21/,1(.
IF YOU HAVE ANY QUESTIONS REGARDING FILLING OUT THE MOTOR CARRIER C2//,6,21 REPORT, PLEASE CALL (503) 986-3507.
www.oregontruckingonline.com/cf/MCAD/pubMetaEntry/accidentRpt/
QUALIFYING VEHICLE
COMMERCIAL TRUCK (GVWR OVER 10,000 LBS OR ACTUAL WT AT
TIME OF C2//,6,21 EVEN IF GVWR IS SET UNDER 10,000 LBS)
HAZARDOUS MATERIAL PLACARD
COMMERCIAL BUS (DESIGNED FOR 8 OR MORE PASSENGERS)
FARM TRUCK INTERSTATE (OVER 10,000 LBS.)
FARM TRUCK FOR-HIRE (4 OR MORE AXLES)
FARM TRUCK TOWING TRIPLE TRAILERS
FARM TRUCK (OVER 80,000 LBS.)
CRITERIA
ANY PERSON SUSTAINING A FATALITY (WITHIN 30 DAYS OF THE
C2//,6,21)
ANY PERSON SUSTAINING INJURIES REQUIRING TREATMENT AWAY
FROM THE SCENE
ANY VEHICLE INCURRING DISABLING DAMAGE REQUIRING
REMOVAL FROM THE SCENE BY A TOW TRUCK OR ANOTHER
MOTOR VEHICLE
MOTOR CARRIER NAME
US DOT NUMBER
AUTHORITY/FILE NUMBER
ADDRESS CITY STATE ZIP CODE
DRIVER INFORMATION
DRIVER NAME (LAST, FIRST, MIDDLE) DATE OF BIRTH
CDL / DL NUMBER STATE EXPIRATION DATE OF MEDICAL CERTIFICATELICENSE CLASS
LENGTH OF EMPLOYMENT
YEARS MONTHS
MDA B C
COMPLETE THE FOLLOWING TWO QUESTIONS AS IF DOING A RECAP OF HOURS IN TIME DOCUMENTS AT TIME OF THE C2//,6,21.
AT TIME OF THE C2//,6,21 TOTAL
HOURS DRIVING SINCE LAST OFF-DUTY
PERIOD.
TOTAL HOURS ON DUTY DURING THE PREVIOUS
(FILL OUT ONE ONLY, BASED ON TIME DOCUMENTS)
7 CONSECUTIVE DAYS ____________
8 CONSECUTIVE DAYS ____________
DOES YOUR DRIVER HAVE A MEDICAL WAIVER
YES NO
TYPE OF WAIVER (SIGHT, DIABETES, AMPUTEE, ETC.)
DRIVER INJURY INFORMATION
RELIEF DRIVER INJUREDRELIEF DRIVER KILLED TOTAL NUMBER OF PASSENGERSYOUR DRIVER INJURED
_____KILLED _____ INJURED
YOUR DRIVER KILLED
YES
NO
YES NO YES NO YES NO
OTHER DRIVER INJURY INFORMATION
TOTAL NUMBER OF PEDESTRIANS
_____KILLED _____ INJURED
TOTAL NUMBER OF BICYCLISTS
_____KILLED _____ INJURED
OTHER MOTOR CARRIER INFORMATION
(IF 2 OR MORE MOTOR CARRIERS WERE INVOLVED)
MOTOR CARRIER NAME
VEHICLE LICENSE # AND STATE
DRIVERS NAME
DRIVERS LICENSE # AND STATE
MOTOR CARRIER VEHICLE INFORMATION
YEAR MAKE UNIT NUMBER LICENSE PLATE # & STATE - TRUCK/TRACTOR/BUS TOTAL NO. OF AXLES
INCLUDING TRAILERS
TRACTOR TYPE (SELECT APPROPRIATE TYPE)
1
Triples (tractor with 3 trailers
5
2
Triples (truck with 2 trailers)
6
3
7
Straight truck-full trailer
4
8
Doubles (any)
Standard
9
Tractor/Semi Trailer
Straight Truck
10
7UDFWRU2QO\
11
Saddlemount
Heavy Haul
Bus/Van (8 or more
passenger capacity)
Auto/Pickup
TOTAL NUMBER OF OTHER DRIVERS
_____KILLED _____ INJURED
TOTAL NUMBER OF OTHER PASSENGERS
_____KILLED _____ INJURED
735-9229 (-2)
COMPLETE REVERSE SIDE
SUPPLEMENTAL – MOTOR CARRIER C2//,6,21 REPORT
TRAILER TYPE (CHECK ONE)
VAN FLATBED TANKER CONTAINER POLE/LOG DUMP BELLY-DUMP CAR CARRIER LIVESTOCK
MOBILE HOME TOTER PASSENGER DROP-BOX GARBAGE BULK-HOPPER
MIXER
6$''/(02817
WRECKER FIXED LOAD HEAVY HAUL UTILITY
COMMODITY INFORMATION
COMMODITY BEING TRANSPORTED AT TIME OF C2//,6,21
WAS A HAZARDOUS COMMODITY BEING HAULED
YES NO
WAS HAZARDOUS MATERIAL RELEASED FROM
THE VEHICLE CARGO(NOT A FUEL RELEASE)
YES NO
HAZARD CLASS
C2//,6,21 INFORMATION
LOCATION OF C2//,6,21 (NEAREST CITY OR TOWN) HIGHWAY AND MILEPOINT/STREET/COUNTY ROAD DIRECTION OF YOUR VEHICLE (CHECK)
N S E W
DATE OF C2//,6,21
TIME
AM
PM
DAY OF THE WEEK (CHECK ONE)
MON TUES WED THU FRI SAT SUN
CONDITIONS AT TIME OF C2//,6,21
WEATHER
(CHECK ONE)
1. CLEAR 2. RAIN 3. SNOW
4. CLOUDY 5. SLEET 6. FOG 7. OTHER
ROAD SURFACE
(CHECK ONE)
1. DRY 2. WET 3.SNOW
4.IC( 5. OTHER
LIGHT CONDITION
(CHECK ONE)
1. DAY 2. DAWN 3. DUSK
4. ARTIFICIAL LIGHTS
5. DARK 6. OTHER
DESCRIBE WHAT HAPPENED BY CHECKING ALL BOXES THAT APPLY. YOUR VEHICLE IS ALWAYS NO.1. IF OTHER VEHICLES WERE INVOLVED, COMPLETE
COLUMNS 2 & 3 TO CORRESPOND TO THE ACTIONS OF THE SAME NUMBERED VEHICLES LISTED ABOVE UNDER "OTHER DRIVER INFORMATION".
VEHICLES
1 2 3
ACTION VEHICLES
1 2 3
ACTION VEHICLES
1 2 3
ACTION
SLOWING - STOPPING
STOPPED
REAR-END
BACKING
MAKING RIGHT TURN
MAKING LEFT TURN
MAKING U TURN
PROCEEDING STRAIGHT
INTERSECTION
ENTERING TRAFFIC
(FROM SHOULDER,
MEDIAN, PARKING STRIP OR PRIVATE DRIVE)
PASSING
CHANGING LANES
SIDESWIPE
HEAD-ON
SKIDDING
VEHICLE OUT OF CONTROL
ROLL-AWAY
CONTROLLED RR CROSSING
UNCONTROLLED RR CROSSING
RAN OFF ROAD
JACKKNIFE
OVERTURN
SEPARATION OF UNITS
FIRE
EXPLOSION
CARGO SHIFT
CARGO SPILL (HAZARDOUS)
CARGO SPILL (NON-HAZARDOUS)
OTHER (DEER, GUARDRAIL, ETC)
DID YOUR VEHICLE STRIKE A PARKED VEHICLE WAS YOUR PARKED VEHICLE STRUCK BY ANOTHER VEHICLE
YES NO YES NO
DESCRIPTION OF C2//,6,21 (BY CARRIER OR DRIVER)
NAME AND TITLE OF PERSON SIGNING REPORT TELEPHONE NUMBER(S)
SIGNATURE I CERTIFY THE INFORMATION PROVIDED IS TRUE AND ACCURATE
X
DATE

File Features

Fact Detail
Reportable Conditions Drivers must report if damage to any vehicle or property exceeds $2500, there's any injury, death, or if a vehicle needs to be towed due to damages.
Timeframe for Filing The report must be filed within 72 hours of the crash.
Failure to Report Consequences Not reporting can lead to the suspension of driving privileges.
Filing Requirement Despite Police Report A driver must file a report even if a police report is filed.
Non-Oregon Residents Out-of-state licensees must also file a report for incidents occurring in Oregon.
DMV's Role DMV does not assign fault but will record the crash on the drivers' records who are required to report.
Insurance Verification DMV verifies insurance information submitted, and incomplete information can result in driving privileges suspension.
Instruction for Totaled Vehicles If the crash resulted in a totaled vehicle, specific instructions provided in the form must be followed according to Oregon law (ORS 801.527).
Commercial Vehicle Operators Operators of commercial vehicles are required to file an additional form, Form 735-9229, within 30 days if the crash involves fatalities, injuries, or disabling damages.
Submission Methods Reports can be submitted via email, fax, mail, or in person at a DMV office.
Governing Law Oregon Revised Statutes (ORS) 802.220(5) and ORS 801.527 govern the reporting requirements and definitions for a totaled vehicle, respectively.

Detailed Steps for Using Oregon Dmv Accident Report

After being involved in a traffic accident in Oregon, if certain conditions apply such as significant damage or injuries, you are required to fill out the Oregon DMV Accident Report form. This form must be completed and submitted within 72 hours of the accident to avoid potential penalties like the suspension of your driving privileges. Here's a step-by-step guide to help you accurately complete the form:

  1. Begin by reading all the instructions on the form carefully to understand what details are necessary.
  2. In SECTION 1, record the crash date, day of the week, time of day, and county. Also, include the crash reference number if known.
  3. Mark the appropriate checkboxes that describe the type of crash under the "TYPE OF CRASH" subsection in SECTION 1.
  4. In SECTION 2, enter your vehicle information as Vehicle #1. Fill in all fields including your name, driver’s license number, address, and insurance details like company name, policy number, and your vehicle's identification number (VIN).
  5. For SECTION 3, check all statements that apply to your situation, such as damage exceeding $2500, involvement of any injuries or deaths, or if the vehicle was towed due to damage.
  6. If there was another vehicle involved, fill out their details in SECTION 4. If more than one other vehicle was involved, use the Supplemental Report (Form 735-32B) provided for additional vehicles.
  7. In SECTION 5, describe what happened during the crash. Be concise but provide enough detail to give a clear picture of the incident.
  8. Sign and date the form in the provided field for SECTION 5. If you are not the driver or if the driver is unable to sign, indicate the relationship to the driver and the reason for the absence of the driver's signature.
  9. Check the weather conditions and provide information about your intended action and vehicle type in the additional sections provided on the backside of the form.
  10. Finally, submit the completed form via email, fax, mail, or in person at a DMV office. Make sure to keep a copy for your records along with proof of submission, especially if sending by email or fax.

It’s crucial to supply all the required information accurately and completely to avoid any complications with your driving privileges. If you have any questions or need further assistance, contact the DMV Crash Reporting Unit at the provided phone number.

Important Points on This Form

What circumstances require me to file an Oregon Traffic Crash and Insurance Report?

You must file a report if you are involved in a traffic crash that meets any of the following conditions:

  1. Damage to your vehicle is over $2,500.
  2. Damage to any one person's property over $2,500.
  3. Any injury, no matter how minor.
  4. Any vehicle is towed from the scene as a result of damages.
  5. Death resulting from the crash.
Oregon law mandates that these reports be filed within 72 hours of the accident.

What happens if I don't file the report within 72 hours?

If you're unable to file the report within the 72-hour window, you should submit it as soon as possible. Failure to report the crash to the DMV may lead to the suspension of your driving privileges.

If the police file a report, am I still required to file one with the DMV?

Yes, even if the police department files a report, you are still required to submit your own Oregon Traffic Crash and Insurance Report to the DMV.

Does completing this form assign fault for the crash?

No, the DMV does not use this form to determine who was at fault in the crash. However, the DMV will post the crash to the driving records of the drivers required to report, unless the involved vehicle was parked.

What information is necessary to complete the report?

You need to fill out the form with black or dark blue ink, pressing firmly, and complete both sides. Specify the date, location, and time of the crash, vehicle identification, your insurance details, and describe the crash circumstances. Be prepared to provide:

  • Insurance company name (not agent), policy number, and VIN for your vehicle.
  • Details about the other vehicle(s) if involved, using the Supplemental Report (Form 735-32B) for additional vehicles.

What are some important reminders when completing the Insurance section?

It is crucial to complete the insurance section accurately since DMV verifies this information. Failing to provide complete insurance and vehicle information may trigger a Notice of Suspension due to incomplete information. Ensure you report the insurance company name, policy number, and your vehicle’s VIN.

How can I submit the report to the DMV?

You have several submission options, including email ([email protected]), fax (503-945-5267), mail (DMV Crash Reporting Unit, 1905 Lana Ave NE, Salem, Oregon 97314), or in person at a DMV office. Make sure to keep a copy of the report and a document that verifies when you submitted your report to the Oregon DMV.

What should I do if my vehicle is considered "totaled"?

If your vehicle is "totaled," meaning it's considered a total loss by an insurer or the cost to repair it is at least 80% of its retail market value, you must follow specific instructions:

  • Surrender the title to your insurer or DMV, depending on your situation.
  • Notify DMV if unable to obtain the title, with a signed statement including a description of the vehicle and a statement that it has been totaled.
You can obtain the Application for Salvage Title (Form 735-229) for more details on how to proceed.

What are the penalties for failing to comply with the reporting requirements?

Failure to comply with the requirements, such as not reporting a crash or not following the totaled vehicle instructions, can result in a Class A misdemeanor. This could lead to imprisonment, a fine, or both.

Common mistakes

When filling out the Oregon DMV Accident Report Form, people often make mistakes that can affect the processing of their report or even lead to further complications. Here's a list of common errors:

  1. Not reporting within the 72-hour window, as required by Oregon law, which can lead to the suspension of driving privileges.
  2. Failing to use black or dark blue ink and pressing firmly, which can make the report hard to read and process.
  3. Forgetting to complete both sides of the form, which leaves out critical information needed by the DMV.
  4. Omitting details about additional vehicles involved, which is necessary for the DMV to have a complete understanding of the accident.
  5. Not providing complete insurance information, leading to possible suspension of driving privileges due to incomplete information.
  6. Inaccurately reporting the principal purpose of driving, which is essential for identifying commercial vehicle operators.
  7. Skipping the description of what happened or not signing the form, both of which are crucial for documenting the accident properly.
  8. Incorrectly handling the reporting for a totaled vehicle, which has specific instructions that must be followed according to Oregon law.
  9. Misunderstanding the definition of property damage, which includes more than just damage to vehicles.

It's also worth mentioning a few more general oversights:

  • Not keeping a copy of the report and documentation of submission, which is important for your records.
  • Omitting weather and road conditions, which can provide context about the accident.
  • Neglecting witness information, which can be invaluable in case of disputes or for further investigation.

Avoiding these mistakes can help ensure your report is complete and processed without unnecessary delay.

Documents used along the form

When handling an accident in Oregon, particularly one that requires you to fill out the Oregon DMV Accident Report form, you might need several other forms and documents to thoroughly document the incident, process claims, or follow legal requirements. Understanding these additional documents can help ensure that all necessary steps are taken in the aftermath of an accident.

  • Police Report: This document is created by the responding officer at the scene of the accident, detailing their observations, statements from those involved, and any citations issued.
  • Insurance Policy: Your current insurance policy documents are crucial for filing a claim. They outline coverage, limits, and your responsibilities after an accident.
  • Medical Reports: If injuries occurred, detailed medical reports from treating healthcare professionals will be needed for insurance claims and potential legal proceedings.
  • Vehicle Repair Estimates: Quotes from auto repair shops that describe the damage to your vehicle and the estimated cost for repairs are necessary for insurance claims.
  • Supplemental Report (Form 735-32B): For accidents involving more than two vehicles, this additional DMV form provides a template to document additional vehicles and drivers involved.
  • Motor Carrier Crash Report (Form 735-9229): Required for commercial motor vehicle crashes, this form must be filed alongside the standard DMV accident report under certain conditions.
  • Witness Statements: Written accounts from witnesses can provide additional perspectives on the accident, potentially aiding in insurance claims and legal matters.
  • Photographs of the Accident Scene: Pictures can offer clear evidence of road conditions, vehicle positioning, and damage for insurance and legal analyses.
  • Salvage Title Application (Form 735-229): If your vehicle is declared a total loss, this DMV form is used to apply for a salvage title, documenting that the vehicle has been damaged to the extent that the cost of repair exceeds its value.

Collecting and organizing these documents promptly can streamline the process of dealing with post-accident procedures, from insurance claims to legal considerations. Each piece serves as a component of a comprehensive account of the incident, which can be crucial for resolving disputes and securing appropriate compensation for damages and injuries.

Similar forms

The Vehicle Accident Report Form used in other states is remarkably similar to Oregon's Traffic Crash and Insurance Report form. This document, required in the event of accidents resulting in significant damage, injury, or death, mandates detailed information on the crash circumstances, involved parties, and insurance coverage. Like Oregon's form, state-specific versions also typically set deadlines for submission to avoid penalties, such as the suspension of driving privileges. Both forms aim to facilitate the efficient processing of accident information by state departments and insurance companies, ensuring accountability and aid in the management of post-accident procedures.

The Motor Carrier Crash Report, as referenced for commercial motor vehicle operators in Oregon, bears resemblance to the Oregon DMV Accident Report form, specifically in its requirements for reporting accidents involving commercial vehicles. This form is necessary when commercial vehicle accidents result in fatalities, injuries requiring treatment away from the scene, or significant vehicle damage. It collects detailed information about the crash to comply with state and federal regulations governing commercial transportation. Just like the DMV's Accident Report, the goal is to document the incident thoroughly for legal, insurance, and regulatory purposes.

A Property Damage Report is akin to the sections of the Oregon DMV Accident Report focusing on property damage exceeding a certain monetary threshold. When private or public property is damaged as a result of a vehicular accident, detailed documentation similar to that required by the DMV form is often necessary for insurance claims and legal processes. These reports typically include descriptions of the property damaged, estimates or actual costs of the damage, and information on the involved parties, mirroring the necessary elements outlined in Oregon's accident reporting form for vehicular damage claims.

The Personal Injury Report bears similarities to the injury-related sections of the Oregon Traffic Crash and Insurance Report form. When an accident results in injuries, detailed documentation is required, noting the nature and extent of the injuries, involved parties' information, and circumstances surrounding the incident. This parallels the requirements in Oregon's DMV form that mandates reporting of any injuries, no matter how minor, ensuring that all parties have the necessary documentation for insurance, medical, and legal assistance following an accident.

Dos and Don'ts

Filling out the Oregon DMV Accident Report form is crucial for documenting a traffic crash. It requires clarity, accuracy, and attention to detail. Here are 10 do's and don'ts to guide you through completing this form:

  • Do print or type all information neatly using black or dark blue ink to ensure legibility.
  • Do complete both sides of the form comprehensively, providing detailed information as requested.
  • Do file the report within 72 hours of the crash to comply with Oregon law and avoid potential suspension of your driving privileges.
  • Do accurately record the date, location, and time of the crash as this information is critical for processing your report.
  • Do provide complete insurance information, including the insurance company name, policy number, and vehicle identification number (VIN), to prevent a possible suspension of your driving privileges.
  • Do describe the crash in detail in the description section, ensuring clarity and completeness of your account.
  • Do sign and date the form personally, unless you are incapacitated or physically unable to do so.
  • Do keep a copy of the report and any documentation showing when you submitted your report to the Oregon DMV.
  • Don't leave any fields incomplete, especially those regarding the insurance and vehicle information, as this may result in a Notice of Suspension.
  • Don't forget to complete the section on the principle purpose of driving if applicable, particularly in commercial or work-related incidents.

By following these guidelines, you can ensure that your Oregon DMV Accident Report form is filled out thoroughly and accurately, complying with state requirements and aiding in the smooth processing of your report.

Misconceptions

When it comes to filling out the Oregon DMV Accident Report form, there are several misconceptions that can lead to confusion and mistakes. Understanding these misconceptions is key to ensuring that the report is filled out accurately and in compliance with Oregon law. Here are eight common misconceptions explained:

  • Only Oregon residents need to file this report: Regardless of where you are from, if you are involved in a crash in Oregon that meets the reporting criteria, you must file an Oregon Traffic Crash and Insurance Report. This applies even if you are licensed in another state.
  • You don’t need to file a report if the police did: Even if a police report is filed, drivers involved in a crash are still required to submit their own report to the DMV. This step is mandatory and distinct from any police report.
  • You only need to report if there are injuries: Crashes must be reported not only when there are injuries but also when vehicle damage exceeds $2,500, damage to any one person’s property is over $2,500, or a vehicle is towed from the scene.
  • Fault is determined by the DMV based on the report: The DMV does not determine fault in a crash. The primary purpose of the report is to document the event on the driving records of those required to report, unless the vehicle was parked at the time of the incident.
  • The report can be submitted at any time: Oregon law requires that this report be filed within 72 hours of the crash. If it is not possible to file within this timeframe, it should be submitted as soon as possible to avoid potential penalties.
  • Reporting a crash will automatically result in a suspension of driving privileges: Failing to complete the insurance section correctly might lead to a suspension, but simply reporting a crash does not. It's the failure to report or providing incomplete insurance information that may result in a suspension of your driving privileges.
  • You need to submit a title with the crash report if your vehicle is totaled: If your crash results in a totaled vehicle, you must follow specific instructions regarding the title, which do not include submitting it with the crash report. The title may need to be surrendered to an insurer or the DMQ under different circumstances, but not as part of the crash report submission.
  • Completing the form partially is acceptable if you plan to add details later: The form requires complete information at the time of submission. Failing to provide all the necessary details, especially in the insurance section, can lead to penalties, including the suspension of driving privileges.

Understanding these details can help ensure that anyone involved in a traffic crash in Oregon can accurately complete and submit their report, adhering to state laws and avoiding unnecessary complications.

Key takeaways

When filling out the Oregon DMV Accident Report form, it's crucial to understand the specific requirements and procedures to ensure the report is submitted correctly. Here are four key takeaways to help guide you through the process:

  • The requirement to file a Crash & Insurance Report with the Oregon DMV is triggered under certain conditions, such as when vehicle damage exceeds $2,500, there's any injury regardless of severity, death occurs, or a vehicle is towed from the scene because of damages. This underscores the importance of assessing the situation carefully to determine if reporting is mandatory.
  • Reports must be filed within 72 hours of the accident. This tight deadline highlights the need for prompt action following an accident. If it's not possible to file within this timeframe, it's advised to submit the report as soon as you can. Failing to report an accident to the DMV can lead to suspension of driving privileges, indicating the legal importance of fulfilling this obligation.
  • The form requires detailed information about the accident, including insurance details, which the DMV will verify. Incomplete or incorrect information can lead to a Notice of Suspension. This requirement emphasizes the necessity for thoroughness and accuracy when completing the form, ensuring that all sections are filled out with the correct details.
  • The accident report form provides options for submission, including email, fax, mail, or delivery to a DMV office. Keeping a copy of the report and proof of submission (such as email autoreplies or fax confirmation reports) is crucial as the DMV does not provide copies of filed reports. This process allows for different methods of submission and underscores the need for keeping personal records of the submitted report.

Understanding these key aspects can significantly aid in the correct and timely submission of the Oregon DMV Accident Report form, ensuring compliance with state law while protecting one's driving privileges.

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