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construed as an admission of liability.Its purpose is strictly to helpidentify the parties involved in an accident in order to speed up the claim setlement.It should be signed by both driversin any accident taking place in Québec.If there are injuries,even minor ones,call emergency services at once.  \n□ Yes  \n□No  \n\n| Driver's   |  |  |  |\n| --- | --- | --- | --- |\n| licence  \u003Cbr>Fle No.   |  |  |  |\n| Eftective Date   |  | Expiry Date   |  |\n| Family Name  \u003Cbr>First name   |  |  |  |\n| Address   |  | City   |  |\n| Postal Code  \u003Cbr>Tel.Home   |  | TelWork   |  |\n| Vehicle  \u003Cbr>Registration  \u003Cbr>File No.  \u003Cbr>Owner (if driver is not the owner)   |  |  |  |\n| Address   |  | City   |  |\n| Tel.Home  \u003Cbr>Postal Code   |  | Tel.Work   |  |\n| Make of vehicle   |  | Model Year   | No.Cyl.   |\n| Serial Number   |  |  |  |\n| Lcence Plate   |  | Eftective Date   | Expiry Date   |\n| Insurance   |  |  |  |\n| Certificate  \u003Cbr>Insurance Company   |  |  |  |\n| Policy No.   |  | Effective Date   | Expiry Date   |\n| Family Name   |  | First Name   |  |\n| Address   |  | City   |  |\n| Make of insured vehicle   |  | Year   |  |\n| Agent/Broker   |  | Tel.   |  |\n\n| Description of damages  \u003Cbr>and comments   | Show  \u003Cbr>initial point of  \u003Cbr>impact with an  \u003Cbr>arrow.   | Diagram of accident  \u003Cbr>Draw streets or roads;show and identifydirection of vehicles A and B  \u003Cbr>and position at impact;trafic signals.   |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Show  \u003Cbr>initial point of  \u003Cbr>impact with an  \u003Cbr>arrow.   |  | Description of damages  \u003Cbr>and comments   |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Car   |  |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Truck or other   |  |  |\n|  | Tnuck or other   |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n\nDo not alter Report in any way after it has been signed by both drivers and copies have been separated.  \nTHIS DOCUMENT MAY NOT BE REPRODUCED WITHOUT THE PRIOR WRITTEN PERMISSION OF THE GROUPEMENT DES ASSUREURS AUTOMOBILES.  \n4.Property damage other than to vehicles A and B  \n5.Witnesses:names,addresses,tel.numbers.State if passenger(s)in vehicle A or B  \n\n| Driver's   |  |  |  |  |\n| --- | --- | --- | --- | --- |\n| licence  \u003Cbr>File No.   |  |  |  |  |\n| Effective Date   |  | Expiry Date   |  |  |\n| Family Name  \u003Cbr>First name   |  |  |  |  |\n| Address   |  | City   |  |  |\n| Tel.Home  \u003Cbr>Postal Code   |  | Tel.Work   |  |  |\n| Vehicle  \u003Cbr>Registration  \u003Cbr>File No.  \u003Cbr>Owner (if dniver is not the owner)   |  |  |  |  |\n|  |  |  |  |  |\n| Address   |  |  | City   |  |\n| Tel Home  \u003Cbr>Postal Code   |  |  | Tel.Work   |  |\n| Make of vehicle   |  | Model Year  \u003Cbr>No.Cyl   |  |  |\n| Serial Number   |  |  |  |  |\n| Licence Plate   |  | Effective Date   |  | Expiry Date   |\n| Insurance   |  |  |  |  |\n| Certificate  \u003Cbr>Insurance Company   |  |  |  |  |\n| Policy No,   |  | Effective Date   |  | Expiry Date   |\n| Family Name   |  | First Name   |  |  |\n| Address   |  | City   |  |  |\n| Make of insured vehicle   |  | Year   |  |  |\n| Agent/Broker  \u003Cbr>Tel.   |  |  |  |  |\n\nSignature of driver B  \n0 F A UT0 M0 BI LE A C CI D E N T  \nIf someone is inj","cbCaifsi09QNl8Al","https://ap.wps.com/l/cbCaifsi09QNl8Al","pdf",277936,"English","# Joint Report of Automobile Accident\n## What to do if someone is injured\n## Completing the form\n## Driver, vehicle, and insurance sections\n## Damages description and accident diagram\n## Signatures, witness information, and document handling","[{\"question\":\"What is the purpose of completing this joint report?\",\"answer\":\"To help identify the parties involved in an accident and speed up the claim settlement.\"},{\"question\":\"What should you do if someone is injured?\",\"answer\":\"Call emergency services at once (even if the injury is minor), then complete the joint report.\"},{\"question\":\"What happens after the drivers sign the report?\",\"answer\":\"Do not alter the report after it has been signed by both drivers and copies have been separated; keep a copy for several years.\"}]","Joint Report of Automobile Accident - Completion and Signatures | PDF"]