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Includes fields for accident date and time, employee and driver identities, licensing and agency data, vehicle specifications, damage descriptions, passengers, estimated repair costs, insurance details, and information on other vehicles and property. Also collects injured parties’ information, witness contacts, police investigation and citation status, collision report compliance, and narrative description of events plus accident location and road/conditions factors.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/vehicle-accident-report-form-p2645/252887/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/vehicle-accident-report-form-p2645/252887.png","ImageObject",442,249,{"name":88,"@type":89},"Noah","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-27","2026-09-13",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",10,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"What key incident details are required in this form?","Question",{"text":109,"@type":110},"The form collects the date and time of the accident, the location (city/county and intersection context), the accident type, and a detailed description of what happened, including road conditions and visibility factors.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"What information must be provided about the involved parties and vehicles?",{"text":114,"@type":110},"It requires state employee and driver identities, license numbers and restrictions, vehicle numbers and vehicle details (year, make, body type), passenger counts, owning agency or owner information for privately owned vehicles, and insurer policy information.",{"name":116,"@type":107,"acceptedAnswer":117},"How are injuries, witnesses, and police actions reported?",{"text":118,"@type":110},"The form includes sections for injured parties (extent of injury, age, and vehicle/pedestrian involvement), witness names and contact information, and whether police investigated, issued citations, the division involved, and whether a collision report form was filed as required by law.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},252887,1789263313,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":73,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":126,"read_time":9},8796095462418,"https://ap-avatar.wpscdn.com/avatar/80000253c1241d02b47?x-image-process=image/resize,m_fixed,w_180,h_180&k=1778826106357471780","INSTRUCTIONS: This report must be mailed* within two working days to the following offices:  \nc Department of Enterprise Services d Safety/Risk Management  \nOffice of Risk Management Office of Reporting Agency  \n1500 Jefferson Street SE /POB 41466 Olympia, Washington 98504-1466  \n*Scanned form can be [e-mailed to desmiriskmanagement@des.wa.gov](e-mailed to desmiriskmanagement@des.wa.gov)  \n\n| Date of Accident (MM/DD/YYYY) |\n| --- |\n| Time 􀂅 AM\u003Cbr>􀂅 PM |\n\n\n| STATE EMPLOYEE | DRIVER | Name |  |  |  |  |  |  |  |  |  |  | Age | Employing Agency |  |  |  |  |  |  |  | Position |  |  |  |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n|  |  | Business Address Zip |  |  |  |  |  |  |  |  | Business Phone |  |  |  | Email |  |  |  |  | Was vehicle being used on 􀂆 Yes\u003Cbr>Official State Business 􀂆 No |  |  |  |  |  |  |  |  |  |  |\n|  |  | Operator’s License No. |  |  |  |  | License Restrictions\u003Cbr>􀂆 Yes 􀂆 No |  |  |  |  | If Yes, Indicate |  |  |  |  |  |  |  | Have you had a previous accident 􀂆 Yes while driving on state business? 􀂆 No |  |  |  |  |  |  |  |  |  |  |\n|  | VEHICLE NO. 1 | License No. |  | Year |  |  | Make |  |  |  |  | Body Type |  |  | Where Located |  |  |  |  | No. of Passengers |  |  |  |  |  |  |  | Est. Repair Cost |  |  |\n|  |  | Owning Agency |  |  |  |  | Describe Damages Fully (Parts, type, and extent of damage) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  |  | If Privately Owned, Name and Address of Owner (If State Owned, Equipment No. Only) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Insurer |  |  |  |  |  |  |  |\n| OTHER VEHICLES |  | Owner Car No. 2 |  |  |  |  |  |  |  | Phone |  |  |  |  | Owner Car No. 3 |  |  |  |  |  |  |  |  |  |  |  | Phone |  |  |  |\n|  |  | Address City Zip |  |  |  |  |  |  |  |  |  |  |  |  | Address City Zip |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  |  | Driver |  |  |  |  |  |  | Age | Phone |  |  |  |  | Driver |  |  |  |  |  |  |  |  | Age |  |  | Phone |  |  |  |\n|  |  | Address City Zip |  |  |  |  |  |  |  |  |  |  |  |  | Address City Zip |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  |  | Driver’s License No. |  |  |  |  |  | Vehicle License No. |  |  |  |  |  |  | Driver’s License No. |  |  |  |  |  |  | Vehicle License No. |  |  |  |  |  |  |  |  |\n|  |  | Vehicle Make |  |  |  | Year |  | Body Type |  |  |  |  |  |  | Vehicle Make |  |  |  | Year |  |  | Body Type |  |  |  |  |  |  |  |  |\n|  |  | Name of Passengers |  |  |  |  |  |  |  |  |  |  |  |  | Name of Passengers |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  |  | Repair Cost | Describe Damage |  |  |  |  |  |  |  |  |  |  |  | Repair Cost |  | Describe Damage |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  |  | Insurance Company |  |  |  |  |  |  |  | Policy No. |  |  |  |  | Insurance Company |  |  |  |  |  |  |  |  |  |  |  | Policy No. |  |  |  |\n| OTHER\u003Cbr>PROPERTY |  | What was Damaged? |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Repair Cost |  |  |  |\n|  |  | Name and Address of Owner City Zip |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Phone |  |  |\n| INJURED PARTIES |  | Name and Address |  |  |  |  |  |  |  |  |  |  |  |  |  | Extent of Injury |  | Age |  |  | Veh. 1 |  |  |  |  | Veh. 2 |  |  | Veh. 3 | Ped. |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| WITNESSES |  | Name Address City Zip |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Phone |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  |  |  |  ","cbCaiaEVrRtM0a0T","https://ap.wps.com/l/cbCaiaEVrRtM0a0T","pdf",331107,"English","# Incident Information\n## Accident Date, Time, Location and Type\n## Accident Details and Narrative\n# Parties, Vehicles, Damage and Costs\n## State Employee and Driver Sections\n## Vehicle and Other Vehicle Details\n## Injured Parties and Witnesses\n# Police and Compliance Information\n## Investigation, Citation and Report Filing","[{\"question\":\"What key incident details are required in this form?\",\"answer\":\"The form collects the date and time of the accident, the location (city/county and intersection context), the accident type, and a detailed description of what happened, including road conditions and visibility factors.\"},{\"question\":\"What information must be provided about the involved parties and vehicles?\",\"answer\":\"It requires state employee and driver identities, license numbers and restrictions, vehicle numbers and vehicle details (year, make, body type), passenger counts, owning agency or owner information for privately owned vehicles, and insurer policy information.\"},{\"question\":\"How are injuries, witnesses, and police actions reported?\",\"answer\":\"The form includes sections for injured parties (extent of injury, age, and vehicle/pedestrian involvement), witness names and contact information, and whether police investigated, issued citations, the division involved, and whether a collision report form was filed as required by law.\"}]","Vehicle Accident Report Form - P2645 | PDF"]