Road accident record and exchange of details (Ireland)

When to use this document

• ·Another car hit yours at a junction in Ireland and you need to swap details with the driver.
• ·The other driver insists the crash was your fault and you want your own account written down.
• ·You had a minor bump in a car park and want a record for your insurer.
• ·You want to note down the details of a road accident while you still remember them.

What you fill in

The details the document asks for.

• ·Date of the incident
• ·Time
• ·Location
• ·Road and weather conditions (blank to leave out)
• ·Your name (the driver making this record)
• ·Your address, with Eircode
• ·Town and county (e.g. Ennis, Co. Clare; or Dublin 8)
• ·Phone
• ·Make and model
• ·Registration number
• ·Owner of your vehicle, if not you (blank if you own it)
• ·Insurer
• ·Policy number
• ·Other driver's name
• ·Other driver's address
• ·Other driver's phone (blank if not given)
• ·Other vehicle: make, model and colour
• ·Other vehicle's registration number
• ·Owner of the other vehicle, if not the driver (blank if the same)
• ·Other driver's insurer
• ·Other driver's policy number (blank if not given)
• ·What happened, step by step (facts only)
• ·Description of the damage
• ·Damage to the other vehicle (blank to leave out)
• ·Injuries to anyone (blank if none)
• ·Witnesses (names and phone numbers)
• ·Reported to An Garda Síochána?
• ·Garda station and reference (blank if none)
• ·Date

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