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Road accident record and exchange of details (Northern Ireland)
Northern Ireland · in English
€2.00Fill it in online free — pay only to download
30 questions · about 13 min
Made for use in Northern Ireland
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For a driver in Northern Ireland after a collision: one place to write down the other driver’s name, address, vehicle and insurer, the time and place, what happened, the damage and the witnesses, while the details are fresh. Each driver keeps their own record and sends it with the insurance claim. It is not an admission of fault, and it does not replace the report to the police that Article 175 of the Road Traffic (Northern Ireland) Order 1981 requires if anyone else is hurt or you did not give your details at the scene.
- Made for use in Northern Ireland
- Last updated October 29, 2026
- Document in English
Where a UK document reproduces the words of legislation or of a government publication — UK, Scottish or Northern Irish — it contains public sector information licensed under the Open Government Licence v3.0.
Published byDocMuse
When to use this document
- Someone has just driven into the back of your car on a road in Northern Ireland.
- The other driver wants to swap details and you want them written down properly.
- You scraped a parked car and need a record of what happened for your insurer.
- You want one clear note of the crash, the damage and the witnesses while it is fresh.
What you fill in
The details the document asks for.
- Date of the incident
- Time it happened (for example 8:15am)
- Location
- Road, light and weather conditions
- Your full name
- Your address (flat, house number and street)
- Town or city
- Your postcode
- Phone
- Make and model
- Vehicle registration number (number plate)
- Owner of your vehicle, if not you (name and address)
- Insurer
- Policy number
- Other driver's full name
- Other driver's address, with postcode
- Other driver's phone number
- Other vehicle: make, model and colour
- Other vehicle's registration number
- Owner of the other vehicle, if not the driver (name and address)
- Other driver's insurer
- Other driver's policy number
- What happened, step by step (direction, speed, lanes, signals)
- Damage to your vehicle
- Damage to the other vehicle or property
- Injuries (who, and what)
- Witnesses (names and phone numbers)
- Was the accident reported to the police?
- Police reference number
- Date
Common questions
- What does the law in Northern Ireland ask of a driver after a collision?
- To stop and to give your name and address, the owner’s and the vehicle’s registration number to anyone entitled to ask for them. If you did not give them at the scene, or if anyone other than you was injured — even if details were exchanged — report the accident to the Police Service of Northern Ireland forthwith, at a police station or to a police officer (Article 175 of the Road Traffic (Northern Ireland) Order 1981; ‘forthwith’ is its word). Failing to stop or report is an offence. Call 999 if anyone is hurt or there is danger.
- Is it wise to sign the other driver’s account after a crash in Northern Ireland?
- Only if you agree with every word. Keep to the facts: what happened, where and when. Insurers usually ask you not to admit liability or offer to pay at the scene, because it can affect your claim. This record says it is not an admission of fault, and the other driver’s signature on it, if they give one, confirms only the details exchanged.
- What if the other car in the collision is from the Republic of Ireland?
- Take the same details, including the insurer and the policy number, and photograph the other car’s registration plate and any insurance document the driver shows you. Tell your own insurer as soon as you can, even if you do not mean to claim: it deals with claims involving drivers insured in another country. If the other driver has no insurance or drives off, your insurer or the Motor Insurers’ Bureau can say what happens next.
How you can sign this document
- Print it and sign by hand. The signature lines in the document are left blank on purpose — sign on them in ink.
- Sign it yourself with a qualified electronic signature. If you already hold a QES — Evrotrust, B-Trust, StampIT, ZealiD or any qualified provider on the EU Trusted List, on a card, a USB token, in a mobile app or in the cloud — our signing guide explains step by step how to sign this exact file without invalidating it. Step-by-step help, and a way to check it worked
DocMuse sells documents, not legal advice. Acceptance always depends on the recipient's rules and your local law.
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