Homepage Fill in Your Minnesota Accident Report Template
Table of Contents

The Minnesota Accident Report form is a crucial document that every driver must complete after being involved in a motor vehicle accident, especially if the incident results in property damage exceeding $1,000 or involves injury or death. This form serves multiple purposes, including aiding in the collection of data to enhance road safety across the state. It requires essential information such as the date, time, and location of the accident, as well as details about the vehicles and individuals involved. Drivers must provide their personal information, including name, address, and driver's license number, alongside their insurance details. The form also prompts users to describe the accident's circumstances and the type of collision that occurred. Additionally, it includes sections for documenting weather conditions, traffic control devices, and any injuries sustained. Timeliness is critical; the report must be submitted to Driver and Vehicle Services within ten days of the accident. Failing to do so may result in legal penalties. Understanding how to accurately fill out this form is vital for drivers to ensure compliance with Minnesota law and to contribute to safer roadways.

Sample - Minnesota Accident Report Form

MINNESOTA MOTOR VEHICLE ACCIDENT REPORT

PS 32001 - 08

The information on this report is used to help build safer roads.

Every driver in a crash involving $1,000 or more in property damage, or injury or death, MUST COMPLETE this form and send it to Driver and Vehicle Services within 10 days.

Failure to provide this information is a misdemeanor under Minnesota Statute 169.09, subdivision 7. See reverse side for address and for data privacy information.

A

B

C

DRIVER’S TRAFFIC ACCIDENT REPORT

E-form available at www.mndriveinfo.org

 

 

 

DO NOT DETACH

 

 

DATE OF

MONTH

DAY

YEAR

DAY OF WEEK

TIME

 

 

TOTAL # OF

 

COUNTY

 

 

NAME OF CITY OR TOWNSHIP

 

 

 

 

T

 

ACCIDENT

 

 

 

 

 

 

 

 

 

 

AM

VEHICLES

 

 

 

 

 

CITY

 

 

 

 

 

I

 

 

 

 

 

 

 

 

 

 

 

 

 

PM

INVOLVED

 

 

 

 

 

TWP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

M

 

ACCIDENT OCCURRED

LOCATION OF ACCIDENT:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E

 

(Choose only one box below

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

and proceed to the right)

ON:

 

 

 

 

 

 

 

 

 

 

 

 

 

AT:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

-

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AT INTERSECTION

 

 

 

 

(Street Name or Road Number)

 

 

 

 

 

 

 

 

(Street Name or Road Number)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

P

 

 

 

 

 

LOCATION OF ACCIDENT:

 

 

 

 

DISTANCE

 

 

DIRECTION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

L

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MILES

N

E

 

 

 

 

 

 

 

A

 

 

NOT AT INTERSECTION

ON:

 

 

 

 

 

 

 

 

 

 

FEET

S

W FROM:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

 

 

 

 

 

 

 

 

 

(Street Name or Road Number)

 

 

 

 

(Number)

 

 

 

 

 

(Street Name or Road Number)

 

 

 

 

 

 

IN PARKING LOT

DESCRIBE LOCATION:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D DRIVER’S FULL NAME

 

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

CITY

 

 

STATE

ZIP CODE

 

INJURY

M

 

R

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CODE*

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Y

 

I

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

V

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER’S LICENSE NUMBER

 

 

 

 

 

 

 

 

CLASS

 

 

STATE OF ISSUE

 

DATE OF BIRTH

 

SEX

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VE

E R

H

V

 

OWNER’S FULL NAME

 

 

ADDRESS

 

CITY

 

STATE

ZIP CODE

I

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

E

 

 

 

 

 

 

 

 

 

 

 

 

H

 

 

 

 

 

 

 

 

 

 

 

 

L

 

 

 

 

 

 

 

 

 

 

 

 

I

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LICENSE PLATE NUMBER

YEAR

STATE OF ISSUE

PARTS OF VEHICLE DAMAGED

 

 

 

ESTIMATE COST TO REPAIR

E

C

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

L

 

 

 

 

 

 

 

 

 

 

$

 

 

E

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TYPE (CAR, PICKUP, VAN, SUV, MOTORCYCLE, TRUCK, ETC.)

MAKE

 

MODEL

YEAR

 

COLOR

 

# OF OCCUPANTS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IGIVE FULL LIABILITY INSURANCE INFORMATION OR IT WILL BE ASSUMED YOU DID NOT HAVE INSURANCE

N

SPLEASE NAME OF INSURANCE COMPANY (NOT AGENCY)

 

 

U

COPY

Automobile Insurance

 

 

 

 

 

 

 

 

 

 

 

 

MONTH

 

DAY

 

YEAR

 

 

 

MONTH

 

DAY

 

YEAR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

R

FROM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

POLICY NUMBER

 

 

 

 

 

 

 

 

Policy Period: from

 

 

 

 

 

 

 

 

to

 

 

 

 

 

 

 

 

 

 

A

POLICY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

N

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

 

Name of Policy Holder

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Your Signature X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D

OTHER

FULL NAME

 

 

 

ADDRESS

 

 

 

 

 

CITY

 

 

 

 

STATE

ZIP CODE

 

INJURY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CODE*

O

 

R

DRIVER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

T

 

I

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

V

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

H

 

DRIVER’S LICENSE NUMBER

 

 

 

 

 

 

CLASS

 

STATE OF ISSUE

 

 

 

DATE OF BIRTH

 

 

 

 

SEX

 

E

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

R

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

R

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

V

 

V

OTHER FULL NAME

 

 

 

ADDRESS

 

 

 

 

 

CITY

 

 

 

 

STATE

ZIP CODE

 

 

 

 

HE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E

 

OWNER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

H

 

I

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LICENSE PLATE NUMBER

 

YEAR

STATE OF ISSUE

 

PARTS OF VEHICLE DAMAGED

 

 

 

 

 

 

 

 

ESTIMATE COST TO REPAIR

I

 

C

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

 

 

 

 

 

C

 

L

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

L

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TYPE (CAR, PICKUP, VAN, SUV, MOTORCYCLE, TRUCK, ETC.)

MAKE

 

 

MODEL

 

 

 

 

YEAR

 

 

COLOR

 

 

# OF OCCUPANTS

 

 

 

 

 

 

 

 

 

 

 

 

 

E

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IF MORE THAN TWO VEHICLES - FILL IN SECTION “C” ON SEPARATE FORM AND ATTACH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*SEE CODES ON REVERSE SIDE*

ENTER NUMBER FOR CORRECT RESPONSE IN EACH BOX BELOW

 

 

 

 

TYPE ACCIDENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COLLISION WITH A(N)

 

 

 

 

COLLISION WITH FIXED OBJECT

 

 

 

NON-COLLISION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1- MOTOR VEHICLE

 

 

8- DEER

 

21- CONSTRUCTION EQUIPMENT

29- HYDRANT

 

37- EMBANKMENT/DITCH/CURB

51- OVERTURN/ROLLOVER

 

 

 

 

2- PARKED MOTOR VEHICLE

 

9- OTHER ANIMAL

 

22- TRAFFIC SIGNAL

30- TREE/SHRUBBERY

 

38- BUILDING/WALL

52- SUBMERSION

 

 

 

 

3- ROADWAY EQUIPMENT - SNOWPLOW

 

 

 

23- RR CROSSING DEVICE

31- BRIDGE PIERS

 

39- ROCK OUTCROPS

53- FIRE/EXPLOSION

 

 

 

 

4- ROADWAY EQUIPMENT - OTHER

 

12- COLLISION WITH OTHER

 

24- LIGHT POLE

 

32- MEDIAN SAFETY BARRIER

40- PARKING METER

54- JACKKNIFE

 

 

 

 

5- TRAIN

 

 

TYPE OF NON-FIXED OBJECT

 

25- UTILITY POLE

33- CRASH CUSHION

 

41- OTHER FIXED OBJECT

55- LOSS/SPILLAGE NON-HAZ MAT

 

 

 

 

6- PEDALCYCLE, BIKE, ETC.

 

13- OTHER COLLISION TYPE

 

26- SIGN STRUCTURE

34- GUARDRAIL

 

42- UNKNOWN FIXED OBJECT

56- LOSS/SPILLAGE HAZ MAT

 

 

 

 

7- PEDESTRIAN

 

 

 

 

27- MAILBOXES

 

35- FENCE (NON-MEDIAN BARRIER)

 

64- NON-COLLISION OF OTHER TYPE

 

 

 

 

 

 

 

 

 

28- OTHER POLES

36- CULVERT/HEADWALL

 

65- NON-COLLISION OF UNKNOWN TYPE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WORK ZONE (CIRCLE CORRECT RESPONSE)

 

 

 

 

SPEED LIMIT ENTER POSTED SPEED LIMIT ( NOT YOUR TRAVEL SPEED)

 

YES

NO

 

 

 

 

 

 

 

 

DID THE CRASH OCCUR IN A WORK ZONE?

 

 

 

 

 

 

 

 

 

YES

NO

IF YES, WERE WORKERS PRESENT?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WEATHER / ATMOSPHERE

5- SLEET/HAIL/FREEZING RAIN

8- SEVERE CROSSWINDS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1- CLEAR

3- RAIN

6- FOG/SMOG/SMOKE

90- OTHER

 

 

 

 

ROAD SURFACE

 

 

 

 

 

 

2- CLOUDY

4- SNOW

7- BLOWING SAND/DUST/SNOW

 

 

 

 

 

1- DRY

3- SNOW

5- ICE PACKED SNOW

7- MUDDY

9- OILY

 

 

 

 

 

 

 

 

2- WET

4-SLUSH

6- WATER (STANDING/MOVING)

8- DEBRIS

90- OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LIGHT CONDITION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1- DAY LIGHT

 

4- DARK (STREET LIGHTS ON)

7- DARK (UNKNOWN LIGHTING)

 

 

 

 

TRAFFIC CONTROL DEVICE

 

 

 

 

 

2- BEFORE SUNRISE (DAWN)

5- DARK (STREET LIGHTS OFF)

90- OTHER

 

 

 

 

1- TRAFFIC SIGNAL

 

 

7- SCHOOL BUS STOP ARM

 

13- RR OVERHEAD FLASHERS

3- AFTER SUNSET (DUSK)

6- DARK (NO STREET LIGHTS)

 

 

 

 

 

2- OVERHEAD FLASHERS

 

8- SCHOOL ZONE SIGN

 

14- RR OVERHEAD FLASHERS/GATE

 

 

 

 

 

 

 

 

3- STOP SIGN - ALL APPROACHES

 

9- NO PASSING ZONE

 

15- RR SIGN ONLY

 

 

 

 

 

 

 

 

 

4- STOP SIGN - NOT ALL APPROACHES

 

10- RR CROSSING GATE

 

(NO LIGHTS, GATES OR STOP SIGN)

MANNER OF COLLISION

4- RAN OFF ROAD - LEFT SIDE

8- HEAD ON

 

 

 

 

5- YIELD SIGN

 

 

11- RR CROSSING -FLASHING LIGHTS

 

1- REAR END

 

5- RIGHT ANGLE (”T-BONE”)

9- SIDE SWIPE - OPPOSING DIRECTION

 

 

 

 

 

 

 

 

 

 

 

 

6- OFFICER/FLAG PERSON/SCHOOL PATROL

12- RR CROSSING - STOP SIGN

 

90- OTHER

 

2- SIDESWIPE - SAME DIRECTION

6- RIGHT TURN

90- OTHER

 

 

 

 

 

 

 

 

 

98- NOT APPLICABLE

3- LEFT TURN

 

7- RAN OFF ROAD - RIGHT SIDE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MY

VEHICLE

OTHER

VEHICLE

ACTIONS / MANEUVERS PRIOR TO ACCIDENT

BY VEHICLE

PARKED VEHICLES

1- GOING STRAIGHT AHEAD

21- PARKED LEGALLY

FOLLOWING ROADWAY

22- PARKED ILLEGALLY

2- WRONG WAY INTO

23- VEHICLE STOPPED

OPPOSING TRAFFIC

OFF ROADWAY

3- RIGHT TURN ON RED

 

4- LEFT TURN ON RED

 

5- MAKING RIGHT TURN

 

6- MAKING LEFT TURN

 

7- MAKING U-TURN

 

8- STARTING FROM PARKED POSITION

 

9- STARTING IN TRAFFIC

 

10- SLOWING IN TRAFFIC

 

11- STOPPED IN TRAFFIC

 

12- ENTERING PARKED POSITION

 

13- AVOID UNIT/OBJECT IN ROAD

 

14- CHANGING LANES

 

15- OVERTAKING/PASSING

 

16- MERGING

 

17- BACKING

 

18- STALLED ON ROADWAY

 

 

 

 

 

 

 

 

 

 

DIRECTION OF TRAVEL PRIOR TO ACCIDENT

BY PEDESTRIAN

 

 

 

 

BY BICYCLIST

1- NORTHBOUND

 

 

 

 

 

 

 

31- CROSSING WITH SIGNAL

 

40- WALKING/RUNNING IN ROAD

51- RIDING WITH TRAFFIC

2- NORTH EASTBOUND

 

 

 

 

 

 

 

32- CROSSING AGAINST SIGNAL

 

AGAINST TRAFFIC

 

52- RIDING AGAINST TRAFFIC

3- EASTBOUND

 

 

 

 

 

 

 

33- DARTING INTO TRAFFIC

 

41- STANDING/LYING IN ROAD

53- MAKING RIGHT TURN

4- SOUTH EASTBOUND

 

 

 

 

 

 

 

34- OTHER IMPROPER CROSSING

 

42- EMERGING FROM BEHIND

54- MAKING LEFT TURN

5- SOUTHBOUND

 

 

 

 

 

 

 

35- CROSSING IN A MARKED CROSSWALK

PARKED VEHICLE

 

55- MAKING U-TURN

6- SOUTH WESTBOUND

 

 

 

 

 

 

 

36- CROSSING (NO SIGNAL OR CROSSWALK)

43- CHILD GETTING ON/OFF SCHOOL BUS

56- RIDING ACROSS ROAD

7- WESTBOUND

 

 

N

 

 

 

37- FAIL TO YIELD RIGHT OF WAY TO TRAFFIC

44- PERSON GETTING ON/OFF VEHICLE

57- SLOWING/STOPPING/STARTING

8- NORTH WESTBOUND

 

 

 

 

 

38- INATTENTION/DISTRACTION

 

45- PUSHING/WORKING ON VEHICLE

 

 

 

 

 

 

 

 

 

 

 

 

8

1

2

 

 

39- WALKING/RUNNING IN ROAD WITH TRAFFIC

46- WORKING IN ROADWAY

90- OTHER

 

 

 

 

 

 

 

 

W

 

7

 

 

3

 

E

 

 

 

47- PLAYING IN ROADWAY

 

 

 

 

 

 

 

 

 

6

 

 

4

 

 

 

 

48- NOT IN ROADWAY

 

 

 

5

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

S

 

 

 

 

 

 

 

 

 

 

 

 

CONTINUE

 

WAS THERE A POLICE

 

IF YES, WHAT DEPARTMENT (NAME OF CITY, COUNTY OR STATE PATROL)

 

 

 

 

 

 

 

OFFICER AT THE

 

 

 

 

 

 

 

 

 

 

 

REPORT ON

 

 

 

 

 

 

 

 

 

 

 

 

 

SCENE?

 

 

 

 

 

 

 

 

 

 

 

 

OTHER SIDE

 

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE

MY

VEHICLE

OTHER

File Specs

Fact Name Description
Mandatory Submission Drivers involved in an accident with $1,000 or more in property damage, or any injury or death, are required to complete and submit the Minnesota Accident Report form within 10 days of the incident.
Legal Consequences Failure to submit the report is classified as a misdemeanor under Minnesota Statute 169.09, subdivision 7, which may result in legal repercussions.
Data Privacy The information collected on this form is subject to the Minnesota Data Privacy Act, ensuring that certain data may only be disclosed as specified by law.
Form Availability The Minnesota Accident Report form can be accessed online as an E-form at www.mndriveinfo.org, facilitating easier completion and submission.

Minnesota Accident Report - Usage Guidelines

Completing the Minnesota Accident Report form is essential for documenting the details of a vehicle accident. After filling out the form, it must be submitted to Driver and Vehicle Services within 10 days. Ensure that all sections are completed accurately to avoid any issues.

  1. Begin by filling in the date of the accident, including the month, day, and year.
  2. Indicate the day of the week and the time of the accident.
  3. Provide the county and the name of the city or township where the accident occurred.
  4. Describe the location of the accident by choosing one of the options provided (e.g., on a street, at an intersection).
  5. Fill in the driver's full name, address, city, state, and zip code.
  6. Enter the driver's license number, class, state of issue, date of birth, and sex.
  7. Provide the owner's full name, address, city, state, and zip code.
  8. Fill in the license plate number, year, and state of issue for the vehicle involved.
  9. List the parts of the vehicle damaged and provide an estimate cost to repair.
  10. Indicate the type of vehicle (e.g., car, truck) and its make, model, year, and color.
  11. Provide the insurance information, including the name of the insurance company, policy number, and policy period.
  12. For additional vehicles involved, repeat the steps for each vehicle in the appropriate sections.
  13. Indicate the type of accident by entering the corresponding number from the list provided.
  14. Fill in details about the weather conditions and road surface at the time of the accident.
  15. Complete the sections regarding light conditions and traffic control devices present at the scene.
  16. Describe the actions or maneuvers taken by your vehicle and any other vehicles involved prior to the accident.
  17. Indicate whether a police officer was present and provide the department name if applicable.
  18. In the description section, detail what happened during the accident.
  19. Sign the report and include your address and the date of the report.
  20. Mail the completed report to the specified address: DVS / Accident Records, 445 Minnesota Street, Suite 181, St. Paul, MN 55101-5181.

Your Questions, Answered

What is the purpose of the Minnesota Accident Report form?

The Minnesota Accident Report form is designed to collect essential information about motor vehicle accidents. This data helps authorities analyze traffic incidents to improve road safety. It is mandatory for drivers involved in accidents with $1,000 or more in property damage, or any injury or death, to complete and submit this form.

Who is required to complete the form?

Every driver involved in a crash that results in significant property damage, injury, or death must complete the Minnesota Accident Report form. This requirement applies regardless of fault. Failure to submit the report can lead to misdemeanor charges under Minnesota law.

How long do I have to submit the report?

Drivers must submit the Minnesota Accident Report form within 10 days of the accident. Timely submission is crucial to avoid penalties and ensure that all necessary information is recorded accurately.

Where do I send the completed form?

The completed Minnesota Accident Report form should be mailed to the following address: DVS / Accident Records, 445 Minnesota Street, Suite 181, St. Paul, MN 55101-5181. Ensure that the form is sent to the correct address to avoid delays in processing.

What information is required on the form?

The form requires detailed information, including the date, time, and location of the accident, as well as details about the vehicles involved, drivers, and any injuries sustained. Insurance information must also be provided. Completing all sections accurately helps facilitate the investigation and record-keeping process.

Is the information on the form confidential?

While the information collected on the Minnesota Accident Report form is used for statistical purposes, certain details may be disclosed under Minnesota law to parties involved in the accident. However, your version of events is treated as confidential and cannot be used against you in legal proceedings.

What happens if I don’t submit the report?

Failing to submit the Minnesota Accident Report form within the required timeframe can result in misdemeanor charges. This can lead to fines and other legal consequences. It is essential to comply with this requirement to avoid potential legal issues.

Common mistakes

  1. Failing to provide complete information. Every section of the form must be filled out accurately. Missing details can lead to delays or complications.

  2. Not submitting the report within the required timeframe. The form must be sent to Driver and Vehicle Services within 10 days of the accident.

  3. Inaccurate accident location. Clearly indicate whether the accident occurred at an intersection or on a specific road. This information is crucial for proper documentation.

  4. Omitting insurance details. Provide complete liability insurance information. If this is missing, it will be assumed that you did not have insurance at the time of the accident.

  5. Not including all involved parties. If there are multiple vehicles, ensure that all drivers and passengers are listed correctly. This includes their names, addresses, and other relevant details.

  6. Using unclear or vague descriptions of the accident. Clearly describe what happened and include any relevant details that can help explain the circumstances.

  7. Neglecting to sign the report. The signature of the person submitting the report is required. Without it, the report may not be accepted.

Documents used along the form

The Minnesota Accident Report form is a critical document for drivers involved in a crash. In addition to this form, there are several other documents that may be required or helpful in the aftermath of an accident. Below is a list of these documents, along with a brief description of each.

  • Driver’s Traffic Accident Report: This form provides a detailed account of the accident from the driver's perspective. It is often used to supplement the Minnesota Accident Report.
  • Insurance Claim Form: This document is submitted to your insurance company to initiate a claim for damages or injuries resulting from the accident.
  • Police Report: If law enforcement responded to the scene, they would create a report documenting the incident. This report can be crucial for insurance claims and legal proceedings.
  • Medical Records: If injuries occurred, medical records serve as evidence of treatment received. These records may be necessary for insurance claims or legal actions.
  • Witness Statements: Statements from individuals who witnessed the accident can provide additional context and support your version of events.
  • Photographs of the Scene: Photos taken at the accident scene can help illustrate the circumstances of the crash, including vehicle damage and road conditions.
  • Vehicle Repair Estimates: After an accident, obtaining estimates for vehicle repairs can help in assessing damages and filing claims with insurance companies.
  • Accident Reconstruction Report: In complex cases, a professional may be hired to analyze the accident and create a report that outlines the sequence of events leading to the crash.
  • Release of Liability: This document may be signed by parties involved to formally release each other from future claims related to the accident.

These documents can play a vital role in the resolution of any claims or legal matters that arise from an accident. It is essential to gather and retain all relevant information to ensure proper handling of the situation.

Similar forms

The Minnesota Accident Report form shares similarities with the Uniform Accident Report (UAR) used in various states across the U.S. Like the Minnesota form, the UAR is designed to collect essential details about motor vehicle accidents. This includes information about the drivers, vehicles involved, and the circumstances surrounding the incident. Both forms aim to provide a standardized method for reporting accidents, ensuring that law enforcement and insurance companies have access to consistent data for analysis and processing claims.

Another comparable document is the California Traffic Collision Report. This report, much like the Minnesota form, requires drivers involved in accidents to provide detailed information about the event, including the location, time, and nature of the crash. The California report also emphasizes the importance of submitting the information promptly to facilitate investigations and assist in improving road safety, similar to the requirements outlined in the Minnesota form.

The National Highway Traffic Safety Administration (NHTSA) Form 578, which is used for reporting crashes involving commercial vehicles, bears a resemblance to the Minnesota Accident Report. Both forms focus on gathering comprehensive data about the accident, including vehicle types, driver information, and environmental conditions. The NHTSA form specifically addresses the unique aspects of commercial vehicle incidents, while the Minnesota form encompasses a broader range of motor vehicle accidents.

Additionally, the New York State Motor Vehicle Accident Report is similar in purpose and structure. This report collects vital information about the accident, including driver details, vehicle descriptions, and a narrative of the incident. Both reports serve as official documents that can be used by law enforcement and insurance companies to assess liability and damages, reinforcing the importance of accurate reporting in the aftermath of a crash.

The Texas Motor Vehicle Accident Report is another document that aligns closely with the Minnesota form. It requires drivers to detail the circumstances of the accident, including the involved parties and any injuries sustained. Both forms aim to capture critical information that can aid in legal proceedings and insurance claims, emphasizing the necessity of thorough and timely reporting.

The Florida Traffic Crash Report shares similar objectives with the Minnesota Accident Report. Both forms collect data on the accident's specifics, such as the types of vehicles involved and the conditions at the time of the crash. They serve to inform state agencies and contribute to the development of safer roadways, highlighting the shared goal of reducing accidents and improving public safety.

Finally, the Washington State Collision Report is comparable in its focus on gathering detailed information about traffic incidents. Like the Minnesota form, it requires participants to provide information about the vehicles, drivers, and circumstances leading to the crash. This report aims to facilitate law enforcement investigations and insurance claims, underlining the necessity of accurate and timely documentation in the event of an accident.

Dos and Don'ts

Things to Do When Filling Out the Minnesota Accident Report Form:

  • Provide accurate information about the accident, including the date, time, and location.
  • Include full names and addresses of all drivers and vehicle owners involved.
  • List all vehicles involved and provide their license plate numbers.
  • Complete all sections of the form, including details about injuries and damages.
  • Submit the form to Driver and Vehicle Services within 10 days of the accident.
  • Keep a copy of the completed form for your records.
  • Contact your insurance company to report the accident.
  • Use clear and concise language when describing the accident.

Things Not to Do When Filling Out the Minnesota Accident Report Form:

  • Do not leave any sections blank; incomplete forms may cause delays.
  • Avoid providing false or misleading information.
  • Do not detach any part of the form.
  • Do not forget to sign the report before submission.
  • Refrain from using legal jargon or complex terms; keep it simple.
  • Do not submit the form after the 10-day deadline.
  • Do not assume that your insurance information is optional; it is required.
  • Avoid discussing fault or liability in the report.

Misconceptions

  • Misconception 1: The form is optional for all accidents.
  • This is incorrect. The Minnesota Accident Report form must be completed for any crash involving $1,000 or more in property damage, or any injury or death. It is a requirement.

  • Misconception 2: You can submit the form anytime after the accident.
  • The form must be submitted within 10 days of the accident. Delaying this can lead to legal consequences.

  • Misconception 3: Only the driver needs to fill out the form.
  • While the driver is primarily responsible, all parties involved should ensure their information is included for accuracy.

  • Misconception 4: The report can be used against you in court.
  • The report is confidential and cannot be used as evidence in civil or criminal matters. Your version of events remains protected.

  • Misconception 5: You don't need to provide insurance information if you don't have it.
  • If you lack insurance, you must still submit the form. Failure to do so can result in penalties.

  • Misconception 6: The form is only for vehicle accidents.
  • The report is also necessary for accidents involving pedestrians, bicycles, and other non-motorized vehicles.

  • Misconception 7: You can fill out the form online at any time.
  • While an electronic version is available, it must still be printed and mailed to the appropriate address after completion.

  • Misconception 8: All information on the form is public.
  • Some information is protected under the Minnesota Data Privacy Act, ensuring that personal details are kept confidential.

Key takeaways

Filling out the Minnesota Accident Report form is an important step after a vehicle accident. Understanding how to complete this form correctly can make a significant difference in the outcome of your situation. Here are some key takeaways to keep in mind:

  • Mandatory Reporting: If the accident involves $1,000 or more in property damage, injury, or death, it is required by law to complete this form and submit it to Driver and Vehicle Services within 10 days.
  • Timeliness is Key: Ensure that the report is mailed promptly. Missing the 10-day deadline could result in legal consequences.
  • Accurate Information: Provide accurate details about the accident, including the date, time, and location. This information is crucial for building safer roads and understanding traffic patterns.
  • Insurance Information: Be sure to include your liability insurance details. If you do not provide this information, it may be assumed that you did not have insurance at the time of the accident.
  • Witnesses and Police: If a police officer was present at the scene, note their department on the report. This can help corroborate your account of the accident.
  • Descriptive Details: In the section asking for a description of the accident, provide as much detail as possible. Include what happened leading up to the accident, the actions of each vehicle, and any other relevant circumstances.
  • Submit to the Correct Address: Mail the completed form to the address specified on the form. Double-check that you have the correct address to avoid any delays.

Completing the Minnesota Accident Report form thoughtfully and accurately can help protect your rights and ensure that the necessary information is on record. Take your time to fill it out carefully.