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dmv accident report

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MV-104 5/11 PAGE 1 of 2 HERE FOLD New York State Department of Motor Vehicles Use only for accidents that happen in New York State REPORT OF MOTOR VEHICLE ACCIDENT www. Dmv.ny. gov BEFORE COMPLETING THIS FORM READ THE INSTRUCTIONS IN SECTION A ON PAGE 2 DO NOT FORGET ACCIDENT DATE Accident Date Month Day o Page of Day of Week Time Year RUSH - DRIVER OF VEHICLE 1 - LICENSE SUSPENDED FOR FAILURE TO REPORT Number of Vehicles AM Injured Killed o VEHICLE 2 State of License Driver License ID Number...
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Who needs an MV-104 form?

A member of a car accident that occurred in the state of New York must submit the completed Report of Motor Vehicle Accident, called MV-104, to New York State Department of Motor Vehicles, if: 1) fatality occurred; 2) someone got injured; 3) private property was damaged for the amount of more than $ 1000.

What is the MV-104 form for?

The type of a car accident, the parties affected by it and its consequences are specified in the MV-104 form.

Is the MV-104 form accompanied by other forms?

This form is not accompanied by other forms. However, you can also attach an additional report to the first page of an MV-104 form. Each additional page of the report should be numbered.

When is the MV-104 form due?

You are obliged to notify the authorities of the traffic accident that happened in the state of New York within ten days.

How do I fill out the MV-104 form?

Comprehensive instructions for completing MV-104 form appear on its second page. In any case, you have to provide the following information: 1) type of vehicle involvement (two-cars, a pedestrian, a bicyclist or other people, a vehicle other than a motor vehicle, an unoccupied vehicle, more than two cars); 2) information for each driver (according to driver license); 3) vehicle damage; 4) accident location; 5) list of names of all people involved in the crash; 6) safety equipment use; 7) list of injuries; 8) insurance information and list of damaged property.

Where do I send the MV-104 form?

The report must be signed by the driver of vehicle 1, except when the driver has suffered an injury and ?a not do that. Original should be sent to:

CRASH RECORDS CENTER, 6 Empire State Plaza, PO Box 2925, Albany NY 12220-0925.

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