Value Car Hire

Vehicle Accident Report

Complete immediately after the incident. Submission of this form does not constitute an admission of liability.

Incident Details

Complete as accurately as possible.

Date of Accident*Time (approx)

Location / Address*

Location TypeAccident Type*Weather Conditions

Road SurfaceDescription of what happened*

Vehicle & Driver

Vehicle Registration*Cost Centre / Department

Driver Name*Driver Phone

Driver ID NumberDriver Licence Number

Circumstances

Vehicle drivable?*Tow required?*Third party involved?*

Injury Severity*

Police Case Number (if opened)Police Station

Reported By

Contact details of the person completing this form.

Your Name*Your Email*Your Phone

Photo Evidence

Optional — attach photos of the damage, scene, or third-party vehicles. Max 20 images, 20 MB each.

Click or drag to add photos

JPEG · PNG · WebP · HEIC · max 20 MB each