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Late Accident Report

  1. Did this occur on

  2. Safety Devices*

  3. Passenger*

  4. Please enter YOUR vehicle information

  5. Accident Type*

    Choose only one

  6. Vehicle Owner

  7. Was there another vehicle involved?*

  8. Do you have their information?*

  9. If the vehicle information is not known, plese check Unknown

  10. Other Vehicle Information

  11. Where there passengers in the other vehicle?

  12. Do you have their information?

  13. Were there any witnesses?*

  14. Do you have their information?*

  15. Light Conditions

  16. Weather Conditions

  17. Road Surface Conditions

  18. Road Grade

  19. Did this occur within an intersection?

  20. Direction of Travel

  21. If you have photos or any other documents you deem important to this case please attach here.

  22. Thank you for completing the form. We will have a Traffic Officer assigned to your case and will give you a report number. If you would like to know the status of your case please contact (928) 556-2212 or (928) 679-4102. Should you need immediate assistance please contact the Flagstaff Police Department at (928) 774-1414.

  23. Leave This Blank:

  24. This field is not part of the form submission.