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Late Vehicle Collision Report

  1. Did this occur on

  2. Safety Devices*

  3. Passenger*

  4. Enter Vehicle Information

    Please enter YOUR vehicle information

  5. Accident Type*

    Choose only one

  6. Vehicle Owner

  7. Confirm Other Vehicles

  8. Was there another vehicle involved?*

  9. Do you have their information?*

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

  11. Other Vehicle Information

  12. Where there passengers in the other vehicle?

  13. Do you have their information?

  14. Confirm Witness

  15. Were there any witnesses?*

  16. Do you have their information?*

  17. Property Damaged (other than vehicles)

  18. Road And Weather Conditions

  19. Light Conditions

  20. Weather Conditions

  21. Road Surface Conditions

  22. Road Grade

  23. Did this occur within an intersection?

  24. Direction of Travel

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

  26. Complete!

    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.

  27. Leave This Blank:

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