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The European Accident Statement is a standardized form designed to systematically record the particulars of a traffic accident. It serves as an essential document required in the event of any accident, and its content is uniform across all languages. The form, consisting primarily of short-answer fields, is designed to facilitate straightforward completion. This form is provided with the vehicle. Should additional copies be required, the file may be downloaded and printed.
When do I need this?
- All traffic accidents, including single-vehicle accidents
How to Fill Out
This form should be filled out promptly at the scene of the accident. For multi-vehicle collisions, a separate statement must be completed with the driver of each vehicle directly involved in the accident. The contents in the blue (Vehicle A) and yellow (Vehicle B) sections are identical; therefore, it is only necessary to complete one of the two. Completion in capital letters is strongly advised. The original form uses pressure-sensitive copy paper, so the text is automatically transcribed onto the duplicate sheet below. For detailed instructions on each numbered entry, please consult the guidelines provided below:
- Date of Accident, Time
- 24-hour format recommended
- Locality
- Street, city, country, as detailed as possible
- Injuries
- Even if slight
- Material Damage
- Other than to vehicle A and B = Damage to any third-party vehicles
- Objects other than vehicles = Damage to non-vehicle property (e.g., streetlights, guardrails)
- Witnesses
- Personal details, if available
- Insured/Policyholder
- Personal details, as per the vehicle contract
This is the contract holder, not the driver involved in the incident.
- Vehicle
- Make, type/model, registration/plate no., country of registration (France)
- Insurance Company
- Company (WTW France), policy/contract no., effective/expiry dates, etc., as per the memo vehicle insured
- Leave the fields from agency (bureau, broker, etc.) onwards blank
- For the final question regarding comprehensive (own damage) coverage, please check 'yes'
- Driver
- Personal details, as per the driver's license
This is the driver involved in the incident, not the contract holder.
- Initial Impact
- Use an arrow to designate the point of initial impact on the passenger car diagram.
In the event of multiple impacts, only the initial point of impact should be indicated.
- Vehicle Damage
- Visible damage to the vehicle
- Circumstances
- Indicate all applicable situations from 1 to 17, and enter the total count at the end
- Sketch of Accident
- Briefly sketch the accident scene, indicating the road layout and street names, the position of vehicles (in boxes labeled A and B) and their direction of travel with arrows, and any relevant traffic lights or road sign
- Remarks
- Any discrepancies in accounts or differing opinions, etc. ⇐ In the event of minor damage, should the decision be made to continue operating the vehicle without workshop repair, a statement to that effect must be recorded in this section.
- Signature
- Prior to signing, review all details and request corrections if necessary ⇒ Upon signing, each party shall retain one copy
The supplementary form (e.g., Motor Accident Report, Declaration) may be finalized at the discretion of the individual, or should the Assistant require it for supplementation. It must be noted, however, that the submission of this form is a strict requirement for all single-vehicle incidents. Inasmuch as the form serves only to document the individual's own account, its completion may be deferred until a subsequent time, following the conclusion of all on-site proceedings.
Regardless of perceived necessity, preparing the supplementary form will significantly expedite the claims process.
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Written Statement
Personal Details
- Name: John DOE
- Birthday: April 20, 1991
- Email: { ... }
- Phone Number: { ... }
Detailed Description of the Accident
On Oct 17, 2026, around 11:00 AM, I was driving westbound on { ... road name or number ... }. I had a green light and my speed was approximately 40 km/h in a 50 km/h zone.
When I entered the intersection, the other car from the opposite direction made a sudden left turn without signaling, cutting directly into my path.
I braked hard and turned sharply to the right, but could not avoid a collision. The front-left of my vehicle struck the front-right of the other car.
After the collision, we stopped our vehicles safely and exchanged details. However, we disagreed on the key facts of the accident. The other driver claimed that I was speeding and had run a yellow light. This disagreement was noted on the we filled out at the scene.
Injuiry(ies)
I did not suffer any immediate injuries, but I felt some pain in my neck and shoulders a few hours after the accident. I plan to see a doctor for a check-up.
Police Involvement
The police were called to the scene. The responding officer was { ... officer's name/contact, if known ... }. An official police report was filed.
Statement Declaration
I declare that the information provided in this statement is true and accurate to the best of my knowledge and belief.
This statement is warranted when the standard European Accident Statement is insufficient for a comprehensive account of an accident's complexities or the involved party's position. Its submission is considered essential for single-vehicle accidents, particularly where the inevitable nature of the incident must be demonstrated. Furthermore, this statement may be required to delineate the factual relationships in a multi-vehicle collision, elaborate upon the circumstances and extent of sustained injuries, or formally present a substantiated argument in the event of a dispute with the other party.
When do I need this?
- Single-vehicle accidents
- When the European Accident Statement is deemed insufficient
- When otherwise requested by the assistant
How to Write
The party's position should be described in a factual and structured manner, and may be submitted in handwritten form, as an email, or as a digital document file. While there is no prescribed format, the statement generally includes the components listed below:
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Personal Details
Given that the primary personal particulars are already provided on the European Accident Statement, only a brief entry of the author's name, date of birth, and contact information is required.
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Detailed Description of the Accident
This constitutes the core section of the statement, where the sequence of events must be described chronologically in concise and clear sentences. Speculative language, such as 'I think' or 'I guess,' is to be avoided; the narrative must remain objective and factual. Where appropriate, it is also advisable to attach a diagram depicting the accident or photographs of the scene.
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Injuiry(ies)
Describe the nature and extent of any injuries sustained. If other individuals were injured, their details must also be recorded. In the absence of injuries, indicate 'None' or 'Not applicable.'
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Police Involvement
If the police were notified and responded to the scene, the pertinent information should be recorded here. It is highly advisable to obtain the official Police Report and submit it separately. If no police were involved, indicate 'None' or 'Not applicable.'
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Statement Declaration
A declaration affirming that the statement is true and correct. The provided sample sentence may be used without modification.
Lastly, the document must be concluded with a signature (waived for email submissions), the date, and the applicant's name in capital letters. Should a signed document be necessary, a digital image or scan thereof must be transmitted via email. To ensure clarity, it is advisable to utilize a document scanning application.
Please complete this document in English or French. Documents in other EU languages may take a significant amount of time to process.
This is an official document that certifies the factual details of an incident reported to the police, containing the personal details of the reporting party, the nature of the incident, and a list of any damages or losses. Rendered officially valid by the signature or seal of the attending police officer, the report is mandatory in the event of criminal damage to a vehicle, such as theft or vandalism.
When do I need this?
- Vehicle theft
- Vehicle vandalism
- When the police are called to the scene of an incident
- When otherwise requested by the assistant
How to Obtain
This document must be obtained in person and preferably within 48 hours from the police station. Use a map application or similar tools to locate and proceed to the one nearest to the scene of the incident.
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Visit a police station with an identification card, driver's license, vehicle registration document, photos taken at the scene, and any other documents deemed necessary. If a completed European Accident Statement is available, bring that along as well.
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Be aware of a potential waiting period prior to consultation with the assigned officer. Certain police departments may issue a brief informational form in advance, which is to be completed during this time.
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Although protocol may vary, the report is generally drafted via a question-and-answer session with the assigned officer. It is important to respond to all inquiries calmly, presenting materials such as the European Accident Statement and photos to clarify the situation as needed.
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Once the statement is complete, a printed copy of the report will be provided. It is crucial to review the document for accuracy. Should any discrepancies be found, a correction must be requested.
Upon departing the police station, it is advisable to create a photographic copy of the document as a precaution against potential loss or damage. To ensure clarity, it is advisable to utilize a document scanning application. The original document must be stored in a secure location.
Please be aware that local police stations can be busy and some waiting time may be required.