Temecula Police Department - Counter Traffic Collision Report Form printable pdf download

Temecula Police Department

Traffic Collision Counter Report

Instructions

Your collision has been determined to be the type of collision called a “Counter Report”.

A Counter Report is a report that is taken after the collision, away from the collision

scene. Use of this form is appropriate when:

A. There are no injuries to any party and

B. All parties are identified or

C. The collision is a hit and run where identification and prosecution of the suspect

is not likely.

Section 20015 of the California Vehicle Code prohibits a law enforcement officer from

establishing fault in a “Counter Report”. Although we will not investigate the collision,

we will maintain a copy of the report for purchase by any involved party or their

insurance company’s representative. In some cases, the officer issuing your counter

report will have a report number immediately available for you and should write it at the

top of the counter report prior to giving it to you. A sample report number would look

something like this: TE092580XXX.

In other cases, the officer will not have a report number immediately available. In these

cases you will be contacted via telephone by an officer with a report number after you

have submitted your counter report.

Copies of your report will be available from the Temecula Police Department after you

have submitted your completed report to us and it has been processed. The normal fee for

copies of police reports will apply.

When completed, return this form to the Temecula Police Department or mail to:

Temecula Police Department

30755-A Auld Road

Murrieta, Ca. 92563

California Law requires that all persons involved in a collision involving injury or

damage in excess of $750.00, file an SR-1 Financial Responsibility form with the

Department of Motor Vehicles within 10 business days of the collision. This form does

not satisfy that requirement. You may obtain the form from the Department of Motor

Vehicles, your insurance carrier or most law enforcement agencies. Failure to file the

SR-1 form will result in the suspension of your driving privilege.

Warning:

Providing false information on this form is a crime.

Temecula Police Department - Counter Traffic Collision Report Form