Temecula Police Department - Counter Traffic Collision Report Form (Page 5 of 5) in pdf

Temecula Police Department - Counter Traffic Collision Report Form Page 5

38. If you spoke with the other driver, what did he / she say?____________________

________________________________________________________________________

39. Describe the other driver:

Male

Female Approx. age___________

Hair color:__________Eye color:___________

Clothing worn:__________________________________________________________

Other description (hair length, tattoos, jewelry, etc.):__________________________

________________________________________________________________________

40. Describe any passengers in the other vehicle:______________________________

________________________________________________________________________

_____________________________________________________________________

41. If you’re reporting this collision more than three (3) days after it occurred,

please explain the delay:_______________________________________________

________________________________________________________________________

42. Other information that you believe might be of importance:_________________

________________________________________________________________________

I affirm under penalty of perjury that the above information is true and correct:

____________________

___________________________________________

Date

Signature

Warning: California Vehicle Code section 31 makes it a crime to provide false

information during a traffic collision investigation.

Temecula Police Department - Counter Traffic Collision Report Form Page 5