Form Mv4002 - Wisconsin Driver Report Of Accident
Download a blank fillable Form Mv4002 - Wisconsin Driver Report Of Accident in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Mv4002 - Wisconsin Driver Report Of Accident with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2Wisconsin
DRIVER REPORT OF ACCIDENT
DO NOT COMPLETE
this Driver Report of Accident if a law enforcement officer
completed a Wisconsin Motor Vehicle Accident Report.
COMPLETE this Wisconsin Driver Report of Accident if:
•
There was $1000 or more damage to any one person’s property
— OR —
•
Anyone was injured
— OR —
•
There was $200 or more damage to government property, other than vehicles.
Wisconsin Department of Transportation
MV4002
3/2014
s.346.70(2) Wis. Stats.
Please provide all requested information. Print clearly.
1. You are “Unit 1”.
2. An individual involved in the accident must sign the report.
3. Provide all information on the other driver(s)/owner(s) involved. Incomplete reports may be returned
requesting missing information. If you need assistance, contact your insurance agent, local law
enforcement agency, or Wisconsin Department of Transportation (WisDOT) at: (608) 266-8753.
4. Use the “Narrative” and “Diagram” sections to explain how the accident happened.
5. If more space is needed, use plain paper and attach to this report.
6. This form is available at:
IMPORTANT: DO NOT ENLARGE, REDUCE OR MOVE the FIM and barcodes. They are only valid as printed!
Retain a copy of this report for your records before mailing.
Special care must be taken to ensure FIM and barcode are actual size AND placed properly on the mail piece
to meet both USPS regulations and automation compatibility standards.
Mail completed report to address shown below.
(Fold report so that address panel shows to outside – tape bottom edge closed and mail – Do not staple)
______
Important
– Please print your return address:
PLACE
STAMP
HERE
______
TRAFFIC ACCIDENT SECTION
WISCONSIN DEPT OF TRANSPORTATION
PO BOX 7919
MADISON WI 53707-7919
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Ld-t - Annual Report Of Premiums,taxes And Fees Of Foreign Life And Accident And Health Insurance Companies - 2011
Financial
Form 285-o - Technical Report Of U.s. Army Ground Accident Statement Of Reviewing Officials
Business
Related Categories
Parent category: Legal