Request For Motor Vehicle Accident Report - City Of Gaithersburg printable pdf download

Gaithersburg Police Department

REQUEST FOR MOTOR VEHICLE ACCIDENT REPORT

(Type or Print)

ALL FIELDS WITH * MUST BE FILLED OUT

*Police Report Number: ______________________(mandatory) Date of Accident: __________________________

Request for an official copy of Motor Vehicle Accident Report involving *______________________________

(Driver)

and ___________________________

________________________________

(Driver or Pedestrian)

(Route)

*Requestors Name: ____________________________________________________________________

*Requestors Address: ___________________________________________________________________

__________________________________________________________________

(City, State & Zip Code)

*Requestor Home/Work/Cell:_______________________________________________________________________________

An official copy of an accident report can be obtained in two ways: (1) Obtain a copy of the report at the

Gaithersburg Police Department located at 14 Fulks Corner Avenue, Gaithersburg, MD 20877, for all

accidents investigated by the Gaithersburg Police, five days after the date of the accident during regular

business hours (8:30 a.m. - 4:30 p.m., Monday - Friday, excluding City Holidays). Bring a check or money

order (no cash) $4 non-refundable document search fee made payable to the City of Gaithersburg. It is

recommended that you call the Gaithersburg Police Department at (301) 258-6400 prior to coming to

ensure the report is available. (2) You may download a Maryland Motor Vehicle Accident Report Request

Form

by visiting our web-site at

Under Departments, click on Police and

scroll down to Documents and Forms.

After downloading, print and complete the form and mail it, with a

check or money order for $4, to the address on the form. An official copy of the report will be mailed to

you. Requests for copies of Motor Vehicle Accident Reports should not be submitted until more than 5

days have elapsed since the date of the accident. This will give the police department staff sufficient time

to receive and process reports.

Be advised, Legal Counsel must provide documentation of representation.

Gaithersburg Police Department Staff Only:

Received by: ______________________________________________________

Date: _______________________

(Name of Staff)

Processed By: _________________________________

__________________ Check #___________/Money Order ______

(Name of Staff)

(Date)

Has person received report Yes / No (circle)

Has payment been received Yes / No (circle)

Request For Motor Vehicle Accident Report - City Of Gaithersburg