Get CA DMV Form SR 1 2017-2024

Comprehensive and collision insurance does not meet the legal requirement. 1806 of the California Vehicle Code CVC requires the DMV to record accident information regardless of fault when individuals report accidents under the Financial Responsibility Law or if law enforcement agencies or CHP investigate and make a report. This may require that you contact the owner of the property for an estimate of damages. Once you have completed this report please mail it to DePARTMeNT OF MOTOR VehICleS FINANCIAl ReSPONSIBIlITY MAIl STATION J237 SACRAMeNTO CA 94284-0884 DMV does not accept reports or take actions against non-reporting or uninsured motorists unless this SR-1 form is sent to DMV by someone involved in the accident or their designee and the report is received by DMV within one calendar year of the accident date. ADVISORY STATeMeNT The accident information on the SR-1 is required under the authority of Divisions 6 and 7 of the California Vehicle Code. The law requires the driver to file this SR-1 form with DMV regardless of fault. This report must be made in addition to any other report filed with a law enforcement agency insurance company or the California Highway Patrol CHP as their reports do not satisfy the filing requirement. An insurance agent attorney or other designated representative may file the report for the driver. from operating or owning a motor vehicle. The minimum insurance level for financial responsibility is public liability and property damage coverage of 15 000 for injury or death of one person 30 000 for injury or death of two or more persons and 5 000 property damage per accident. DATE PRINTED NAME SIGNATURE X SR 1 REV. 9/2008 WWW ADDITIONAL INFORMATION ATTACHED Print Clear Form A YOUR VEHICLE CALIFORNIA INSURANCE INFORMATION DMV FILE NUMBER DO NOT DETACH The Department may send this part to the insurance company indicated. If not fully completed it will be assumed you were not insured for the accident and your license will be suspended. NAME OF INSURANCE COMPANY NOT AGENCY OR BROKERAGE THAT ISSUED THE LIABILITY POLICY COVERING THE OPERATION OF YOUR VEHICLE I N S U R C E From To IN OR NEAR CITY OR TOWN CALIFORNIA ONLY VEHICLE IDENTIFICATION NUMBER DRIVER FULL NAME OF POLICY HOLDER OWNER DRIVER OF YOUR VEHICLE If the policy was not in effect this form must be completed and returned to the Department within 20 days. The undersigned company advises that with respect to the reported accident the policy reported on the reverse side WAS NOT IN EFFECT Was not a liability policy Policy Number Signature Title Date Did not cover the vehicle/driver Number is not a company policy number Policy Period from to MAIL TO Department of Motor Vehicles Financial Responsibility P. O. Box 942884 Sacramento CA 94284-0884 IMPORTANT INFORMATION California law requires traffic accidents on a California street/highway or private property to be reported to the Department of Motor Vehicles DMV within 10 days if there was an injury death or property damage in excess of 750. DMV USE ONLY REPORT OF TRAFFIC ACCIDENT OCCURRING IN CALIFORNIA A Public Service Agency READ IMPORTANT INFORMATION ON BACK AS APPROPRIATE PLEASE TYPE OR PRINT IN BOXES OF VEHICLES DATE OF ACCIDENT ACCIDENT LOCATION - CITY/COUNTY CALIFORNIA ONLY ON PRIVATE PROPERTY Yes REPORTING PARTY S INFORMATION TIME OF ACCIDENT AM PM Hour Moving Stopped in Traffic No DRIVING FOR EMPLOYER Parked Pedestrian Bicyclist Other E.G. ROLLAWAY DRIVER S NAME FIRST MIDDLE LAST DRIVER LICENSE NUMBER DRIVER S STREET ADDRESS STATE DATE OF BIRTH CITY ZIP CODE TELEPHONE NUMBERS Wk VEHICLE LICENSE PLATE OR VEHICLE IDENTIFICATION NUMBER VEHICLE YEAR AND MAKE Hm DAMAGES OVER 750 VEHICLE OWNER PERSON OR COMPANY ADDRESS INSURANCE COMPANY NAME NOT AGENT OR BROKER AT THE TIME OF THE ACCIDENT COMPANY NAIC NUMBER POLICY NUMBER POLICY PERIOD POLICY HOLDER NAME From To Stopped in Traffic OTHER PARTY S INFORMATION NAME AND ADDRESS OF INDIVIDUAL INJURED OR DECEASED INJURY/DEATH PROPERTY DAMAGE Injured Driver Passenger Deceased OTHER PROPERTY DAMAGED TELEPHONE POLES FENCE LIVESTOCK ETC. Place the correct National Association of Insurance Commissioners NAIC number for your insurance company in the boxes provided. The NAIC number should be located on your insurance ID card or you can contact your insurance agent or company for the information. Identify any person involved in the accident driver passenger bicyclist pedestrian etc. who you saw was injured or complained of bodily injury or know to be deceased. Record in the OTHER PROPERTY DAMAGED section any damage to telephone poles fences street signs guard posts trees livestock dogs etc. meeting the filing requirement including amount. This may require that you contact the owner of the property for an estimate of damages. Once you have completed this report please mail it to DePARTMeNT OF MOTOR VehICleS FINANCIAl ReSPONSIBIlITY MAIl STATION J237 SACRAMeNTO CA 94284-0884 DMV does not accept reports or take actions against non-reporting or uninsured motorists unless this SR-1 form is sent to DMV by someone involved in the accident or their designee and the report is received by DMV within one calendar year of the accident date. ADVISORY STATeMeNT The accident information on the SR-1 is required under the authority of Divisions 6 and 7 of the California Vehicle Code. Failure to provide the information will result in suspension of the driving privilege. Except as made confidential by law e.g. medical information or exempted under the Public Records Act the information is a public record is regularly used by law enforcement agencies and insurance companies and is open to public inspection. 16005 CVC limits the public record for SR-1 reports to accident involvement but does allow persons with a proper interest involved drivers their employers etc. to receive specified information. Individuals may inspect or obtain copies of information contained in their records during regular office hours.