
Igating officer(s) and the State s adjuster(s). WITHIN 48 HOURS: Send copy to AG s Office Claims Manager, DMV Legal/Tort Claims, 555 Wright Way, Carson City, NV 89711 Send copy to Risk Management Claims Manager, 201 S. Roop St., Suite 201 Carson City NV 89701 Time Date of Accident OUR INFORMATION: Driver s Name Agency Office Address Bus. Phone State Driver s Lic. No. Contact Person Phone Title Is this a MOTOR POOL Vehicle? Plate No. Expiration Date Vehicle ID No. (VIN) Year.
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How to fill out the NV RSK-001 online
The NV RSK-001 is a crucial document for reporting vehicle accidents involving state vehicles. This guide provides comprehensive, step-by-step instructions to help you fill out the form accurately and effectively, ensuring all necessary information is reported.
Follow the steps to complete the NV RSK-001 form online.
- Press the ‘Get Form’ button to access the NV RSK-001 form and open it in your editor.
- Begin by entering the time and date of the accident in the designated fields.
- Provide your information by filling in the driver’s name, agency, office address, business phone number, driver's license number, contact person's name, and phone number.
- Indicate whether the vehicle involved is a motor pool vehicle by selecting 'Yes' or 'No'.
- Fill out the vehicle information, including plate number, expiration date, vehicle ID number (VIN), year, make, and model.
- Specify the location of the vehicle and the location of the accident.
- Describe any damage to the state vehicle, specifically indicating if only windshield damage is present.
- State whether the accident was reported to any investigating officers and provide details if applicable.
- For third-party information, indicate if a self-insurance card was provided, then fill in the owner’s name, daytime phone number, address, city/state/zip, insurance company, policy number, insurance agent, and their contact details.
- Document any damage to the other vehicle and note any reported injuries.
- Provide a detailed explanation of the accident circumstances.
- List any witnesses, including their names, addresses, and phone numbers.
- If any persons were injured, include their information, particularly noting if the injured person is a state employee.
- Attach any damage estimates or indicate if estimates will follow.
- Finally, ensure you sign and date the form, and it gets reviewed by a safety coordinator and department head.
- After completing the form, save your changes and choose to download, print, or share the completed NV RSK-001 form.
Complete the NV RSK-001 online to ensure timely reporting of vehicle accidents.
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