Printed Document Instructions

Instructions how to fill in a printed European Accident Statement. Pages 1-2 are for your insurance company, and pages 3-4 are for the other party’s insurance company:

English European Accident Statement of facts page1. First STATEMENT OF FACTS page

Fill in this page. If another party is involved in the accident, they must fill in the other column. If you don’t agree with the information the other party has provided, you can mention this in the “My remarks” section. You must both sign the page at the bottom. Keep this page and send it to your insurance company.

 

 

 

 

English European Accident Statement declaration page2. first DECLARATION page

Fill in this page as soon as possible. Sign the page at the bottom, and send it to your insurance company. This page is optional and may not be included in the downloaded PDF document.

 

 

 

 

English European Accident Statement of facts page3. Second STATEMENT OF FACTS page

If another party is involved in the accident, you and the other party must fill in the columns on this page in exactly the same way as on the first STATEMENT OF FACTS page. If you don’t agree with the information the other party has provided, you can mention this in the “My remarks” section. You must both sign the page at the bottom. The other party keeps this page, and sends it to their insurance company.

 

 

 

English European Accident Statement declaration page4. Second DECLARATION page

The other party must fill in this page as soon as possible, sign it at the bottom, and send it to their insurance company. This page is optional and may not be included in the downloaded PDF document.

 

 

 

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