Click the button below to start downloading the official Dutch European Accident Statement form pdf. In Dutch this document is called “Europees Schadeformulier”.
When you had a traffic accident, you must enter all your details in one of the columns. Make sure you sign the form at the bottom before sending it to your insurance company.
Fill in as many details as you can before your holiday and keep the pre-filled document in your car. This will make it easier when you have to enter all your details right after the accident.
If another party is involved with the same accident, they must enter their details in the other column. Make sure they also sign the form. They can send a copy to their insurance company.
It is allowed that you send e.g. an English version of the form to your insurance company and, they send a French form to theirs. As long as both forms contain the same details and are signed by both parties.
Download other languages
- English – European Accident Statement
- Dutch – Europees Schadeformulier
- Spanish – Declaración Amistosa De Accidente
- French – Constat Amiable D’Accident Automobile
- German – Europäischer Unfallbericht
- Italian – Constatazione Amichevole di Incidente
- Czech – Evropský záznam nehody
- Portuguese – Declaração Europeia de Acidente
- Polish – Wspólne Os’wiadczenie O Zdarzeniu Drogowym
- Russian – Извещение о дорожно-транспортном происшествии