Request For Accident Report

As required by the Texas Transportation Code§ 550.65, please provide the information below:
Date of Accident*field type date
The name of any person involved in accident*field type single line
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Relation to the person involved in the accident*field type single line
(Self, Insurance Company, Vehicle Owner, etc. * )
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The specific location of the accident*field type single line
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Incident Nofield type single line
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Your Driver's License Number*field type single line
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Upload Driver's License*field type file upload
Drop files here
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Click Upload to attach a copy of your Driver's License

Contact Information

Phone Number*field type single line
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Email Address*field type single line
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If you do not meet the criteria listed in the Texas Transportation Code Sec. 550.65, the

· Department cannot legally provide you with a copy of any accident report.
Your Name*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Signature*field type signature
Fees for Accident Reports are defined by State Law.
** Proof of relationship to driver may be required