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Instructions for
Operator's Report of Motor Vehicle Accident Form

If you are involved in a motor vehicle accident where someone is injured (no matter how minor), or if there is over $1000 in damage to any vehicle or property, you must submit an accident report to the Registry of Motor Vehicles within five (5) business days. Your license can be suspended or revoked if you fail to submit an accident report within this time period.

When filling out an accident report you are required to provide the following information (please type or print clearly):

-->Full name of operator and address
 
-->Date of birth
 
-->Driver’s license number and state
 
-->Registration number (license plate) and state
 
-->Owner's name and address (if different than operator)
 
-->Insurance company
 
-->Location of accident (street and number, or route number, nearest intersection, and city/town)
 
-->Date and time of accident
 
-->Number of vehicles involved
 
-->Description and diagram of accident
 
-->Signature and date
 
-->Other vehicle information - registration number (license plate) and state*
Other operator information - name, date of birth, and driver’s license number*

*This information must be provided to the RMV if it has been provided to you as a result of any paperwork exchange at the time of the accident or otherwise. If this information is not known to you, please write UNKNOWN in the applicable section. Keep in mind that the release of this information by the Registry of Motor Vehicles or the Hatfield Police Department is restricted by Federal Law, so do not call the police department or visit an RMV office to request this information.

You will need three (3) completed copies of this form. The first copy must be forwarded to the Massachusetts Registry of Motor Vehicles. The second copy must be forwarded to your insurance company. The third copy must be forwarded to the police department of the city or town in which the accident occurred. If the accident happened in Hatfield and was covered by the Hatfield Police Department, you can get our mailing address in the Contact Us section. It is also a good idea to keep one additional copy of the accident report for your own records.

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