Page 704 - The Central Motor Vehicles Rules, 1989

676 THE CENTRAL MOTOR VEHICLES RULES, 1989 ANNEXURE-XIII

Verification:
Verified at ..................................... on this ................................. day of ............................. that
the contents of the above Form are true to my knowledge and the documents attached
are true copies of their originals.
Documents to be attached:
i. ID/address proof
ii. Registration Certificate
iii. Driving Licence of the Driver
iv. Insurance Policy
v. Permit
vi. Fitness
FORM-V
INTERIM ACCIDENT REPORT (IAR)
By Passenger(s) and Pedestrian(s) to Investigating Officer to Claims Tribunal
Within fifty (50) days of Accident
Copy to Victim(s) and Insurance Company and SLSA

FIR No.
Date
Under Section
Police Station

1. Date of Accident
2. Time of Accident
3. Place of Accident
4. Offending Vehicle
Registration No.

Vehicle Make
Vehicle Model
5. Driver of the offending vehicle
Name
Father’s Name

Mobile No.
Address
Driving Licence Permanent
Learner’s
Juvenile
Without License
Others (Specify)

Driving Licence No.