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Navigating the aftermath of a vehicle crash involves more than just dealing with the immediate physical and emotional impacts—it also requires handling certain legal responsibilities, one of which includes completing the Tennessee Driver Form. Issued by the Tennessee Department of Safety and Homeland Security, this form is an essential document for drivers who find themselves in the unfortunate situation of a car crash that results in injury, death, or property damage exceeding $400. The form requests detailed information about the crash, such as the date, location, and specifics about the vehicles and individuals involved. Additionally, it inquires about insurance coverage and requires the driver to disclose whether there were any injuries or fatalities as a result of the incident. The completion and timely submission of this form, directly to the Tennessee Department of Safety and Homeland Security, are crucial not just for compliance with state laws but also for the potential impact on one’s driving privileges. Failure to submit this report within twenty days of the crash could lead to the suspension of a driver’s license and registrations, highlighting the importance of understanding and promptly fulfilling this legal obligation.

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TENNESSEE DEPARTMENT OF SAFETY

AND HOMELAND SECURITY

OWNER / DRIVER REPORT

IMPORTANT: COMPLETE FORM BELOW AND MAIL TO: TN DEPARTMENT OF SAFETY AND HOMELAND SECURITY P.O. BOX 945

NASHVILLE, TN 37202-0945

DATE OF CRASH:

PLACE OF CRASH:

 

 

 

Month/Day/Year

 

 

 

 

VEHICLE MAKE:

 

 

VEHICLE YEAR:

NAME OF OPERATOR:

 

 

 

First

 

 

 

 

 

Last

 

 

 

ADDRESS:

 

 

 

 

Number

Street

DRIVER LICENSE NUMBER:

 

 

 

 

STATE:

NAME OF OWNER:

 

 

 

First

 

 

 

 

 

Last

 

 

 

ADDRESS:

 

 

 

 

Number

Street

DRIVER LICENSE NUMBER:

 

 

 

 

STATE:

WERE THERE INJURIES OR DEATH INVOLVED IN THIS CRASH? WERE THERE DAMAGES TO YOUR VEHICLE?

IF YES, WERE THEY LESS THAN $1,500?

OR GREATER THAN $1,500

WERE THERE DAMAGES TO STATE OR LOCAL PROPERTY?

IF YES, WERE THEY LESS THAN $400?

OR GREATER THAN $400

City

County

VEHICLE TYPE:

DOB:

MiddleMonth/Day/Year

City

State

Zip

EXPIRATION DATE:

DOB:

MiddleMonth/Day/Year

City

 

State

Zip

 

EXPIRATION DATE:

 

YES

NO

 

YES

NO

 

IF OVER $1,500, ENTER AMOUNT

 

YES

NO

 

IF OVER $400, ENTER AMOUNT

 

IF AVAILABLE, LIST THE FOLLOWING INFORMATION ON THE OTHER DRIVER INVOLVED IN THIS CRASH:

Last NameFirst NameMiddle Initial Driver License Number

DID YOU HAVE LIABILITY INSURANCE COVERAGE FOR THIS CRASH?

YES

NO

 

IF YES, PROVIDE COMPLETE INFORMATION BELOW:

 

 

 

 

 

 

NAME OF INSURANCE COMPANY (NOT AGENCY):

 

 

 

 

 

 

ADDRESS:

 

 

 

 

City

 

 

 

 

 

 

Number

Street

 

 

State

Zip

POLICY NUMBER:

 

 

 

POLICY PERIOD:

FROM:

 

TO:

 

 

NAME OF POLICYHOLDER:

 

 

 

 

 

 

 

 

 

 

ADDRESS:

 

 

 

 

City

 

 

 

 

 

 

Number

Street

 

 

State

Zip

NAME OF INSURANCE REPRESENTATIVE (AGENCY) WHO ISSUED POLICY:

 

 

 

 

 

 

ADDRESS:

 

 

 

 

City

 

 

 

 

 

 

Number

Street

 

 

State

Zip

NOTE: THE INSURANCE INFORMATION YOU PROVIDE WILL BE FORWARDED TO THE INSURANCE COMPANY FOR VERIFICATION.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature

 

 

 

Date

 

SF-0395 (Rev. 12/18)

RDA 1348

TENNESSEE DEPARTMENT OF SAFETY AND HOMELAND SECURITY

OWNER / DRIVER REPORT

As set forth under the provisions of 55-12-104, T.C.A., you must file, or have filed in your behalf, a personal report with the Department of Safety and Homeland Security, if you were involved in an automobile crash as an owner or driver involving death or injury, or in which damage to property was in excess of one thousand five hundred dollars ($1,500) to any person involved OR if an accident results in damage to state or local government property in excess of four hundred dollars ($400). This report is required regardless of who was at fault and in addition to any report filed by an investigating officer.

Failure to file a personal crash report with the Tennessee Department of Safety and Homeland Security may result in the suspension of driver license and registrations or nonresident operating privileges of any person involved in a crash.

Your report must be submitted to the Department within twenty (20) days from the crash. You can satisfy this requirement by completing the reverse side of this from and mailing it to the Tennessee Department of Safety and Homeland Security, P.O. Box 945, Nashville, TN 37202. If you have any questions, please call

toll-free (866) 903-7357 or the Telecommunications Device for the Deaf (615) 532-2281.

Thank you for your cooperation.

TENNESSEE DEPARTMENT OF SAFETY AND HOMELAND SECURITY

SF-0395 (Rev. 12/18)

RDA 1348

Document Data

Fact Detail
Governing Law Tennessee Code Annotated (T.C.A.) § 55-12-104 mandates the filing of this report for certain crashes.
Form Name Tennessee Department of Safety and Homeland Security Owner / Driver Report (SF-0395 Rev. 2/14)
Submission Address TN Department of Safety and Homeland Security P.O. Box 945, Nashville, TN 37202
Required Reporting Conditions Report is required for crashes involving death or injury, or property damage in excess of four hundred dollars ($400).
Submission Deadline Report must be filed within twenty (20) days from the date of the crash.
Penalties for Non-Compliance Failure to file may result in suspension of driving privileges and vehicle registrations.
Contact Information for Questions Toll-free number (866) 903-7357 or Telecommunications Device for the Deaf (615) 532-2281.
Insurance Verification Provided insurance information will be forwarded to the named insurance company for verification.

Detailed Guide for Using Tennessee Driver

After an automobile crash in Tennessee that results in injury, death, or property damage greater than $400, you are required to file a personal crash report with the Tennessee Department of Safety and Homeland Security. This is a rule regardless of who was at fault. It's a crucial step to ensure that your driving privileges are maintained. Completing and submitting this form within 20 days of the incident helps you comply with state laws and can prevent the suspension of your driver's license. This form is your way of officially reporting the incident. If you need any assistance, don't hesitate to reach out to the provided contact numbers.

To fill out the Tennessee Driver form, follow these steps:

  1. Date of Crash: Enter the month, day, and year when the crash occurred.
  2. Place of Crash: Write the city and county where the accident took place.
  3. Vehicle Information: Include the make, year, and type of your vehicle.
  4. Name of Operator: Provide your last, first, and middle name, along with your date of birth (DOB).
  5. Address: Enter your street address, city, state, and zip code.
  6. Driver License No: Fill in your driver's license number, the state it was issued in, and its expiration date.
  7. Name of Owner: If you're not the vehicle owner, provide the owner's last, first, and middle name, and DOB.
  8. Owner's Address: Include the vehicle owner's street address, city, state, and zip code. Repeat driver license details for the owner if different from the operator.
  9. Injuries or Death: Indicate whether the crash involved injuries or fatalities by marking "YES" or "NO".
  10. Damage to Your Vehicle: Specify if the damage was less than or over $400. If over $400, provide the estimated amount.
  11. Other Driver Information: If another driver was involved, list their information including name, driver license number, if available.
  12. Liability Insurance Coverage: Indicate whether you had liability insurance for this crash. If yes, fill in the insurance company's name, address, policy number, policy period, name of the policyholder, and the insurance representative who issued the policy.
  13. Signature and Date: Sign the form and write the date to verify that the information provided is accurate.
  14. After completing the form, mail it to the Tennessee Department of Safety and Homeland Security at the address provided on the form. Remember, this document should be sent within 20 days of the crash to comply with Tennessee law. Make sure to keep a copy of the form for your records.

Important Questions on This Form

What is the purpose of the Tennessee Owner/Driver Report?

The Tennessee Owner/Driver Report is a crucial document designed for individuals involved in automobile crashes. It serves to report incidents involving death, injury, or property damage exceeding $400 to the Tennessee Department of Safety and Homeland Security. This form fulfills the requirements set by the state law, ensuring that all pertinent information about the crash is officially documented. It's an additional step to any report that may have been filed by an investigating officer at the scene.

When should the Tennessee Owner/Driver Report be submitted?

According to the guidelines provided by the state, this report must be submitted within 20 days following the crash. Timely submission is critical to comply with the law, and failing to do so might lead to the suspension of your driving privileges, including the suspension of your driver's license and vehicle registrations.

Where should I mail the completed Tennessee Owner/Driver Report?

Once you have filled out the report, mail it to the Tennessee Department of Safety and Homeland Security at the following address: P.O. Box 945, Nashville, TN 37202. This ensures that your report reaches the appropriate department for processing and verification.

What information is required on the Tennessee Owner/Driver Report?

The report requires detailed information from the crash, including:

  • The date and place of the crash, including city and county.
  • Details about the vehicle involved, such as make, year, and type.
  • The name, date of birth, address, and driver's license information of both the operator and owner of the vehicle.
  • Information regarding injuries or death, if any, related to the crash.
  • The extent of damages to your vehicle.
  • Details about the other driver involved, if available.
  • Liability insurance coverage information.

Who needs to file a Tennessee Owner/Driver Report?

This report must be filed by or on behalf of the owner or driver of a vehicle involved in an auto crash that results in either death, injury, or property damage in excess of $400. It does not matter who was at fault for the accident; the requirement to file this report applies to all involved parties.

What happens if I do not submit the Tennessee Owner/Driver Report?

Failing to submit the Tennessee Owner/Driver Report within the specified 20-day period can have severe consequences. Those involved in the crash risk having their driver licenses and registrations suspended. The report is a legal requirement intended to keep the roads safe for everyone by ensuring all incidents are properly documented and reviewed.

Common mistakes

When filling out the Tennessee Driver Form, it's essential to approach it with attention to detail. Frequently, individuals can make errors that can lead to complications or delays in their submissions. Understanding these common pitfalls can help ensure the process goes smoothly.

One of the most common mistakes is providing inaccurate information regarding the date and place of the crash. It's crucial to double-check these details because they are key to the report. Another frequent oversight is not being precise about the vehicle information, including make, year, and type. This information helps identify the vehicle involved in the crash accurately.

Additionally, many people mistakenly provide incomplete or incorrect personal information. This includes the name of the operator or owner, date of birth, and especially the driver license number and expiry date. For the form to be processed without delay, all personal details must be correct and thoroughly checked before submission.

Moreover, errors can occur when addressing the question regarding injuries or death involved in the crash. It is imperative to answer this honestly and ensure that the details around damages—whether below or above $400—are accurately reported. Misunderstandings or mistakes in this section can have serious implications.

Another common mistake is failing to provide complete and accurate insurance information, including the name of the insurance company, policy number, and policy period. This information is crucial for verification and to ensure that all parties involved are adequately covered. Failing to list correct information can lead to delays and complications with insurance claims.

People often forget to include information about the other driver involved in the crash, if applicable. This includes the other driver's full name, driver license number, and insurance information, if available. This oversight can lead to incomplete reports and potential challenges in establishing responsibility and pursuing claims.

  1. Not double-checking the date and place of the crash for accuracy.
  2. Omitting or inaccurately detailing vehicle information.
  3. Providing incomplete or incorrect operator or owner personal information.
  4. Misreporting details regarding injuries, death, and damages.
  5. Failing to supply complete and accurate insurance information.
  6. Forgetting to list information on the other driver involved.

In conclusion, to ensure that the process of filing the Tennessee Driver Form goes as intended, individuals must take care to avoid these common mistakes. Diligence in completing the form, coupled with double-checking all entered information, will help in fulfilling the requirement efficiently and accurately. Remember, the accuracy of this information is crucial not just for bureaucratic processing, but also for any necessary follow-up actions related to insurance or legal matters.

Documents used along the form

When completing the Tennessee Driver Form for reporting an automobile accident, various other documents may be required to ensure a comprehensive submission. These documents are essential for a variety of reasons, such as verifying personal information, providing additional details about the incident, or fulfilling state legal requirements. Understanding each document's role can significantly streamline the process for all parties involved.

  • Proof of Insurance: This document verifies that the vehicle involved in the crash was covered by an insurance policy at the time of the incident. It should list the policy number, coverage dates, and the name of the insurance company.
  • Vehicle Registration: The vehicle registration provides essential information about the vehicle, including the make, model, year, and registered owner, which must match the details on the Tennessee Driver Form.
  • Driver’s License: A copy of the driver’s license for each person involved in the crash verifies their identity and driving privileges at the time of the incident.
  • Police Report: If law enforcement was called to the scene, a police report would offer an objective third-party perspective on the crash. It includes detailed information about the circumstances surrounding the incident.
  • Witness Statements: Statements from witnesses can provide additional insights into the crash, contributing to a more thorough understanding of events.
  • Medical Reports: If there were injuries, medical reports detail the extent and nature of these injuries. This is crucial for insurance claims and legal proceedings.
  • Photographs of the Accident Scene: Photos taken at the scene can offer visual evidence of the crash, showing vehicle positioning, damage, and road conditions.
  • Repair Estimates: Documentation of repair estimates or receipts for vehicle damage resulting from the crash helps to substantiate claims for compensation.
  • Correspondence with Insurance Companies: Keeping a record of all communications between the involved parties and insurance companies ensures transparency and might be necessary for settling disputes.

Together, these documents complement the Tennessee Driver Form by providing a full narrative and evidentiary support for the incident. It's important for individuals involved in a crash to collect and organize these documents promptly to avoid potential delays in processing their reports or claims. By understanding the purpose and requirement of each document, individuals can navigate the post-accident procedures with greater ease and confidence.

Similar forms

The Tennessee Driver form shares similarities with the California Accident Report form, primarily in its function and the type of information it solicits. Both forms are designed to collect details about vehicle accidents directly from the involved parties. They require information about the date and location of the crash, details of the vehicle and operator, including driver's license number and state, as well as specifics about damages and injuries. Furthermore, both forms ask whether there was insurance coverage for the incident and necessitate policy details for verification. This collect-and-report approach facilitates a database for law enforcement and insurance companies, enhancing post-accident procedures.

Similarly, the New York Motor Vehicle Accident Report form echoes the structure and content of the Tennessee Driver form. It's designed to compile exhaustive information from the accident's participants, focusing on the incident's specifics, vehicle details, and personal information about the driver and the vehicle owner. What makes it akin is its compulsory nature when the accident involves significant damages or injuries, aiming to ensure a formal record is maintained. Additionally, it emphasizes the importance of insurance information, mirroring Tennessee's approach to corroborating coverage and streamlining the insurance claim process.

The Texas Peace Officer’s Crash Report form, while filled out by law enforcement rather than the individuals involved, also parallels the Tennessee Driver form in content and purpose. This document records comprehensive accident details, including but not limited to the date, time, and location of the crash, participant information, and an assessment of damages and injuries. The collection of insurance details for validation purposes is another common feature. The key difference lies in the reporter's identity, showcasing the Tennessee form's uniqueness in empowering the drivers and owners to submit their account directly.

The Florida Traffic Crash Report form is utilized by law responders to document road incidents comprehensively, presenting another document sharing the consumer-direct reporting intent of the Tennessee Driver form. Like its counterparts, it demands exhaustive crash specifics, vehicle and personal details of the parties involved, and mandatory insurance information to facilitate claims and legal procedures. Although differing in the preparer, the essence of capturing a detailed record for future reference, insurance validation, and legal compliance underlines a shared objective with the Tennessee Driver form, emphasizing the uniform need across states to meticulously document traffic incidents.

Dos and Don'ts

When you're filling out the Tennessee Driver form, it's important to follow certain do's and don'ts to ensure the process goes smoothly and your form is accepted. Here’s a guideline to help you:

Things You Should Do:

  1. Double-check the date of the crash, making sure it's correctly entered as month/day/year.
  2. Write the complete address including street, city, and state in the designated spaces for both the operator and owner of the vehicle.
  3. Specify whether there were injuries or deaths involved in the crash by marking the appropriate YES or NO option.
  4. Be accurate when reporting damages to your vehicle and specify the amount if the damages are over $400.
  5. Provide complete insurance information, including the name of the insurance company (not the agency), policy number, and policy period.
  6. Sign and date the form at the bottom to verify that all the information provided is true and correct.

Things You Shouldn't Do:

  • Don’t leave any required fields blank. If a section does not apply, it’s better to write “N/A” than to leave it empty.
  • Don’t guess on the details; make sure all the information is accurate to avoid processing delays or issues with insurance verification.
  • Avoid providing incomplete or inaccurate insurance information. This could lead to complications, especially if the crash involved significant damages or injuries.
  • Don’t overlook the section that asks about the other driver involved in the crash, if applicable. Provide as much information as you have available.
  • Do not write outside the provided fields or margins to ensure that all the information is readable when the form is processed.
  • Don’t forget to mail the form within 20 days from the date of the crash to the Tennessee Department of Safety and Homeland Security to avoid potential penalties.

Misconceptions

Understanding the Tennessee Driver Form can sometimes lead to confusion, primarily due to misconceptions about its purpose and requirements. Here are six common misconceptions and the truths behind them:

  • Misconception 1: The form is only necessary for accidents involving serious injuries or fatalities.

    Actually, Tennessee law requires this form for any crash involving injury, death, or property damage over $400. This includes minor accidents that may not seem significant at the time.

  • Misconception 2: You only need to fill out this form if the police did not respond to the crash.

    Even if law enforcement is present and files a report, owners or drivers involved still need to submit this form to the Tennessee Department of Safety and Homeland Security according to state law, if the damage exceeds $400 or there's an injury or death.

  • Misconception 3: Filing this form will automatically cause your insurance rates to increase.

    Filing this form is a legal requirement and does not automatically signal to your insurance company that your rates should increase. It’s the claim filed with your insurance that might affect your premium, not the submission of this report.

  • Misconception 4: You have infinite time to submit this form after an accident occurs.

    The law stipulates a 20-day window post-crash to submit this form to the Department of Safety and Homeland Security. Delaying beyond this period could lead to penalties, including the suspension of driving privileges.

  • Misconception 5: The form is complex and requires legal assistance to complete.

    While the form does require thorough information about the crash, it’s designed for drivers to complete without the need for legal help. Clear instructions are provided to guide individuals through the process.

  • Misconception 6: Personal information provided on the form will be shared publicly.

    The information you provide on the form is used for official purposes, to verify insurance coverage, and to comply with state laws regarding crash reporting. It's not made publicly available and is shared with your insurance for verification purposes only.

Understanding these key points can help demystify the process of completing and submitting the Tennessee Driver Form and ensure compliance with state requirements following a crash.

Key takeaways

When individuals are involved in an automobile accident in Tennessee, particularly one that results in injury, death, or property damage exceeding $400, they are required to file an Owner/Driver Report with the Tennessee Department of Safety and Homeland Security. This requirement applies regardless of who was at fault in the accident. Here are key takeaways about completing and utilizing the Tennessee Driver form:

  • The form must be submitted within 20 days from the date of the crash. Timely submission is crucial to avoid potential suspension of driver's licenses and registrations or nonresident operating privileges for those involved.
  • It is important to provide detailed information about the crash, including the date, location (city and county), and specifics about the vehicle(s) involved (make, year, and type).
  • The Operator and Owner sections require full names, dates of birth, addresses, driver’s license numbers, and license expiration dates for both the driver and the owner of the vehicle, if they are not the same person.
  • Reporting accurately whether there were injuries or deaths as a result of the crash is mandatory. This information is critical for the Department of Safety and Homeland Security.
  • For crashes involving damages, it is necessary to indicate whether the damages were less than or over $400. If over $400, the exact amount should be provided.
  • If another driver was involved in the crash, their information should also be included if available. This assists in the comprehensive documentation of the incident.
  • Confirming whether there was liability insurance coverage at the time of the crash is required, with specific details about the insurance company, policy number, and policy period.
  • The insurance information will be forwarded to the named insurance company for verification, underscoring the importance of providing accurate and complete information.
  • The form must be signed and dated by the individual completing it, affirming the accuracy and truthfulness of the information provided.

Adherence to these guidelines when filling out and submitting the Tennessee Department of Safety and Homeland Security Owner/Driver Report form not only complies with Tennessee law, as set forth under the provisions of 55-12-104, T.C.A., but also facilitates the efficient handling of crash reports and potential insurance claims following an automobile accident.

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