Accident Abstract

REPUBLIC OF KENYA
THE KENYA POLICE
ABSTRACT FROM POLICE ON A ROAD ACCIDENT
To: The officer i/c ……………………………………………………… Division. Date ...………………………………………………..

P.O. Box …………………………………………………………………………… Our ref………………………………………………..
…………………………………………………………………………………………. Police ref…………………………………………….
I/we understand that your Police Sta on received a report of an accident involving……………………………
………………………………………………………………………………………………………………………………………………………………
of (address)……………………………………………………………………………………………………………………………………………
Which occurred on (date)………………………………………..at ( me and place)………………………………………………
……………………………………………………………………………………………………………………………………………………………..
involving vehicle(s) Reg .No. ………………………………………......................make……………………………………………
and……………………………………………………………………......make……………………...............................…………………
Name of police sta on where accident reported……………………………………………………………………………………
From the record could you please furnish us with the following informa on:
1. (a) Name and address of the owner of the vehicle Reg.No…………………………………………………………………
……………………………………………………………………………………………………………………………………………………………….
(b). Name of the Insurance Company…………………………………………………………………………………………………...
2. Has the inves ga on been completed? Yes/No. (delete as appropriate.)
If so, has anyone been charged? Yes /No.
If this case is s ll under inves ga on is there any likelihood of either party being prosecuted? Yes/No.
3. If it is intended to prefer charges, state:
(a) Name of driver/cyclist/pedestrian…………………………………………………………..………………………………………..
(b) Vehicle registra on No………………………………………………………………………………………………………………………
4. Name of charge………………………………………………………………………………………………………………………………….
5. Court Case File No………………………………………/Traffic Charge Reg. No…………………………………………………
6. Name of Inves ga on Officer……………………………………………………………………………………………………………
7. Result of inves ga ons or prosecu ons (if known)……………………………………………………………………………
8. Accident Register/OB Number……………………………………….and date……………………………………………………
9. Persons Injured Name Class of Person Address Nature of Injury
……………………………………............ ………… ……. ……… …………………………… ........................................
……………………………………… ……… ………………. ………. ………….……. ………… ……………………………….......
……………………………………… ……… ………………. ………. ……………... …………… …………………………............
10. Name of Witnesses Addresses
……………………………………………………………………….. ……………………………………………………………………….
………………………………………………………………………… ……………………………………………………………………….
……………………………………………………………………….. ……………………………………………………………………….
Date ……………………………………………………… (Signed)…………………………………………………………………………
Officer-in-Charge
………………………………………………………..
Police Sta on
11. When completed, this form is to be returned to:
Name and address of Insurance Company…………………………………………………………………………………………….
................................................................................................................................................................... .
OR
Legal Representa ve or other interested party sta ng interest and/or connec on with the accident…… .........
………………………………………………………………………………………………………………………………………………………………… .......
.....................................................................
Signature of Person/Company
Applying for the abstract
Note: - when applying forward in triplicate to officer i/c Division.

Accident Abstract

Uploaded by

Copyright:

Available Formats

Accident Abstract

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Accident Abstract

Uploaded by

Copyright:

Available Formats

REPUBLIC OF KENYA

THE KENYA POLICE

ABSTRACT FROM POLICE ON A ROAD ACCIDENT

To: The officer i/c ……………………………………………………… Division. Date ...………………………………………………..

You might also like