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Injured Employee Statement Form Name: Job Title: Telephone: Supervisor: Work Location: Location of Accident: Accident Time and Date: Please fully describe the accident sequence from start to finish
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How to fill out accident investigation witness statement
How to fill out an accident investigation witness statement:
01
Begin by providing your personal information, including your full name, contact details, and occupation.
02
Clearly state the date, time, and location of the accident that you witnessed. Be precise and accurate in describing these details.
03
Provide a detailed account of what you saw and heard leading up to, during, and after the accident. Include any relevant information, such as weather conditions, visibility, or any other factors that may have contributed to the incident.
04
Make sure to stick to the facts and avoid adding any personal opinions or assumptions. Your statement should only consist of what you actually observed.
05
Include any identifying information about the individuals involved in the accident, such as names, vehicle descriptions, or other distinguishing characteristics.
06
If you were able to render any assistance or provide any aid following the accident, make sure to mention it in your statement.
07
Sign and date the witness statement to authenticate it. If necessary, have the statement witnessed or notarized by a legal authority.
Who needs an accident investigation witness statement?
01
Law enforcement agencies often require witness statements to investigate and understand the circumstances surrounding an accident accurately.
02
Insurance companies may request witness statements to determine liability and settlement negotiations.
03
Legal professionals and attorneys utilize witness statements during litigation or court proceedings related to the accident.
04
Employers may also request witness statements for internal accident investigations to improve workplace safety protocols and prevent future incidents.
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