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MV104 (5/11) PAGE 1 of 2Submit to: assets heritage centers.orgHEREFOLDNew York State Department of Motor Vehicles only for accidents that happen in New York StateREPORT OF MOTOR VEHICLE ACCIDENT www.dmv.ny.govBEFORE
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How to fill out mv-104 511 page 1
How to fill out mv-104 511 page 1
01
To fill out the MV-104 511 page 1, follow these steps:
02
Start by providing the date and time of the accident in the designated fields.
03
Fill in the specific location where the accident occurred.
04
Provide detailed information about the involved vehicles, including their make, model, year, license plate number, and VIN.
05
Indicate the severity of the accident by selecting the appropriate option.
06
Note any injuries sustained by individuals involved in the accident.
07
Provide information about the involved parties, including their names, addresses, and roles in the accident (e.g., driver, passenger).
08
Include the insurance information for each involved vehicle.
09
Describe the sequence of events leading up to the accident and include any additional details that may be relevant.
10
If there were witnesses to the accident, provide their names and contact information.
11
Finally, sign and date the form to certify its accuracy.
12
Remember to review the completed form for any errors or omissions before submitting it.
Who needs mv-104 511 page 1?
01
Individuals involved in a motor vehicle accident in New York State are required to fill out the MV-104 511 page 1. This includes drivers, passengers, and pedestrians who were injured or witnessed the accident.
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