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Navigating the aftermath of a vehicle crash in Tennessee can be stressful, but understanding the proper steps to report the incident is crucial for all involved parties. The Tennessee Department of Safety and Homeland Security provides a specific form, known as the Owner / Driver Report (SF-0395 Rev. 2/14), for individuals to report an automobile crash. This form is essential in instances where the crash led to injuries or death, or if there was property damage exceeding $400. It gathers comprehensive details including the date and location of the crash, information about the vehicle and the driver, as well as specifics regarding any damages and insurance coverage. Furthermore, Tennessee law mandates that this form must be submitted within 20 days following the crash, irrespective of the fault. Failing to submit this report can lead to penalties such as the suspension of driving privileges. The form also serves as a means to communicate with insurance companies for verification purposes. Understanding the importance of this document and accurately completing it ensures compliance with state laws, aids in the swift processing of insurance claims, and helps maintain accurate records of road incidents within the state.

Preview - Tennessee Driver Form

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

Form Data

Fact Name Description
Form Identification The form is identified as SF-0395 (Rev. 2/14).
Governing Law The form is governed by the provisions of 55-12-104, T.C.A. (Tennessee Code Annotated).
Required Reporting Owners or drivers involved in crashes resulting in death, injury, or property damage over $400 must file this report.
Submission Deadline The report must be submitted within 20 days from the date of the crash.
Submission Method The completed form should be mailed to the Tennessee Department of Safety and Homeland Security, P.O. Box 945, Nashville, TN 37202.
Reporting Failure Consequence Failure to file may result in the suspension of driving privileges and vehicle registrations.
Contact Information For questions, there are toll-free and TDD numbers: (866) 903-7357 and (615) 532-2281, respectively.

Instructions on Utilizing Tennessee Driver

To ensure compliance with the Tennessee Department of Safety and Homeland Security, individuals involved in a vehicle crash resulting in injury, death, or significant property damage need to submit a detailed report. This documentation aids in the official record-keeping of the incident and is a requirement that serves to protect the interests of all parties involved. Completing the form accurately and submitting it within the set timeframe can prevent potential license or registration suspensions. The following instructions are designed to guide you through the process of filling out the Tennessee Owner/Driver Report.

  1. Start by entering the Date of the Crash in the format month/day/year.
  2. Fill in the Place of Crash section with the City and County where the incident occurred.
  3. Specify the Vehicle Make, Year, and Type in the respective fields.
  4. Provide the Name of Operator including the Last, First, and Middle names.
  5. Enter the Date of Birth (DOB) of the Operator.
  6. Fill in the complete Address, including Street, City, State, and ZIP code for the Operator.
  7. Include the Driver License Number, State of issuance, and its Expiration Date.
  8. Repeat steps 4 through 7 to provide details for the Name of Owner if different from the Operator.
  9. Mark whether there were Injuries or Death involved in the crash with a YES or NO.
  10. Indicate the Damage to Your Vehicle, selecting less or over $400, and specify the amount if over $400.
  11. If another driver was involved, list their Last Name, First Name, Middle Initial, and Driver License Number.
  12. Answer whether you had Liability Insurance Coverage for this crash with a YES or NO.
  13. If you had insurance, provide the Name of Insurance Company, their Address, and ZIP code.
  14. Include the Policy Number and Policy Period details.
  15. Fill in the Name of Policyholder and their Address.
  16. List the Name of Insurance Representative (Agency) and their Address, including ZIP code.
  17. Read the note regarding insurance information verification by the company.
  18. Sign and date the form at the bottom to verify the accuracy of the information provided.

Once completed, mail the form to the Tennessee Department of Safety and Homeland Security at the address provided. It's crucial to complete each step with accurate and current information to avoid any legal complications or delays in processing your report. Remember, this document serves as an official record of the incident and is instrumental in the resolution of any claims or disputes that may arise.

Obtain Answers on Tennessee Driver

  1. What is the Tennessee Department of Safety and Homeland Security Owner/Driver Report?

    This report is a document you must fill out and submit if you were involved in a car crash in Tennessee as either the owner or the driver of a vehicle. This requirement kicks in if the crash resulted in injury or death, or if there was property damage exceeding $400 to anyone involved. It's your way of providing a personal account of the incident, aside from any report a police officer might make.

  2. When do I need to submit this report?

    You must send this report to the Tennessee Department of Safety and Homeland Security within 20 days of the crash. This is a strict deadline that, if missed, could lead to consequences such as the suspension of your driving privileges.

  3. Where should I mail the completed form?

    After filling out the form, mail it to the Tennessee Department of Safety and Homeland Security at P.O. Box 945, Nashville, TN 37202.

  4. What information will I need to provide in the report?

    Information needed for the report includes details of the crash like the date, place, your vehicle information, your personal details (name, date of birth, address, driver license info), if there were any injuries or deaths, damages to your vehicle, insurance coverage details, and information about the other driver if applicable.

  5. What happens if I don't report a crash?

    Failure to submit this report can result in the suspension of your driver's license and vehicle registrations or nonresident operating privileges. It's vital to comply with this requirement to avoid legal and logistical issues down the line.

  6. Do I still have to file this report if the police have already made one?

    Yes, regardless of whether a police officer has filed a report on the crash, you are still required by law to submit your personal crash report. This serves as an additional record and may be necessary for insurance or legal reasons.

  7. Does it matter who was at fault in the crash?

    No, your obligation to file this report does not depend on who was at fault in the accident. Whether you caused the crash or were a victim, if the incident meets the criteria (injury, death, or property damage over $400), you need to submit the report.

  8. How do I know if there was more than $400 damage?

    If you're unsure about the extent of the property damage, it's a good idea to consult with a professional mechanic or auto repair specialist. They can provide a detailed estimate. Whenever in doubt, or the damage seems close to the threshold, submitting a report is the safer route to avoid potential penalties.

  9. Who can I call if I have questions about filling out the report?

    If you have any questions or require assistance while completing the form, you can call the Tennessee Department of Safety and Homeland Security toll-free at (866) 903-7357. For individuals who are deaf or hard of hearing, there's a Telecommunications Device for the Deaf (TDD) available at (615) 532-2281.

Common mistakes

  1. Failing to provide complete information regarding the date and place of the crash is a common mistake. It's crucial to enter the exact date (month/day/year) and the complete location (city and county). This ensures the report can be accurately attributed to the event in question.

  2. Not specifying the details of the vehicle involved, such as its make, year, and type, is another oversight. This information helps in identifying the vehicle and understanding the crash dynamics.

  3. Many people forget to include their driver license number, state, and expiration date. This is essential for identifying the driver and verifying their legal ability to drive.

  4. Incorrect or incomplete insurance information, including the name of the insurance company, policy number, and policy period, can lead to issues with claim processing. It's essential to provide full and accurate insurance details as this information will be forwarded to the insurance company for verification.

  5. Omitting information about whether there were injuries or death involved in the crash, as well as not properly indicating the extent of damage to the vehicle, can result in incomplete reporting which may affect insurance claims and legal responsibilities.

  6. Signature and date at the end of the form are often overlooked. However, this is a crucial step as it certifies the accuracy of the information provided and completes the submission process.

It's important to remember that the completed report must be sent within twenty days from the crash to avoid any potential penalties, including the suspension of driving privileges. Thoroughness and accuracy are key to ensuring that the report fulfills legal requirements and assists in any subsequent insurance or legal processes.

Documents used along the form

When dealing with an automobile crash in Tennessee, particularly one that necessitates filing an Owner/Driver Report with the Tennessee Department of Safety and Homeland Security, there are several other documents and forms that may be necessary to provide a comprehensive account of the incident, facilitate insurance claims, or comply with legal requirements. The following documents often supplement the Tennessee Driver form to ensure all relevant details and procedures are thoroughly covered.

  • Proof of Insurance: A document provided by your insurance company verifying your current coverage. This is often required at the scene of the crash, for the Owner/Driver Report, and when registering or renewing vehicle registration.
  • Vehicle Registration: This document proves that the vehicle involved in the crash is legally registered under state law. It is necessary for identification purposes and to verify ownership.
  • Accident Information Exchange Form: A form filled out at the crash scene, including information on all parties involved, insurance details, and a brief description of the accident. This form is helpful for insurance claims and legal purposes.
  • Medical Records: If the crash resulted in injuries, medical records might be necessary to document these injuries' nature and extent. This is crucial for insurance claims and potential legal action.
  • Police Report: A report filed by the responding officer at the scene of the crash provides an impartial account of the incident. This report is essential for insurance claims and legal matters.
  • Witness Statements: Written accounts from witnesses can provide additional perspectives on the crash's circumstances. These statements can be valuable for insurance and legal processes.
  • Photographs of the Accident Scene: Pictures taken at the crash site, including damages to vehicles, relevant road conditions, and traffic signs, can serve as important evidence for insurance claims and legal inquiries.
  • Repair Estimates: Written estimates from auto repair shops detailing the cost of repairing damages to the vehicle(s) involved in the crash. These estimates are usually required by insurance companies to process a claim.
  • Receipts for Expenses Incurred due to the Crash: Documentation of any out-of-pocket expenses related to the crash, such as car rentals, medical expenses, or repairs, can be necessary for reimbursement from insurance companies.

Navigating the aftermath of a vehicle crash involves handling numerous documents and forms that are crucial for legal, insurance, and personal record-keeping purposes. The proper compilation and submission of these documents, including the Tennessee Department of Safety and Homeland Security Owner/Driver Report, facilitate the accurate assessment of the crash and ensure compliance with state laws. Armed with the right information and documentation, individuals involved can effectively manage the situation, support insurance claims, and fulfill legal obligations.

Similar forms

The Tennessee Driver Form, a detailed document required by the Tennessee Department of Safety and Homeland Security in the event of a vehicle crash, shares similarities with several other types of documents. These documents are all integral in various administrative, legal, and official processes, each designed to collect specific information for official record-keeping, verification, and sometimes, for legal compliance. Here’s a look at nine documents similar to the Tennessee Driver Form:

  • Car Insurance Claim Forms: Like the Tennessee Driver Form, insurance claim forms require detailed information about the vehicle, the incident, and the parties involved. They are used to assess responsibility and calculate compensations.
  • Accident Report Forms: Typically filled out at the scene of an accident or shortly after, these forms gather information about the participants, the nature of the accident, and any damages incurred, similar to the details required by the Tennessee Driver Form.
  • Vehicle Registration Forms: These forms collect detailed information about the vehicle owner and the vehicle itself, much like sections of the Tennessee Driver Form, though focused on registration rather than incident reporting.
  • Driver's License Application Forms: These require personal information, including name, address, and driver license number, paralleling the personal identification details requested in the Tennessee Driver Form.
  • Health Insurance Claim Forms: While focused on medical information, like car insurance forms, they require detailed incident documentation to process claims, aligning with the injury or damage reporting component of the Tennessee Driver Form.
  • Property Damage Reports: Used to report damages to property, these forms necessitate comprehensive documentation of the incident's circumstances and outcomes, akin to the damage assessment in the Tennessee Driver Form.
  • Legal Affidavits for Traffic Incidents: These documents, used in legal proceedings following traffic incidents, require detailed recounting of the incident, similar to the narrative and factual specificity in the Tennessee Driver Form.
  • Parking Permit Applications: Although for a different purpose, these applications often require vehicle information and owner details similar to what is required in the Tennessee Driver Form.
  • Warranty Claim Forms for Vehicle Repairs: Like insurance claim forms, warranty claims require detailed information about vehicle issues presumably related to accidents or incidents, aligning with the documentation of damages on the Tennessee Driver Form.
  • Feedback Forms for Road Conditions or Traffic Incidents: Such forms, used by municipalities or states, gather citizen reports on road safety issues or incidents, demanding specifics about the incident, location, and sometimes, the reporter’s vehicle, paralleling aspects of the Tennessee Driver Form's use for documenting crash specifics.

Despite the varying contexts and primary purposes of these documents, their common thread lies in the meticulous collection of personal, vehicle, and incident-related information. This information serves as a crucial foundation for processing claims, legal proceedings, registrations, and official records, underscoring the importance of accurate and thorough documentation akin to the Tennessee Driver Form.

Dos and Don'ts

When it comes to filling out the Tennessee Driver Form, making sure you provide accurate and complete information is crucial. Here are some helpful dos and don'ts to ensure your form is properly filled out and submitted:

  • Do make sure to fill out every section of the form that applies to your situation. Leaving out information can lead to delays or even the rejection of your form.
  • Do double-check the accuracy of all personal information, such as your name, address, driver license number, and the details of the vehicle involved in the crash.
  • Do be precise when describing the place and date of the crash, including the city and county. This information is critical for the Department of Safety and Homeland Security.
  • Do not forget to report whether there were any injuries or fatalities as a result of the crash. This information is essential and must be accurate.
  • Do not omit details about your vehicle's damage. Clearly state whether the damages were less than or over $400, and if over, specify the amount. This helps in the assessment of your claim.
  • Do not leave out information regarding your insurance coverage. Providing complete information about your liability insurance, including the policy number and period, is mandatory.

Remember, the Tennessee Department of Safety and Homeland Security requires that this form be filed within 20 days from the date of the crash. Ensuring that your form is filled out correctly and mailed promptly will help avoid any potential delays or complications with your driving privileges. For any questions, do not hesitate to contact the Department directly using the toll-free number or the Telecommunications Device for the Deaf.

Misconceptions

Many individuals encounter confusion regarding the Tennessee Driver form, which is crucial for reporting automobile accidents in the state. Below are four common misconceptions about this form, dispelled to provide clearer understanding and guidance.

  • Only the driver at fault needs to complete the form. This is incorrect. According to the form's instructions, any owner or driver involved in an automobile crash that resulted in death, injury, or property damage over $400 must report the incident. This requirement is independent of fault.
  • The form is optional if a police report is filed. Many people mistakenly believe that if a police officer investigates the crash and files a report, they don't need to submit a personal crash report. However, the form must be submitted by involved individuals within 20 days of the crash, regardless of an officer's report, as per the instructions provided by the Tennessee Department of Safety and Homeland Security.
  • Submitting the form can be postponed indefinitely. A specific timeline is in place for a reason. The form must be mailed to the Tennessee Department of Safety and Homeland Security within 20 days of the incident. Failure to comply can lead to the suspension of driving privileges. Ignorance of this deadline often leads to unintended legal complications.
  • Insurance information is only a formality and not verified. Some drivers fill in their insurance details without ensuring their accuracy, thinking this information is not checked. However, the form clearly states that the provided insurance information will be forwarded to the insurance company for verification. Inaccurate information can lead to penalties or further investigation, making it crucial to provide correct and current insurance details.

Understanding these aspects of the Tennessee Driver form is crucial for responsible vehicle operation and compliance with state regulations. It not only helps in avoiding potential penalties but also ensures that all parties involved in a crash are adequately reported and can be assisted by their insurance policies if needed.

Key takeaways

Filling out and using the Tennessee Driver Form, officially known as the Tennessee Department of Safety and Homeland Security Owner / Driver Report, is a critical step following a vehicle accident in Tennessee. Here are five key takeaways to ensure compliance and accuracy when dealing with this document:

  • Timeliness is crucial. Individuals involved in a vehicle crash resulting in injury, death, or property damage exceeding $400 are mandated by the law under the provisions of 55-12-104, T.C.A., to file the report within twenty (20) days following the crash. Delaying beyond this period risks suspension of driving privileges.
  • The report requires comprehensive information regarding the crash, including the date, location, and specifics of the vehicle involved (make, year, and type). It also calls for detailed personal information from the operator and owner, if they are not the same person. This includes names, addresses, driver license numbers, and states of issue, ensuring both accountability and traceability.
  • Indicating the presence of injuries or fatalities promptly helps in the accurate recording of the crash’s implications. This information aids in distinguishing the severity of incidents and in the decision-making process for follow-up actions by the Department of Safety and Homeland Security.
  • For crashes resulting in property damage above $400, specifying the exact amount is necessary. This aids in the evaluation of the crash's impact and subsequent steps that might be required by both the report filer and the department.
  • Insurance validation plays a significant role. The form mandates the provision of detailed insurance information, including the insurer’s name, policy number, and period. The department verifies this information with the insurance company. Failure to provide accurate insurance details, or the lack of insurance coverage, can lead to severe legal repercussions.

To comply fully with the Tennessee Department of Safety and Homeland Security requirements, ensure that the information provided on the form is complete, accurate, and submitted in a timely manner. The form not only serves as a record of the incident but also as a crucial document for insurance verification and potential legal proceedings. Accurate completion and prompt submission safeguard against possible legal and financial penalties.

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