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arkansas accident report

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ARKANSAS MOTOR VEHICLE ACCIDENT REPORT SR-1 For reporting motor vehicle accidents which result in damage to the property of any one person in excess of 1 000. 00 or in bodily injury to or in the death of any one person* SAFETY RESPONSIBILITY SECTION P. O. Box 1272 Rm* 1120 Little Rock AR 72203 NOTICE This report must be filed within thirty 30 days of accident. S*R* Case Number Office Use Only Phone number 501 682-7100 Fax number 501 682-2100 YOUR VEHICLE DRIVER INFORMATION Driver s Name...
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Name: Driver's Home Phone (Cell): Driver's Toll Free Number: State: Arkansas License plate number: Motor vehicle make: Make: VIN: Car insurance information: VIN Check: Date and time of accident: Date (MM-DD) and time of injury: (HMM) Driver's license information: Personal information: Driver's signature: Please do not use the fax number. Driver's signature required. Name of person causing accident: (Not required if no injuries reported), date and time: PERSONNEL USE NOTICE: You are required to give notice, including a copy of this report, of your failure to renew your driver license as prescribed in Section 62-20-220 (a)(1) or as directed by the Department of Motor Vehicles, for failure to pay (or postpone payment) any unpaid fees for driving privilege, license plate, registration, or vehicle tax. (This request does not include failure to renew your driver license for any other reason.) In lieu of giving notice, driver license holders are allowed to renew their driver license at the Department of Motor Vehicles. This notice should be mailed by certified mail, return receipt requested to: Department of Motor Vehicles Attn: Driver's License Renewal Unit Box 2630 Little Rock, AR 72207 License and Driver's License Fees, Payment of Annual License Fees, and Failure to Renew a Driver License The Department of Motor Vehicles charges a fee from the applicant for each replacement license in lieu of not renewing the driver license under Section 62-20-370 (40). The driver license renewal notice, including the renewal fee, should normally be mailed or delivered by the person to whom the driver license has been issued and includes: 1. A statement that the driver license will expire on the date stated here, and 2. A statement that renewing the driver license will renew driver privilege requirements established in Section 62-20-220. If the driver applies or registers a vehicle, the renewal notice should normally be attached to a current registration or an original registration card. The driver license renewal notice should normally be mailed or delivered by the person to whom the driver license has been issued. All notices and registrations must be presented at the driver licensing offices by a person authorized by the driver licensing office. Driver licenses issued for employment or to enlist in the armed forces remain valid under this law until expiry.
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