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The Tennessee Driver form is a crucial document for individuals involved in an automobile crash in the state. It is essential for both vehicle owners and operators to complete this report when specific conditions arise, such as personal injury or property damage exceeding $400. The form collects vital details including the date and location of the crash, vehicle information, and the names and driving license numbers of those involved. Furthermore, it requires information regarding insurance coverage and any injuries that occurred as a result of the incident, emphasizing the importance of accurate and timely reporting. According to Tennessee law, submitting this form to the Department of Safety and Homeland Security within 20 days of the crash is mandatory. Failure to do so may lead to serious consequences such as the suspension of driving privileges. Understanding the responsibilities outlined in the Tennessee Driver form is not just beneficial; it is necessary for compliance with state regulations and ensuring smooth communication with insurance companies.

Tennessee Driver Example

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 Characteristics

Fact Name Details
Governing Law This form is governed by Tennessee Code Annotated, Section 55-12-104.
Purpose of Form The Owner/Driver Report must be submitted following an automobile crash involving injury, death, or property damage exceeding $400.
Filing Deadline The report must be submitted within twenty days from the date of the crash.
Crash Details Specific information regarding the crash date, location, and types of vehicles involved must be provided.
Insurance Requirement Submitting proof of liability insurance coverage is mandatory if it was in effect at the time of the crash.
Penalties for Non-Compliance Not filing this report may lead to suspension of driver's licenses and vehicle registrations.
Signature Requirement The form must include the signature of the individual submitting the report, along with the date of submission.
Mailing Instructions The completed form should be mailed to the Tennessee Department of Safety and Homeland Security at P.O. Box 945, Nashville, TN 37202.
Contact Information Questions regarding the form can be addressed by calling toll-free at (866) 903-7357.
Form Revision Date The current version of the form, SF-0395, was revised on February 14, 2014.

Guidelines on Utilizing Tennessee Driver

Completing the Tennessee Driver form is an important step following an automobile crash. The information collected will be used for record-keeping and potential follow-ups by law enforcement or insurance companies. To ensure timely processing, make sure to provide accurate details and send the completed form to the specified address. Below are the steps to fill out the form.

  1. Date of Crash: Write the date in the format (month/day/year).
  2. Place of Crash: Enter the city and county where the crash occurred.
  3. Vehicle Make: Specify the make of your vehicle.
  4. Vehicle Year: Indicate the year of your vehicle.
  5. Type of Vehicle: Describe the type of vehicle involved in the crash.
  6. Name of Operator: Fill in the last name, first name, and middle initial of the operator.
  7. Date of Birth: Provide the date of birth of the operator.
  8. Address: Enter the complete address including street, city, state, and ZIP code.
  9. Driver License Number: Write the driver's license number and state.
  10. Expiration Date: Indicate the expiration date of the driver’s license.
  11. Name of Owner: Provide the name of the vehicle's owner (last name, first name, middle initial).
  12. Date of Birth: Fill in the date of birth of the vehicle's owner.
  13. Address: Enter the complete address of the owner, including street, city, state, and ZIP code.
  14. Driver License Number: Write the owner’s driver’s license number and state.
  15. Expiration Date: Indicate the expiration date of the owner’s driver’s license.
  16. Injuries or Death: Check "yes" or "no" to indicate if there were injuries or death involved.
  17. Damages to Your Vehicle: Specify if damages were less than $400 or over $400. If over, enter the amount.
  18. Information on Other Driver: If applicable, provide the last name, first name, middle initial, and driver’s license number of any other driver involved.
  19. Liability Insurance Coverage: Indicate if you had insurance coverage with "yes" or "no."
  20. Insurance Company Name: If applicable, write the name of your insurance company.
  21. Address of Insurance Company: Enter the complete address including street, city, state, and ZIP code.
  22. Policy Number: Provide the policy number of your insurance.
  23. Policy Period: Fill in the period of the policy from start date to end date.
  24. Name of Policyholder: Write the name of the person who holds the insurance policy.
  25. Address of Policyholder: Enter the complete address of the policyholder.
  26. Name of Insurance Representative: Provide the name of the agency or representative who issued the policy.
  27. Address of Insurance Representative: Fill in the complete address of the insurance representative.
  28. Signature: Sign the form in the designated space.
  29. Date: Write the date you completed the form.

After filling out all the necessary information accurately, review the form to ensure there are no errors. Sign and date the form as required, and make a copy for your records. If you have any questions about the process or need assistance, reach out to the provided contact numbers. Finally, mail the completed form to the Tennessee Department of Safety and Homeland Security at the address indicated at the top of the form.

What You Should Know About This Form

What is the purpose of the Tennessee Driver form?

The Tennessee Driver form, also known as the Owner/Driver Report, is used to report automobile crashes in the state of Tennessee. It must be completed if there are injuries, fatalities, or property damage exceeding $400. Submission of this form is required within 20 days of the incident to the Department of Safety and Homeland Security.

Who is required to fill out this form?

Any individual involved in a car crash as either the driver or owner must complete this report. This includes situations where injuries or fatalities occur or where damages exceed $400, regardless of fault.

Where do I send the completed form?

The form should be mailed to the Tennessee Department of Safety and Homeland Security at P.O. Box 945, Nashville, TN 37202. This ensures that your report reaches the appropriate authorities for processing.

What happens if I do not file this report?

Failure to submit the Owner/Driver Report within the specified timeframe may lead to the suspension of your driver's license and vehicle registration. It is essential to ensure compliance to avoid any penalties.

What information is required on the form?

The form requires details including the date and place of the crash, vehicle information, operator and owner details, insurance coverage status, and any injuries or damages incurred. Accurate and complete information aids in the processing of your report.

Is there a fee to file this report?

No fee is required to submit the Tennessee Driver form. It is a government requirement for reporting accidents, and there are no costs associated with fulfilling this obligation.

What if I have liability insurance?

If you have liability insurance, you must provide the name of your insurance company, policy number, and coverage period. This information will be verified with your insurance company to confirm coverage during the incident.

Can someone else file the report on my behalf?

Yes, someone may file the report on your behalf. However, the individual filing will need to provide all necessary information accurately. It is important to ensure compliance with the filing deadline regardless of who submits the form.

What if there are injuries or death involved?

The report must be filed if there are injuries or fatalities resulting from the crash. This requirement is in place to document incidents for legal and insurance purposes. Follow up with local authorities for any further reporting that may be necessary.

Common mistakes

Filling out the Tennessee Driver form correctly is crucial for ensuring that your report is processed smoothly. Unfortunately, many individuals make common mistakes that can lead to delays or complications. Understanding these pitfalls can streamline the process and help avoid unnecessary frustration.

One frequent error is neglecting to provide precise details about the crash itself. While it might seem straightforward, the date and place of the accident must be truthfully noted. Failing to include the correct month, day, and year can complicate the verification process. Similarly, a vague description of the location could lead to confusion or require additional follow-up.

Another common mistake is the omission of vital information regarding the vehicles and their operators. The form requests specific details about the vehicle's make, year, and type. Skipping or inaccurately filling out these fields can result in an incomplete report. Moreover, accurately recording the names and dates of birth of the operators involved is essential. Even minor discrepancies can raise red flags during review.

Providing insurance information might seem tedious, but it is a crucial section of the form. Forgetting to indicate whether you had liability insurance at the time of the crash can leave your report hanging in limbo. Additionally, it is important not only to state whether insurance was present but also to fill in the details accurately, including the name of the insurance company and policy number.

People often overlook the importance of signing and dating the form. A signature validates your report as accurate and truthful. Without it, your submission might be deemed incomplete. Make sure to double-check that you have signed and provided the correct date before mailing the document.

Providing monetary details regarding damages can also be a stumbling block. Whether damages were less than or over $400 should be clearly marked. If the damage amount exceeds $400, ensure that you write the exact figure. Ambiguities in this area can lead to further inquiries from the Department of Safety.

Lastly, some individuals underestimate the importance of submitting the form within the allotted timeframe. The deadline for filing the report is critical. Late submissions can result in penalties, including potential delays in processing or even suspension of driving privileges. A proactive approach ensures that your report is delivered on time and mitigates any negative repercussions.

By being aware of these common mistakes, you can enhance the efficiency of your reporting experience. Taking the time to ensure accuracy and completeness will not only help you avoid potential hassles but also contribute to a smoother resolution following your accident.

Documents used along the form

When filing the Tennessee Driver form, there are several additional documents that are often important to consider in relation to the process. Each of these forms serves a distinct purpose, assisting drivers and their legal representatives in ensuring compliance and protecting their rights. Below is a list of commonly used documents.

  • Tennessee Vehicle Crash Report (Form SF-210): This form is used by law enforcement officers to document the details of a vehicle accident, including the circumstances, involved parties, and any injuries reported.
  • Financial Responsibility Form (SR-22): This form demonstrates that a driver has the required liability insurance coverage after certain violations, such as DUI or reckless driving, that may cause a license suspension.
  • Notice of Accident (NOS): It notifies the Department of Safety and Homeland Security about any accidents involving personal injury or property damage, fulfilling legal requirements reporting to the department.
  • Claim Form: This document is used to submit a claim with your insurance company after an accident. It details the circumstances and the damages being claimed.
  • Witness Statement Form: This form collects information from witnesses of the crash, which can be crucial in establishing the facts surrounding the accident.
  • Vehicle Registration Form: If the vehicle involved was not registered properly, this form must be completed to ensure legal ownership and registration is updated.
  • Letter of Representation: An attorney may submit this form to represent a driver in accidents to communicate directly with insurance companies and other parties involved.
  • Medical Release Form: This form allows healthcare providers to release medical records related to any injuries sustained in the accident, which may be necessary for claims or legal proceedings.
  • Driver Improvement Course Completion Certificate: If a driver has completed a court-approved driver improvement course to reduce points on their license or fulfill court requirements, this certificate is vital.

Understanding these documents can facilitate smoother navigation through the aftermath of an accident. Keeping them organized and readily accessible helps ensure that you are prepared to address any requirements or legal obligations that arise from your involvement in a crash.

Similar forms

  • State Accident Report: Similar to the Tennessee Driver form, this report captures details of a crash, including the time, place, and people involved. It also documents injuries and damages, providing a comprehensive summary for state records.

  • Police Report: This document is generated by law enforcement at the scene of an accident. It includes witness statements, officer observations, and a detailed description of events, which is crucial for insurance claims and legal proceedings.

  • Vehicle Damage Assessment Form: Used by insurance companies, this form details the damages sustained by a vehicle during an accident. It helps determine the repair costs and whether the damages exceed a specific threshold, similar to the damage inquiries in the Tennessee form.

  • Insurance Claim Form: When submitting a claim, individuals provide information about the crash, vehicle, and other involved parties. Like the Tennessee form, it verifies coverage and assesses liability before processing the claim.

  • Driver's License Application: This form includes identification details similar to those requested in the Tennessee Driver form, such as name, address, and driver history. It's essential for verifying driver's identities and history when accidents occur.

  • Insurance Coverage Verification Form: This document requests information about existing insurance policies. It parallels the Tennessee Driver form by seeking to confirm coverage and policyholder details for legal and financial purposes.

  • Medical Report: In the case of injury, a medical report outlines the injuries sustained and any ongoing medical treatment. This parallels the injury inquiry in the Tennessee form to confirm details relevant to insurance claims and liability.

  • Witness Statement Form: Often collected after accidents, these statements document what witnesses observed. Similar in intent, this form helps provide clarity regarding the incident, contributing to the overall understanding of the situation.

  • Property Loss or Damage Claim Form: This form is used when filing a claim for damages to property other than vehicles. It parallels the property damage inquiry in the Tennessee Driver form, ensuring that all financial losses are considered.

  • Vehicle Registration Application: Information about the owner and vehicle is required, similar to the driver’s details requested in the Tennessee form. This application is essential for legal vehicle ownership and is linked to accidents involving the registered vehicle.

Dos and Don'ts

When filling out the Tennessee Driver form, adhering to best practices can make the process smoother and more efficient. Here are ten suggestions that can help ensure that you complete the form correctly.

  • Do read the entire form carefully before beginning to fill it out.
  • Do provide accurate and complete information regarding the crash, such as the date, location, and driver details.
  • Do double-check your vehicle information, ensuring that the make, year, and type are correctly entered.
  • Do answer the injury and damages questions honestly and to the best of your knowledge.
  • Do include your insurance information if applicable, as this will help expedite the verification process.
  • Do sign and date the form before mailing it to avoid delays in processing.
  • Don't leave any fields blank; if a section does not apply, indicate that it is not applicable.
  • Don't use incorrect or outdated addresses when inputting your information.
  • Don't forget to submit the form within 20 days of the crash; timeliness is crucial.
  • Don't hesitate to reach out for help if you have questions while completing the form.

By following these guidelines, you can ensure that your submission is complete and accurate, contributing to a more efficient processing experience. If you have any uncertainties, remember that there are resources available to assist you in this important task.

Misconceptions

Understanding the Tennessee Driver form is essential for anyone involved in an automobile crash within the state. Unfortunately, several misconceptions may cloud the clarity of this important document. Here are some common myths, along with the facts that clarify them.

  • Filing the form is optional. Many people believe that submitting the Tennessee Driver form is merely a suggestion. In reality, if you're involved in an accident resulting in death or injury, or damage exceeding $400, you are required to file this report.
  • The form only needs to be filed if you're at fault. This is not true. The requirement to file does not depend on who caused the accident. Everyone involved must submit a report regardless of fault.
  • You have unlimited time to submit the report. Some assume they can take their time. However, the report must be submitted within twenty days of the crash to avoid potential penalties such as license suspension.
  • Your insurance details are not important on this form. Some people think they can skip providing insurance information. On the contrary, the insurance details you submit will be verified with your insurance company, making this information crucial.
  • The report is only necessary for serious crashes. While serious accidents certainly require reporting, any crash that results in property damage exceeding $400 still mandates a report. Ignoring minor accidents might lead to complications later on.
  • Filing this form protects me from legal issues. This form is primarily for reporting purposes and does not provide legal protection. It's important to consult with a legal professional for advice on how to navigate any potential legal ramifications after a crash.

By clarifying these misconceptions, individuals can better understand their responsibilities and ensure compliance with the law. Taking the necessary steps following an accident can help alleviate stress and confusion during an already challenging time.

Key takeaways

When filling out and using the Tennessee Driver form, consider the following key takeaways:

  • The form must be completed and submitted within 20 days of the crash. This timely submission is crucial to avoid penalties.
  • Clearly provide details about the crash, including the date, place, and type of vehicle involved.
  • If there are other drivers involved, gather and include their information to ensure thorough reporting.
  • Be honest about your insurance situation. If you had liability coverage, include complete information for verification.
  • Failure to submit the report can lead to consequences, such as license suspension or loss of driving privileges.
  • Ensure your signature and date are included at the bottom of the form to validate the submission.

For any questions, contact the Tennessee Department of Safety and Homeland Security using the provided phone numbers. فProper completion of this form helps protect your rights and complies with state requirements.