Accident Report

Cautions

Please take the following steps before reporting the accident to ABC Rent-a-Car.

Aid the injured

If there are any injured persons, immediately ensure safety. Call an ambulance (dial 119) and provide first aid if possible.

Report to the police

Call the police (dial 110), report the details of the accident, and follow their instructions to complete the accident report. Once the police report has been filed, please take the necessary steps to obtain a Traffic Accident Certificate.
　　　　　　　　　　　　　　

Please fill in the required information in the fields below.

日本語版はこちら
事故報告を日本語で提出する場合はこちら.

    【Accident Report Summary】

    　 　　　　　　　　　　　　　　 　　　　　　　　　　　　　　　　　　 　　　　　　　　　　　　　　　　　　　　
    RequiredAccident Vehicle
    RequiredSingle-vehicle accident A single-vehicle accident refers to an accident without a third party involved. (Examples include collisions with cliffs, guardrails, curbs, etc.)
    YesNo
    RequiredReporting Police Station
    RequiredPolice Officer in Charge
    RequiredMake & Model
    RequiredVehicle Number Please enter the number shown on the front license plate.
    RequiredAccident Date and Time :
    RequiredAccident Location (Address)

    【Contract Holder and Driver Information】

    　　　　　　　　　　　　　　　　　　　　　　
    RequiredRenter's Name
    RequiredEmail
    RequiredPhone Number
    OptionalInjury Information (Yourself) 　
    RequiredVehicle Damage (Location and Condition) 　

    【Other Party’s Information】

    　　　　　 　　　　　 　　　　　 　　　　　　　　　　　　 　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　 　　　　　　　　　　　　　　　　　　　　　　　
    RequiredOther Party’s Name
    RequiredMake & Model(Other Party)
    RequiredVehicle Number(Other Party)
    RequiredPhone Number (Other Party)
    RequiredEmergency Phone Number (Other Party)
    RequiredInsurance Company(Other Pary)
    RequiredInsurance Company Contact Person(Other Party)
    RequiredInsurance Company Phone Number(Other Party)
    RequiredInjury Information (Other Party)
    RequiredDamage Location and Condition (Other Party)
    　

    【Details of the Accident】

    RequiredAccident Details
    Please provide detailed information