1. Date of the accident: ______________________________
Day of the week: _________________________________
Time of day: ____________________________________
Weather conditions: ______________________________ 2. Describe in detail the location of the accident.
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________________________________________________________ 3. Describe in detail how the accident occurred.
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________________________________________________________ 4. Did you see any warnings, instructions, or signs giving notice of any dangerous conditions? If so, what did the warning or instructions say, or what did the sign dipict?
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________________________________________________________ 5. Give the name and address of the defendant(s) (include both owner and tenant of the property, if known).
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________________________________________________________ 6. Give the name and address of defendants insurance carrier, and describe how you acquired this information.
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________________________________________________________ 7. Give the name and address of defendants insurance.
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