Private Property Accident

Private Property Accident Report
This form is to self-report an accident on private property where a law enforcement is not required to complete an accident report onscene or a law enforcement officer was not called.

This is not to report an emergency or a report a crime in progress.

Do not use this form if the accident resulted in any injuries or in the case of a hit-and-run.

If this is an emergency, please dial 9-1-1.
Accident Information
Date of Accident

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Location of Accident - Give the Specific Street Address or Nearest Intersection
Confirm Location of Accident
Describe the Conditions - (Examples: Clear, Sunny, Daytime; Cloud, Rainy, Nighttime)
Describe How the Accident Happened
Please provide the narrative of the criminal offense/incident
Upload Any Photos of the Accident

Cancelof
Vehicle #1 Information

Vehicle Numbers are for Reporting Purposes Only
Driver of Vehicle #1 - Name
Driver of Vehicle #1 - Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Driver of Vehicle #1 - License Number
Driver of Vehicle #1 - State License Issued From
Driver of Vehicle #1 - Email Address
example@example.com
Driver of Vehicle #1 - Mailing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Vehicle #1 - Passenger Information (Include: Name, Date of Birth, Address, and Phone Number)
Vehicle #1 - Year
Vehicle #1 - Make (Example: Ford, Chevrolet, Kia Motors, etc.)
Vehicle #1 - Model (Example: F-150, Silverado, Rio, etc.)
Vehicle #1 - License Plate
Vehicle #1 - Vehicle Identification Number (VIN)
Vehicle #1 - Insurance Company (USAA, State Farm, All-State, etc.)
Vehicle #1 - Insurance Policy Number
Vehicle #1 - Describe Any Damage; Include Location on Vehicle and Type of Damage
Any Witnesses? Include: Name and Phone Number
Vehicle #2 Information

Vehicle Numbers are for Reporting Purposes Only
Driver of Vehicle #2 - Name
Driver of Vehicle #2 - Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Driver of Vehicle #2 - License Number
Driver of Vehicle #2 - State License Issued From
Driver of Vehicle #2 - Email Address
example@example.com
Driver of Vehicle #2 - Mailing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Vehicle #2 - Passenger Information (Include: Name, Date of Birth, Address, and Phone Number)
Vehicle #2 - Year
Vehicle #2 - Make (Example: Ford, Chevrolet, Kia Motors, etc.)
Vehicle #2 - Model (Example: F-150, Silverado, Rio, etc.)
Vehicle #2 - License Plate
Vehicle #2 - Vehicle Identification Number (VIN)
Vehicle #2 - Insurance Company (USAA, State Farm, All-State, etc.)
Vehicle #2 - Insurance Policy Number
Vehicle #2 - Describe Any Damage; Include Location on Vehicle and Type of Damage
Any Witnesses? Include: Name and Phone Number
To Get a Copy of This Report:
This report will be ready in approximately one or two business days after the report was submitted.

You can pick up a copy of the report by visiting the Lee County Sheriff's Office Front Desk. Address is: 1900 Frederick Rd, Opelika AL 36801.

You can also call the Front Desk, 334-749-5651, and ask for the Patrol Administrive Assistant and they can email you a copy of this report.

Any questions, email: LCSO@leecosheriffal.gov
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Private Property Accident Report

Accident Information

Vehicle #1 Information

Vehicle #2 Information

To Get a Copy of This Report: