PDF Template

Vehicle Accident Declaration Affidavit

Download a blank template to fill in by hand

This template includes fields for:

  • Full Name
  • ID Number
  • Contact Number
  • Date of Accident
  • Time of Accident
  • Location of Accident
  • Your Vehicle Registration
  • Your Vehicle Make/Model
  • Other Vehicle Registration
  • Other Driver Name
  • Description of Accident
  • Injuries (Yes/No/Details)
  • Police Case Number (if applicable)
  • Insurance Claim Number (if applicable)
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How to Use This Template

  1. 1
    Download and print

    Download the PDF template and print it out on A4 paper.

  2. 2
    Fill in your details

    Complete all the fields with a blue or black pen. Write clearly and legibly.

  3. 3
    Commission at a police station

    Take the completed form to any South African Police Station. A Commissioner of Oaths will verify your identity and witness your signature (free of charge).

  4. 4
    Bring your ID

    Remember to bring your South African ID document or passport when going to commission your affidavit.