Pocatello Police Department

911 N 7th Avenue
Pocatello, Idaho

208-234-6100

You must answer the following questions before filing a report:

Is this an emergency?

Select  Yes No

To file your vehicle accident report, please provide as much information and detail as possible. Fields marked with an asterisk (*) are required. Incomplete reports will not be filed. If you have any questions, please contact the Pocatello Police Department at 208-234-6121.

Attachments

If you have photographs or documents to attach, please upload them below. (LIMIT: 5 files no more than 5MB each)

Drop files here or click to upload.

Reporting Party

First Name
Last Name
Home Address
City
State	Unspecified - Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia  Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
ZIP Code
Daytime Phone
Alternate Phone
Email Address
Alternate Email
Gender	Unspecified - Male Female
Date of Birth	mm/dd/yyyy
Driver's License State	Unspecified - Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia  Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Driver's License Number
Insurance Carrier
Insurance Policy Number

Vehicle Information

Please provide as much information as possible about the vehicle.

Year
Make
Model
Color
License Plate State	Unknown Non-US - Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia  Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
License Plate Number
VIN
Owner's Name
Value of Damage
Damage Description	Please provide a description of the damage to the vehicle.

Other Driver's Information

Please provide any contact information you have including physical address, phone number, and/or email address.

Name
Address
City
State	Unknown Non-US - Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia  Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
ZIP Code
Phone
Email Address
Insurance Carrier
Insurance Policy Number

Other Vehicle's Information

Please provide as much information as possible about the vehicle.

Year
Make
Model
Color
License Plate State	Unknown Non-US - Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia  Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
License Plate Number
VIN
Value of Damage
Damage Description	Please provide a description of the damage to the vehicle.

Accident Information

Time Frame of Accident	Between and
Accident Location	Please provide a description of the exact location where the incident occurred, being as specific as possible.
Accident Description	Please provide a detailed description of how the accident occurred.
Do you have any witnesses?	No   Yes
Do you have video surveillance of the incident?	No   Yes

Witness Information

Witness 1
Witness Name
Contact Information	Please provide any contact information you have including phone number, email address, and/or physical address.

+ Add another witness

Acknowledgment

Acknowledgement #1	I have reviewed my report to ensure that all pertinent details are included, such as any witnesses, photographs, video, vehicle descriptions, suspect descriptions, etc., as the decision to close this case or assign it for further investigation will be made based on the content provided.
Acknowledgement #2	I acknowledge that knowingly falsifying a crime report is punishable by Idaho State law.