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ACCIDENT DESC.PTION <br />Explain in your own words what happened <br />Draw a diagram of accident using 1 as <br />your vehicle, 2 as vehicle No. 2, etc. <br />WITNESSES <br />Name Address <br />Phone Workplace <br />Name Address <br />Phone Workplace <br />DRAPER'S REPORT <br />AT <br />ACCIDENT SCENE <br />Vir Checklist <br /> Stop and Investigate <br />Set Warning Devices <br /> Help the Injured <br /> Protect Your Vehicle and Cargo from <br />Theft and Further Damage <br />Do Not Move Your Vehicle Until <br />Police Arrive <br />Contact Supervisor as Soon as <br />Possible. (Use accident notification <br />card if you can't leave) <br />Discuss Accident Only with Proper <br />Authorities <br />Obtain Names and Addresses of <br />Witnesses. (Use witness cards <br />supplied) <br />Complete This Card At the Scene of <br />Accident <br />Comply With Any Required <br />Alcohol/Drug Test <br />RETURN ENTIRE PACKET TO <br />SUPERVISOR <br />.() Gopynght 2UUb & Published by J J KELLER & ASSOCIATES. INC, Neenah, WI • USA <br />(800) 327-6868 • www.jjkeller corn • Printed in the United States <br />33F-2 Rev. 9/06 <br />RM 5815