The form below is intended as a easy self-reporting system of your private property vehicle crash. Please follow the instructions below when completing the form.
 

DO NOT USE THIS FORM IF THE COLLISION INVOLVES ANY OF THE FOLLOWING:
 

• The driver of either vehicle is under the influence of drugs or alcohol.
• The collision involves reckless driving.
• Personal injuries occured.
• The collision occured on a public street.
• The license plate number of a hit-and-run vehicle was obtained by a witness.

Dial 911 to have a deputy dispatched if any of the above apply.
 

INSTRUCTIONS FOR COMPLETING THE FORM
** NOTE: IF FORM APPEARS AS GREY BOXES IN ADOBE ACROBAT READER X, CLICK ON EDIT, PREFERENCES, PAGE DISPLAY, & CHECK THE "SHOW LARGE IMAGES" **

1. Complete all requested information on the form as indicated.
2. Print out necessary copies for your records or your insurance company.
3. E-mail the form to the Hillsdale County Cental Dispatch. You may also print and mail a copy of the report to the appropriate agency indicated below.