This legal template includes 19 fields. Witness statement form for documenting observations of accidents for legal proceedings. Free to customize and use on ZenBuild.
Witness Full Name (text, required)
Date of Birth (text, required)
Address (text, required)
Email (email, required)
Phone Number (text, required)
Date of Accident (text, required)
Time of Accident (text, required)
Location of Accident (text, required)
Accident Type (dropdown selection, required) — options: Motor Vehicle, Slip and Fall, Workplace, Pedestrian, Bicycle, Construction, Other
Describe Exactly What You Saw (long text, required)
Describe Weather and Road Conditions (long text, optional)
Did You See the Moment of Impact/Incident (multiple choice, required) — options: Yes, No
Approximate Distance from Accident (text, optional)
Did You Call 911 (multiple choice, required) — options: Yes, No
Did You Speak to Police at Scene (multiple choice, required) — options: Yes, No
Officer Name or Badge Number (text, optional)
Did Anyone Appear Injured (multiple choice, required) — options: Yes, No
Any Other Relevant Observations (long text, optional)
Willing to Testify if Needed (multiple choice, required) — options: Yes, No, Maybe
