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(Date of Letter)

(Department of Public Safety) (Street Address) (City, State and Zip Code) RE: Attn: Inquiry of Accident Report Accident Report Clerk

Dear Accident Report Clerk: On the between day of (month/year), an accident occurred

(list vehicles that were involved in the accident). To date, an accident report relative to this matter has not been received by the undersigned. Since the undersigned is a party in interest, an accident report is respectfully requested. In the event a fee is required for this accident report, please advise immediately and the undersigned will comply. Should you need any additional information, do not hesitate to contact the undersigned at the address and/or phone number listed below. Very truly yours,

(Signature) (Address) (City, State and Zip Code) (Phone Number)

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