Form MV-104F.1 "Accident Report for School Vehicles Transporting Pupils/Teachers/Supervisors" - New York

What Is Form MV-104F.1?

This is a legal form that was released by the New York State Department of Motor Vehicles - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2017;
  • The latest edition provided by the New York State Department of Motor Vehicles;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form MV-104F.1 by clicking the link below or browse more documents and templates provided by the New York State Department of Motor Vehicles.

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Download Form MV-104F.1 "Accident Report for School Vehicles Transporting Pupils/Teachers/Supervisors" - New York

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ACCIDENT REPORT FOR SCHOOL VEHICLES
TRANSPORTING PUPILS/TEACHERS/SUPERVISORS
Continuation Sheet
Page _______ of _______ Pages
Accident Date (Month/Day/Year) County of Accident
Last Name of School Bus Driver
First
M.I.
School Bus Plate Number
ALL PERSONS INJURED OR KILLED
INJURY SECTION
Provide Information for Every Person Injured or Killed in Accident (Continued from MV-104F)
Check proper column(s).See instruction 7 on Page 6.
If Deceased, Enter
Which
Safety
Seated/
Name of All Persons Injured or Killed
Describe Injuries
Veh. Occ.
Equip. Used
Age
Sex
Standing
A
B
C
Date of Death
ATTACH TO COPY 1 OF FORM MV-104F
ACCIDENT REPORT FOR SCHOOL VEHICLES TRANSPORTING
PUPILS/TEACHERS/SUPERVISORS.
MV-104F.1 (6/17)
ACCIDENT REPORT FOR SCHOOL VEHICLES
TRANSPORTING PUPILS/TEACHERS/SUPERVISORS
Continuation Sheet
Page _______ of _______ Pages
Accident Date (Month/Day/Year) County of Accident
Last Name of School Bus Driver
First
M.I.
School Bus Plate Number
ALL PERSONS INJURED OR KILLED
INJURY SECTION
Provide Information for Every Person Injured or Killed in Accident (Continued from MV-104F)
Check proper column(s).See instruction 7 on Page 6.
If Deceased, Enter
Which
Safety
Seated/
Name of All Persons Injured or Killed
Describe Injuries
Veh. Occ.
Equip. Used
Age
Sex
Standing
A
B
C
Date of Death
ATTACH TO COPY 1 OF FORM MV-104F
ACCIDENT REPORT FOR SCHOOL VEHICLES TRANSPORTING
PUPILS/TEACHERS/SUPERVISORS.
MV-104F.1 (6/17)
ACCIDENT REPORT FOR SCHOOL VEHICLES
TRANSPORTING PUPILS/TEACHERS/SUPERVISORS
Continuation Sheet
Page _______ of _______ Pages
Accident Date (Month/Day/Year) County of Accident
Last Name of School Bus Driver
First
M.I.
School Bus Plate Number
ALL PERSONS INJURED OR KILLED
INJURY SECTION
Provide Information for Every Person Injured or Killed in Accident (Continued from MV-104F)
Check proper column(s).See instruction 7 on Page 6.
If Deceased, Enter
Which
Safety
Seated/
Name of All Persons Injured or Killed
Describe Injuries
Veh. Occ.
Equip. Used
Age
Sex
Standing
A
B
C
Date of Death
ATTACH TO COPY 2 OF FORM MV-104F
ACCIDENT REPORT FOR SCHOOL VEHICLES TRANSPORTING PUPILS/TEACHERS/SUPERVISORS.
MV-104F.1 (6/17)
ACCIDENT REPORT FOR SCHOOL VEHICLES
TRANSPORTING PUPILS/TEACHERS/SUPERVISORS
Continuation Sheet
Page _______ of _______ Pages
Accident Date (Month/Day/Year) County of Accident
Last Name of School Bus Driver
First
M.I.
School Bus Plate Number
ALL PERSONS INJURED OR KILLED
INJURY SECTION
Provide Information for Every Person Injured or Killed in Accident (Continued from MV-104F)
Check proper column(s).See instruction 7 on Page 6.
If Deceased, Enter
Which
Safety
Seated/
Name of All Persons Injured or Killed
Describe Injuries
Veh. Occ.
Equip. Used
Age
Sex
Standing
A
B
C
Date of Death
ATTACH TO COPY 3 OF FORM MV-104F
ACCIDENT REPORT FOR SCHOOL VEHICLES TRANSPORTING PUPILS/TEACHERS/SUPERVISORS.
MV-104F.1 (6/17)
ACCIDENT REPORT FOR SCHOOL VEHICLES
TRANSPORTING PUPILS/TEACHERS/SUPERVISORS
Continuation Sheet
Page _______ of _______ Pages
Accident Date (Month/Day/Year) County of Accident
Last Name of School Bus Driver
First
M.I.
School Bus Plate Number
ALL PERSONS INJURED OR KILLED
INJURY SECTION
Provide Information for Every Person Injured or Killed in Accident (Continued from MV-104F)
Check proper column(s).See instruction 7 on Page 6.
If Deceased, Enter
Which
Safety
Seated/
Name of All Persons Injured or Killed
Describe Injuries
Veh. Occ.
Equip. Used
Age
Sex
Standing
A
B
C
Date of Death
ATTACH TO COPY 4 OF FORM MV-104F
ACCIDENT REPORT FOR SCHOOL VEHICLES TRANSPORTING PUPILS/TEACHERS/SUPERVISORS.
MV-104F.1 (6/17)
reset/clear
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