[County of Kauai] Minor Traffic Collision Report

KAUA`I POLICE DEPARTMENT

Online Minor Traffic Report

IF THIS IS AN EMERGENCY PLEASE CALL 911!

Temporary ID

You will be provided with a Temporary ID upon submission.

CAD/Report Number Provided by Dispatch or Officer

DRIVERS INFORMATION

Driver's License # State and Expiration Date

Phone Number

MINOR COLLISION DETAILS

Incident Location

Date/Time of Occurance

Vehicle License Plate

Vehicle Description

Insurance Company

Policy Number

Policy Valid From and To

Valid From

Valid To

Incident Narrative

Upload File(s) (Photos,Copy of DL etc)

Click Here to Upload

Sign Here

First Name

Last Name

Choose how to sign

Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.