• ​Collision/Incident Date: If you do not know the exact date, provide an approximate date.

• Collision/Incident Location: If you do not know the exact location, list as much information as possible.

• Driver or Owner: List the driver or owner of the vehicle. If only your property was damaged, please list your name and address.

• Party of Interest: PLEASE CHECK ONLY ONE BOX. The most common Parties of Interest are: Driver, Passenger, Property Owner, Vehicle Owner, Parent of Minor, or Legal Guardian of an individual. If you are not sure you are entitled to a copy of the report/investigation, please contact any CHP Area office to verify whether you are a proper Party of Interest.

• ​Applicant: Print your name in this box.

• Number and Street, City, State, and Zip Code

• Agency/Company: Applies to government entities or insurance companies.

• Signature

• Submit applicable fees.

​Additional Instructions

Photocopy your driver license or picture identification card and attach it to your request for a collision report. If you do not have either of these forms of identification, then, the CHP 190 form must be certified by a notary. Once the CHP has your request and verified you are a proper party of interest, a copy of the report will be mailed to your address upon receipt of payment.