Free Statement of Facts Letter Template
STATEMENT OF FACTS LETTER
[Your Company Name]
[Your Company Address]
[Your Company Number]
October 4, 2051
Lowell Quizon
Claims Adjuster
CodeLoop
Richmond, VA 23218
Dear Mr. Quizon,
I am writing to provide a statement of facts regarding the recent auto accident that occurred on August 20, 2051. Below are the pertinent details:
|
Detail |
Description |
|---|---|
|
Date and Time of Incident |
August 20, 2051, at approximately 3:15 PM |
|
Location of Incident |
The intersection of Maple Street and Oak Avenue, Springfield, IL |
|
Vehicles Involved |
1. 2022 Honda Civic (driven by Jane Smith) |
|
2. 2021 Ford F-150 (driven by Mark Johnson) |
|
|
Description of Incident |
I was traveling eastbound on Maple Street when Mr. Johnson failed to stop at the red light on Oak Avenue, causing a collision at the front driver's side of my vehicle. |
|
Damage to Vehicles |
- Honda Civic: Front end damage (hood and bumper) |
|
- Ford F-150: Driver's side door and rear quarter panel damage |
|
|
Injuries |
- Jane Smith: Minor bruises and a sprained wrist |
|
- Mark Johnson: No injuries reported |
|
|
Witnesses |
- Emily Davis, who was driving behind me (Contact: (555) 987-6543) |
|
Police Report |
Report filed with the Springfield Police Department under number 123456 |
This statement is intended to clarify the circumstances surrounding the auto accident for your records and insurance claim processing. If you require any further information or documentation, please feel free to contact me at [Your Company Number] or [Your Email].
Thank you for your attention to this matter.
Sincerely,
[Your Name]
