Form MV-104

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Get your Form MV-104 in 3 easy steps

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What is MV 104 Form?

The MV 104 Form printable is a one-page blank used to record car accidents on New York State highways and streets. Such events should be properly documented and reported within ten days at the latest. Otherwise, your license might be suspended.

Form MV-104 on PDFLiner

What do I need Form MV 104 for?

  • If you are involved in a car accident that injures people or damages someone's property in excess of $1000, you must complete the MV-104 Form printable and submit it to the Crash Record Center.
  • If the damage is minor and no one was hurt during the incident, the issue can be resolved on the spot and not reported.

How to Fill Out MV-104 Form?

  1. Enter the exact date and time of the accident, the number of vehicles involved and casualties, and the name of the police officer who arrived at the scene (if any).
  2. Fill in the block with the data of the first driver and vehicle: the name of the driver, their ID, address, date of birth, passengers, etc.
  3. Enter information about the second participant in the incident. It can be another vehicle, a bicycle, a pedestrian, and so on.
  4. Write down the registration information of all participants in the accident and calculate the approximate cost of damage.
  5. Explain this event using diagrams and arrows and briefly describe the damage.
  6. Enter the exact location where the accident occurred and provide the insurance details of all participants. Each of them must put their signature.

Form MV-104 on PDFLiner

Organizations that work with MV-104 DMV Form

  • NY DMV

Form Versions

2011 Fillable Form MV-104 (2011) Fill Out Form
Fillable online Form MV-104
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