Accident Version & Diagram Form

Please sketch the position of all vehicles at the time of the

incident in the box below. Show North by arrow.

Symbols

Street Your Give Way

Pedestrians
Intersection Vehicle Sign
Curved Other Traffic
Stop Sign
Street Vehicle Lights

Accident Description
Explain how the accident occured using the provided space below

Have contact with another vehicle in a

roundabout.

Who was at fault? Undeternined Damage to Hertz vehicle: 1WO8AV

Signature: Date: 15/12/2023

Your full name: Yui Chit Chan Your address: 2/16 Elm Grove, Mount Waverley VIC 3149