Dublin Bus — Accident / Incident Report (ARF1)

A

Category Choose one — this decides which sections you need to fill in.

CollisionContact between the bus and another vehicle, person or object Collision & Passenger AccidentA collision in which a passenger was also injured Passenger Accident onlyPassenger injured — no collision between vehicles IncidentAssault, dispute, vandalism, fire/fumes, object thrown, etc.

B

When & where it happened

Depot

Date

Time (24-hour)

Where it happened (street / road)

Opposite street no. (if applicable)

Light conditions

Daylight Dusk Dark

Weather

Road surface

D

Type of collision / passenger accident

Say whether

E

Type of incident Tick all that apply.

F

Driver & vehicle

Driver pay no. (6 digits)

Driver name

Starting time

Fleet no. (start typing — registration fills in automatically)

Registration no.

Route no.

Direction

Inbound Outbound

Type of service

Travelling to garage?

Yes No

G

Collision details

Accident occurred at

Bus movement at the time

Who struck whom?

Bus struck other Bus was struck

Collision with

Width of road (m)

Speed just before (km/h)

Speed at impact (km/h)

Condition of road

Distance from kerb (m)

Last stop before accident

Horn sounded?

By you

Yes No

By other driver

Yes No

Signal given?

By you

Yes No

By other driver

Yes No

Damage to BAC bus

H–L

Third parties Add each person or vehicle involved (up to 3). If more than 3, note it in the description in Section N.

No. of injured persons

No. of fatalities

No. of BAC vehicles involved

No. of third parties involved

No. of bus passengers

Persons in other vehicle

M

Witnesses & Gardaí

Did a Garda witness the accident / incident?

Yes No

Did a Garda take particulars?

Yes No

N

What happened

Describe in detail how the accident / incident occurred

Who, in your opinion, was to blame?

Point of impact on the bus (if a collision)

PHOTOS

Photos of the scene Optional — take photos with your phone camera or upload from your gallery (damage, road position, injuries to property, etc.).

No photos added yet.

O

Sketch of the scene Draw with your finger or mouse — show vehicle directions and approximate road widths.

P

Declaration

I declare that the above report and the particulars given are an accurate reflection of the accident / incident. This report is completed to meet the requirements of the company's solicitor and for the purposes of litigation.

Driver signature (sign in the box with your finger or mouse)

Print full name

Date

Section C (Accident Ref, Claim Ref, District Ref, Cost Centre) and the Inspector's confirmation are completed by the office after submission.

Category Choose one — this decides which sections you need to fill in.

When & where it happened

Type of collision / passenger accident

Type of incident Tick all that apply.

Driver & vehicle

Collision details

Third parties Add each person or vehicle involved (up to 3). If more than 3, note it in the description in Section N.

Witnesses & Gardaí

What happened

Photos of the scene Optional — take photos with your phone camera or upload from your gallery (damage, road position, injuries to property, etc.).

Sketch of the scene Draw with your finger or mouse — show vehicle directions and approximate road widths.

Declaration

✓ Report ready to send