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Reporting of Automobile Accidents - California

STD. 269 (Rev. 8/2016)(916) 376-53001-800-900-3634 Toll FreeSTATE DRIVER FULL NAME STATE DRIVER LICENSE NUMBERDEPARTMENT EMPLOYED BYDATE OF ACCIDENTYEAR / MAKE / MODEL OF STATE VEHICLELICENSE NUMBER OF STATE VEHICLEDEPARTMENT OF GENERAL SERVICESOFFICE OF RISK AND INSURANCE MANAGEMENT707 THIRD STREET, FIRST FLOOR SUITE 1-150 WEST SACRAMENTO, CA 95605 Email: INQUIRY REGARDING accident MAY BE ADDRESSED TO:The state administers a vehicle liability self-insurance program against loss for personal injury and property damage to others. The program protects any o cer or employee of the state whenoperating a vehicle on o cial state vehicle accident reports (STD 270) must be received by theO ce of Risk and Insurance Management (ORIM) within 2 businessdays after the accident .

All vehicle accident reports (STD 270) must be received by the O˜ce of Risk and Insurance Management (ORIM) within 2 business days after the accident. The report must be completed by the driver and reviewed and approved by their supervisor. The vehicle accident report, along with any additional information related to

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