Form HSMV 94010-ADA. Sworn Statement for Crash Report (Accessible) - Florida

Form HSMV 94010-ADA is an accessible version of the Sworn Statement for Crash Report form used in Florida. This form is specifically designed to accommodate individuals with disabilities who may require accessible formats to provide a sworn statement regarding a crash report.

The form consists of sections where the individual can provide their personal information, such as name, address, and contact details, in an accessible format. It includes fields to explain the necessary changes or additions to the original crash report and requires a sworn statement affirming the accuracy of the provided information, all presented in an accessible manner.

Important fields in this form include the individual's information, details regarding the requested changes or additions to the original crash report, and the sworn statement confirming the truthfulness of the provided information. It is crucial for the individual to accurately fill out the form and provide supporting documentation if required, ensuring accessibility requirements are met.

Application Example: An individual with a disability involved in a crash in Florida may use this form to submit additional information or correct inaccuracies in their original crash report. The form should be completed with accurate personal information and a detailed explanation of the necessary changes or additions, while also adhering to accessibility guidelines.

Related Forms: Form HSMV 94010 is the non-accessible version of the Sworn Statement for Crash Report. Both forms serve the purpose of providing a sworn statement for a crash report, but Form HSMV 94010-ADA ensures accessibility for individuals with disabilities.