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Accidents Compension Reports

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FORM COMPP AA
[see Rules 253,254 (c) (iii),254(80 255(1)(iv)]
REPOR ABOUT THE MOTOR VEHICLES ACCIDENTS

No
Contents
:-
Data
1.
Police Station Name.
:-
MAHAD CITY POLICE STATION
2.
CR No.
:-
MOTOR ACCIDETN CR NO 111/2018
3.
Accident No.
:-
---
4.
Date,Time And Place Of Accident
:-
2018-09-20 , 18:49 , At. Vahur Gaon Area Mumbai To Goa High Way Raod Mahad Taluka Mahad District Raigad
5.
Name of Injured/Deceased
:-
Name Of Injured - Sunil Tulshiram Tudilkar At. Shivaji Valan Taluka Mahad Current Address. Somyya Ch
6.
Name of the Hospital to Which He/She Was Removed
:-
RURAL HOSPITAL MAHAD TAL MAHAD DIST RAIGAD
7.
Number Of Vehical and type Of the Vehical
:-
M H 20 B L 1848 , S T Bus
8
Name and Address Of the Driver Of the Vehical With Particulars Or Driving License Of the Said Driver And the Address Of Issuing Autdority Of the Said Driving License.the Number Of Badge in Case Of Public Service Vehical and Address of Issuing Autdority Of the Said Badge
:-
Vishawnath Gayanaba Karjatkar At. ST Depo Mahad Taluka Mahad District Raigad
9.
Name And Address Of the Owner Of the Vehical As It Stand On the Date Of Accident
:-
‎Government of Maharashtra, Mumbai Central, Mumbai
10.
Name And Address Of the Insurance Company With Whome the Vehical Was Insured And the Divisional Office Of the Said Insurance Company.
:-
Null , Null , Null
11.
Number Of Insurance Policy/Insurance Certificate And the Date Of Validity Of the Insurance Policy/Insurance Certificate.
:-
Null,0000-00-00 , 0000-00-00
12.
Action Taken, If Any, And the Result thereof
:-
MAHAD CITY POLICE STATIION MOTOR ACCIDENT CR NO 111/2018
N.B.-tdis from should accompany witd all necessary document viz. (1)F.I.R (2)Panchanama (3) Medical Certificate/Post-Mortem Report.
Inspector of police, ...........Police Station.