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Republic of the Philippines

NATIONAL POLICE COMMISSION


PHILIPPINE NATIONAL POLICE
MANDALUYONG CITY POLICE STATION
Alternate Road, Brgy 27, Mandaluyong City

TRAFFIC ACCIDENT INVESTIGATION REPORT

I. WHERE: South Luzon Express Way, South-bound, Muntinlupa

II. WHEN: Tuesday August 01, 2017 12:00 PM Fair


(Day of the Week) (Date) (Time) (Weather)

III. WHAT: Vehicle Versus: (x)Another Vehicle ( ) Pedestrian ( ) Fixed Object

IV. TYPE OF ACCIDENT: (x) Fatal ( ) Non-fatal ( ) Damaged Property


( ) Head On (x) Rear End ( ) Angle
( ) Others:

V. Number of Vehicle Involved: Two (2)

VEHICLE 1 VEHICLE 2
Type: Montero SUV Type: Fortuner SUV
Plate Number: PI 7575 Plate Number: ILY 143
Driven By: Polar Bear Panda II Driven By: Dora Da Explorer
Sex and Civil Status: Male/ Married Sex and Civil Status: Female/ Married
Vehicle Owner: Polar Bear Panda II Vehicle Owner: Dora Da Explorer
Address: 3165 Interior 11 Pilar Street, Address: 123 Boots Street, Pasig City
Muntinlipa City

VI. Cause of the Accident: The accident happened as the Fortuner which had a speed of
at least 100km/h swerved from the left lane to the center lane, as can easily be
gleaned from the damage to the Montero

P01 BATO SALANGIT


Police Inspector

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