FLITT Driver incident form Please fill out the form below. 1. Driver Incident Form Company: FlittNote: Refer to the Damage to Goods During Loading, Transport or Unloading Policy (FLITT- Policy-001).Date of Incident Time of Incident Hours : Minutes AM PM AM/PM Customer Name First Last Customer Phone NumberJob / Booking Number2. Incident TypeIncident Type(Required) Goods damaged Property damage Vehicle accident Customer complaint Failed delivery Unsafe access / loading issue Other Click all that appliesPlease specify3. Location of IncidentPickup Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Delivery Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Exact Location Where Incident Occurred4. People InvolvedDriver Name First Last Driver PhoneOther person/s involved / witnesses5. Description of Incident / ComplaintDescribe the issue clearlyUpload PhotoMax. file size: 128 MB. 6. Goods / Property InvolvedGoods Items damaged or affected:Estimated ValueCondition before Non-applicable Good condition Existing damage noted Not checked Photos taken before loadingMax. file size: 128 MB. 7. Photos EvidenceTick what has been collected Photos before incident Photos after incident Customer messages Witness Details Delivery notes Other: Please specify:8. Immediate Action TakenAdd any extra notesPlease select Customer notified Flitt notified Goods secured Delivery completed Delivery notes Emergency services contacted Other: Please specify:9. Vehicle and Incident DetailsAdd any extra notesVehicle RegistrationVehicle DetailsDescribe the incident occurredIncident Severity Rating10. NotesAdd any extra notesNotes11. Driver StatementConsent I confirm the information provided is true and accurate to the best of my knowledge.SignatureYour NameYour NameYour NameYour Name
