Road-accident witness statement template (Uganda)
In brief
A precedent witness/party statement recording the facts of a road accident.
When to use this
After a road accident, to record what happened for the police or an insurer.
When a bespoke document is needed instead: As a substitute for the official police report — obtain that as well.
The template
A precedent only. Replace every [PLACEHOLDER] with your own details; it contains no real party data. Have it reviewed before use.
Heading
STATEMENT OF [NAME] REGARDING A ROAD ACCIDENT ON [DATE]
1. The maker of the statement
1.1 I, [NAME], (NIN [NIN]) of [ADDRESS], [occupation], make this statement of what I saw and know.
2. The accident
2.1 On [DATE] at about [TIME], at [PLACE / road], I was the [driver / passenger / pedestrian / independent witness] [of vehicle registration [REG NO], make [MAKE]].
3. What happened
3.1 [Describe, in order, what happened — direction of travel, speed, road and weather conditions, traffic signals, and the point of impact]. I do not admit fault; I state the facts as I observed them.
4. The other vehicle / party
4.1 The other vehicle was registration [REG NO], make [MAKE], driven by [NAME] of [ADDRESS], said to be insured by [INSURER], policy [NO].
5. Damage & injuries
5.1 Damage: [describe to each vehicle/property]. Injuries: [describe to any person]. Medical treatment was sought at [FACILITY].
6. Witnesses & evidence
6.1 Witnesses: [names and contacts]. Evidence: [photographs / sketch / dashcam]. Police were notified at [STATION], reference [SD/CRB NO].
Execution
Signed: ____________ Date: ________
(If a sworn version is required, depose it as an affidavit before a Commissioner for Oaths.)
Drafting notes
- Stick to facts
- Record what you saw, in order; avoid admitting liability or speculating.
- Capture details
- Note vehicles, drivers, insurers, witnesses, the scene, and any injuries and treatment.
- Evidence
- Reference photographs, a sketch and the police report number, and keep them.
- Sworn version
- If a sworn version is needed, convert it to an affidavit before a Commissioner for Oaths.
Execution requirements
- Sign the statement; if it must be sworn, depose it as an affidavit before a Commissioner for Oaths.
- Report the accident to the police and obtain the police reference.
- A negligence claim must be brought within the limitation period.
Governing law & citations
Governed by the Traffic and Road Safety Act, Cap. 361, and the general law of negligence (Limitation Act, Cap. 290).
- Traffic and Road Safety Act, Cap. 361 (2023 Revision).
- Limitation Act, Cap. 290 (2023 Revision).