Florida HSMV Form 94010 Sworn Statement for Crash Report

What Is Florida HSMV Form 94010?

HSMV Form 94010 is the official sworn statement required to request a Florida Traffic Crash Report. The current revision is dated 03/2023. The form serves two main purposes:

• Section One – Allows eligible parties to obtain a crash report within 60 days of filing under Florida Statute § 316.066(2)(b).
• Section Two – Provides the required Driver’s Privacy Protection Act (DPPA) certification for requests made 60 days or more after the report is filed.

Crash reports that contain personal information (names, addresses, phone numbers, dates of birth, driver’s license numbers, etc.) are confidential and exempt from public disclosure for 60 days after the report is filed. Form 94010 is the mechanism that allows qualified requesters to access the report during this restricted period.

Official download link: Download HSMV Form 94010 (PDF)

An accessible version is also available: HSMV Form 94010-ADA.

Legal Basis: Florida Statute § 316.066

Florida Statute § 316.066 governs written reports of crashes. Key provisions relevant to Form 94010 include:

• Crash reports revealing personal information of parties involved are confidential for 60 days after filing.
• During the 60-day period, reports may be released only to specific categories of people and entities listed in the statute.
• As a condition of access, the requester must file a written sworn statement affirming that the information will not be used for commercial solicitation of crash victims.
• Knowingly obtaining a confidential crash report without entitlement, or using the information in violation of the sworn statement, is a third-degree felony. Civil penalties under the federal DPPA may also apply.

After 60 days, reports may be released more broadly to any person or entity that qualifies under the permissible uses listed in the federal Driver’s Privacy Protection Act (18 U.S.C. § 2721(b)).

Source: Florida Statute § 316.066 (2025).

Who Is Eligible to Use HSMV Form 94010 Within 60 Days?

According to Section One of Form 94010 and Florida Statute § 316.066(2)(b), the following individuals and entities may request a crash report within the 60-day confidentiality period:

• A party involved in the crash
• The legal representative of a party involved in the crash (must provide state/bar number)
• A licensed insurance agent of, an insurer of, or an insurer to which coverage has been applied for by a party involved in the crash
• A person under contract to provide claim or underwriting information for a qualifying insurer
• A representative of a victim services program
• A representative of a federal, state, or local governmental agency (or private person/entity acting on behalf of such agency) carrying out its functions
• A representative of a radio or television station licensed by the FCC or a newspaper qualified to publish legal notices (personal information must be redacted)
• A third party acting on behalf of any of the above (the report may only be disclosed to the authorized person or entity)

Persons eligible during the 60-day window remain eligible after the period expires.

How to Complete HSMV Form 94010?

The form is straightforward but must be completed accurately and signed under penalty of perjury.

1. Requester’s Information – Full name, date of request, reference/case number (if any), street address, city, state, ZIP, telephone, fax, and email.
2. Crash Information – Date of crash, crash report number (if known), law enforcement agency case number (FHP or other), location of crash (including county), and parties involved.
3. Section One (Within 60 Days) – Check the single box that best describes your eligibility and complete any required fields (name of party, bar number, license number, agency name, etc.).
4. Signature and Notarization – Sign under penalty of perjury. The form must be sworn to (or affirmed) before a notary public, either in physical presence or via online notarization.
5. Section Two (60 Days or Later) – If requesting after the 60-day period, check all applicable DPPA permissible uses and sign the certification.

Important: You must complete a separate sworn statement for each individual crash report requested.

Where and How to Submit Form 94010?

You have three primary options:

1. Online via the Florida Crash Portal (Recommended for Speed)

Visit the official Florida Crash Portal at FloridaCrashPortal.gov (or services.flhsmv.gov/CrashReportPurchasing). Eligible requesters can often complete the process online. Reports become available for immediate download after payment and must be downloaded within 48 hours.

2. In Person

Requests for 10 or fewer reports may be handled at the Florida Highway Patrol (FHP) Troop Station nearest to where the crash occurred. Bring the completed and notarized Form 94010 plus valid photo identification.

Find FHP station locations: FHP Station Locations.

3. By Mail

Mail the completed, signed, and notarized Form 94010 (one for each report), along with payment, to:

Florida Department of Highway Safety and Motor Vehicles
Crash Records
2900 Apalachee Parkway, MS 28
Tallahassee, FL 32399

Processing time by mail is typically several weeks. Requests for more than 10 reports must be submitted by mail.

Current Fees for Florida Crash Reports

As of 2026, the statutory fee is $10.00 per report under Florida Statute § 321.23. When ordering through the Florida Crash Portal, an additional $2.00 convenience fee applies per transaction. Customers are limited to a maximum of 10 reports per online transaction.

Payment methods:

• Online – Credit/debit card
• Mail – Check or money order payable to “FLHSMV”
• In person – Check with the specific FHP station

Sources: FLHSMV Traffic Crash Reports and Florida Statute § 321.23.

Important Warnings and Penalties

Section 316.066(3) of the Florida Statutes imposes serious consequences for misuse:

• Knowingly obtaining a confidential crash report you are not entitled to is a third-degree felony.
• Using confidential information in violation of a sworn statement is a third-degree felony.
• Civil liability under the DPPA may include actual damages (minimum $2,500 liquidated), punitive damages, attorney fees, and other relief.

Never use crash report information for commercial solicitation of accident victims.

Tips for a Successful Request

• Provide as much identifying information as possible (exact date, location, names of parties, report or case numbers) to help locate the correct report.
• Ensure the form is fully completed and properly notarized.
• Keep a copy of everything you submit.
• If the report is not yet available in the state portal, contact the investigating law enforcement agency directly.
• Download and save the report immediately when using the online portal (48-hour window).

Official Resources and Downloads

• Download Official HSMV Form 94010 (PDF)
• Accessible Version (ADA)
• Florida Crash Portal – Order Online
• FLHSMV Traffic Crash Reports Page
• Florida Statute § 316.066
• FLHSMV Forms Directory

Frequently Asked Questions

Do I always need Form 94010?
Yes for most in-person and mail requests, and often for verification of eligibility online, especially within the first 60 days.

Can someone else request the report for me?
Yes, a third party may request it on behalf of an eligible person or entity, but the form must clearly designate that relationship, and the report may only be disclosed to the authorized party.

How long does it take to get the report?
Online: Immediate download after payment (if available). In person: Same day if the report is ready. Mail: Several weeks.

Is the form the same for all Florida law enforcement agencies?
Yes. HSMV Form 94010 is the statewide standard form required by FLHSMV and used by local agencies as well.