于年月日收到交通警察：
道路交通事故当事人陈述材料
姓名_____________性别______民族_________出生日期_________________身份证号____________________籍贯____________文化程度________________驾驶证号准驾车型________________领证日期__________车辆号牌__________驾驶证号____________________________保险凭证号______________________户籍所在地（国籍、护照号）__________________________________________现住地______________________________________________________________单位及联系方式______________________________________________________经我自行请求（应交通警察要求），现将道路交通事故经过陈述如下：__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
当事人年月日
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