Claim for damages caused by an accident

[Адвокат]

TO _____________ district (city) court ________________________ of a region (region, republic) CUSTOMER: _____________________________ (name, address, telephone numbers) RESPONDENT: __________________________ (name of organization, address, telephone numbers) THIRD PARTY: _______________________ (name, address, telephone numbers) SUIT PRICE: _________________________ THE SUCH APPLICATION for compensation for damage caused by a traffic accident _____________________ (indicate the place and time of the accident) there was a traffic accident involving a car _____________________ (indicate the make, license plate), which belongs to me by right of ownership, and vtomobilya defendant ____________________________ (indicate the brand, number plate). As a result of this traffic accident, my car was damaged. As established by the investigation, the accident occurred through the fault of the driver ___________ (indicate name), driving ____________ (indicate the make, license plate) belonging to the defendant ______________ (indicate name and address of the car owner). The fact of guilt is confirmed ______________________________ (indicate the documents confirming the driver’s guilt) The material damage caused to me is: 1) according to the calculation _______________________________________ (indicate the document number, date of compilation, organization), made on the basis of the vehicle inspection certificate ___________________ (indicate document number, date of compilation) cost repair of my car is - _____________ rubles .; 2) in addition, according to the conclusion of specialists _____________________ (indicate the document number, date of compilation, organization), as a result of the accident, the vehicle has lost its presentation by _______ (indicate how many percent), i.e. the amount of loss of commodity value in connection with an accident is - _________________ rubles .; 3) for the calculation of the calculation I paid - _________________ rubles .; for notification of the defendant by telegraph about the place and time of the vehicle inspection - _________________ руб. Total, the total amount of material damage caused is - _________ rubles. Given the above, on the basis of Article 1064, part 3 of Article 1079 of the Civil Code I ASK: 1. Collect from the defendant ______________________ (indicate the data of the defendant: full name, address - if the defendant is a natural person, or the name of the organization and its address - if the respondent is legal .person) in my favor redress _________ RUB. and the state fee paid by me under this lawsuit _________ rubles. 2. In order to secure the claim, seize the property of the defendant. Appendix: 1. Documents confirming the defendant’s guilt (for example: a traffic police certificate, an administrative sanction, an investigator’s decision to terminate a criminal case, a court verdict, a court decision) 2. Documents confirming material damage (for example: calculation of the repair cost, conclusion on loss of a vehicle’s presentation, vehicle inspection certificates, receipt of payment of expenses for drawing up a calculation, receipt of sending a telegram to the defendant, etc.) 3. A receipt on payment of state duty 4. Kop and the statement of claim to the defendant and the third party's Signature Date

 

[Матушкин Андрей Николаевич]

Thank!