当事人如实陈述保证书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：__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________当事人年第1页共2页月日第2页共2页
