We Handle:

• Automobile

• Motorcycle

• Truck

• Fires

• Industrial Accidents

• Workers'    Compensation

• Defective Products

• Aircraft

• Slip & Fall

• Insurance
   Construction

• Real Estate

• Business Litigation    Cases

• Professional    Negligence
 
   
   
   Our Goal:

To protect your rights, fight for you in an ethical and effective manner to assure that you are compensated for your injuries and to protect innocent employers from improper lawsuits
 
   
 

Welcome to the Law Offices of
Mallery and Stern, APC
Accident Information
Click HERE for a printable version of this form and
keep a copy in your Glove Box

• Call the police if persons are hurt or property damage is in excess of $500.00
• Call your insurance company immediately to report the accident
• Call your doctor if you are hurt or in pain

• Call the Law Offices of MALLERY & STERN (310) 473-0777 or
   (800) 564-5565 or JAFFEE, MALLERY & STERN (909) 948-9999 for advice

Fill in the appropriate boxes below and click the "Submit" button.

Date:        Time:

My Name is:

My Address:

My Phone Number is:

My email address is:

Police Report:

My Insurance Carrier is:

My Insurance Carrier Telephone #:

My Policy #:

Witness Name:

Witness Address:

Witness Telephone#:

Other Party:

Other Party Address:

Other Party Telephone #:

Other Party Insurance Carrier:

Other Party Policy Number:

Agent's Telephone #:

Accident Description:
Describe what happened (Include street names, time of day, etc.)

email us at: attorney@MS-Law.com  for more information.