For guidance on completing this form, go to the What to notify page.
Complete any fields in this section that are applicable to the incident. If none are applicable, scroll to the bottom of the page and click 'Submit'.
If someone was injured or died in the incident, select their role using the drop-down menu below.
If there are more than two rail vehicles involved, please provide these details in the description field.
© 2019 NZ Transport Agency, all rights reserved
New Zealand Government