Printable Witness Statement Form
This one-page witness statement form is for anyone collecting a first-hand account after an incident. It includes fields for incident report number, witness name, role, contact details, and date of statement. The main section gives space to write what was seen and heard in the witness's own words. It also includes a confirmation sentence, plus signature and date lines at the bottom.
Free printable · PDF
- 1 page
- US Letter — choose “Fit to page” for A4
- PDF, 51 KB
Free for personal, family and classroom use.
Use it to record statements in a clear, consistent format before details are forgotten. Fill in the identifying fields first, then ask the witness to write a direct account of the incident. After reviewing the statement, have the witness sign and date the form for your records.
Good for
- Workplace incident record
- School accident statement
- Witness account after an event
Tip: Print on Letter paper and keep a few blank copies with your incident forms.
6 files · DOCX, PDF, XLSX
Get every sheet: Incident Report Template Pack
This sheet plus 5 more in one download, with the editable Word and Excel files. Editable incident report, near-miss report, witness statement and root-cause investigation forms, plus an Excel corrective action log and incident register.
$7.00 USD, one-time 6 files · about $1.17 each
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Printable Incident Report Form
Printable Near-Miss Report Template
Incident Investigation Form
Corrective Action Log Template
Printable Incident Register Template