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The image shows a printed form titled "Motor Vehicle Accident Report" from the New York City Police Department. The date on the report is April 19th, but there's a red mark through it, indicating it may be inaccurate or has been amended. There are sections for accident details such as the time and date of the incident, location, weather conditions, and whether any injuries or fatalities occurred. The form also includes spaces to describe the actions leading up to the accident and the resulting damage. There's a section where evidence of consent to release personal information should be signed. It appears to have been filled out by hand, with some words crossed out and corrections made.