Alaska Form 466 PDF Details

In the vast and often intricate terrain of legal and administrative paperwork that drivers in Alaska may navigate, the Alaska 466 form serves as a crucial document in the aftermath of a vehicle crash. This form, officially titled and issued by the State of Alaska's Division of Motor Vehicles (DMV), plays a fundamental role in the process of reporting and verifying insurance coverage following a crash incident. It gathers comprehensive details, including the crash's date, location, driver's and vehicle owner's personal information, and specifics about the vehicle itself—year, make, model, license plate number, and Vehicle Identification Number (VIN). Crucially, it requires drivers to disclose whether an automobile liability policy covered the crash and includes space for relevant insurance details, such as the policy number, the insurance agent's name and contact information, and the insurance company's details. Failure to complete and submit this form can have significant legal implications, including the suspension of driving privileges under Alaska's mandatory insurance and financial responsibility laws, especially if the crash resulted in personal injury, death, or property damage exceeding $501. The form also specifies the need for drivers to demonstrate financial responsibility through various means in the event of such damages, underlining the state's commitment to ensuring that all drivers have the necessary financial backing to cover the costs incurred by accidents.

QuestionAnswer
Form Name Alaska Form 466
Form Length 1 pages
Fillable? No
Fillable fields 0
Avg. time to fill out 15 sec
Other names alaska form insurance, responsibility form alaska, ak form certificate, crash form alaska

Form Preview Example

STATE OF ALASKA - DIVISION OF MOTOR VEHICLES

CERTIFICATE OF INSURANCE

 

 

 

 

LAW ENFORCEMENT INCIDENT NUMBER:

 

CRASH

Date of Crash:

 

City Where Crash Occurred:

 

INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Driver

 

 

Name: _________________________________ Date of Birth: _____________

License #: _________________

State: ______

DRIVER

Mailing Address: _____________________________________________________________________________________________

 

 

Street or Box

 

City

 

State

Zip

 

Daytime Telephone:

 

 

E-mail:

 

 

 

OWNER

 

 

 

 

 

 

Driver

 

Name: _________________________________ Date of Birth: _____________

License #: _________________

State: ______

OF

Mailing Address: _____________________________________________________________________________________________

VEHICLE

 

Street or Box

 

City

 

State

Zip

VEHICLE

Year:

Make:

Model:

License Plate #:

 

VIN:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Did you have an automobile liability policy in effect covering this crash? YES

NO

Policy Number:

 

 

 

 

 

 

 

Name & Address of Insurance Agent:

 

 

 

 

Phone Number of Insurance Agent:

 

 

 

 

 

 

 

 

Name of Insurance Company:

 

 

 

 

 

Policy Period:

 

 

 

 

 

 

 

 

To

 

Your Signature:

 

 

 

 

 

 

Date:

 

DO NOT WRITE BELOW THIS LINE. THE DIVISION OF MOTOR VEHICLES WILL CONTACT YOUR INSURANCE COMPANY.

Insurance Verification: If the motor vehicle liability insurance policy listed above was not in effect for the motor vehicle listed at the time of the crash please check the appropriate box below and mail or fax this form to the Division of Motor Vehicles at the address or fax number listed on the reverse of this form. If indicated coverage was in effect at the time of the crash, no action is required.

REASON NOT VERIFIED:

Insurance information is incorrect

No insurance in effect at time of crash

Signature of

 

 

 

 

Authorized Representative

 

 

 

Date __

 

 

 

 

 

 

MANDATORY INSURANCE AND FINANCIAL RESPONSIBILITY NOTICE

If the actual or estimated damages of any one person’s property involved in the crash exceeds $501, or if there is any personal injury or death, you are subject to the Alaska mandatory insurance and financial responsibility laws. The mandatory insurance laws require you to file proof of insurance with the State of Alaska. Failure to do so will result in the suspension of your driver’s license.

The financial responsibility laws require a person to show financial responsibility by one of the following methods:

(1)an automobile liability insurance policy in effect at the time of the crash; (2) a release of liability; (3) a settlement agreement and proof of future financial responsibility (SR-22 insurance); (4) a deposit of security and proof of future financial responsibility (SR-22 insurance); (5) a finding of no liability by the court in a civil action (a finding of not guilty of a traffic citation does not apply). Failure to show financial responsibility by one of the listed methods will also result in the suspension of your driver’s license for a period of 3 years if there is a possibility you are liable.

After any suspension you must show future financial responsibility (SR-22 insurance), and pay a reinstatement fee of $100 to $500, in addition to the fee for the license being requested, to have your driving privileges restored. A notice of suspension returned by the post office because of an incorrect address on your driver’s license or DMV records will not invalidate the suspension if the notice was mailed to the last address you provided to DMV.

IMPORTANT: THIS FORM MUST BE COMPLETED IN FULL AND MAILED OR FAXED TO THE DIVISION OF MOTOR VEHICLES WITHIN 15 DAYS FROM THE DATE OF THE CRASH. A participant’s crash report is required if the crash was not investigated by a peace officer and the total amount of damage exceeds $2,000, or there was personal injury.

Mail or Fax Completed Form To:

STATE OF ALASKA

Fax: (907) 465-5509

 

DIVISION OF MOTOR VEHICLES

 

 

ATTN: DRIVER LICENSING

Phone: (907) 465-4361

 

PO BOX 110221

 

 

JUNEAU AK 99811-0221

 

Form 466 (Rev. 03/2011)

Alaska.gov/dmv

E-mail: DOA.DMV.JDS@Alaska.gov

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