Florida Hsmv 83330 Form PDF Details

In the realm of vehicle registration and insurance compliance within the State of Florida, the Florida HSMV 83330 form, commonly known as the Florida Insurance Affidavit, plays a pivotal role. This affidavit requires the vehicle owner to certify, under penalty of perjury, that they have secured the necessary insurance coverages, including Personal Injury Protection (PIP) and Property Damage Liability (PDL), along with Bodily Injury Liability (BIL) when mandated. The form necessitates the vehicle owner to provide detailed information about their insurance policy, including the name of the insurer, policy number, and the company code number, in addition to specifics about the vehicle such as its year, make, and Vehicle Identification Number (VIN). An essential caveat outlined in the document is the directive that a vehicle owner's driver license, license plate(s), and registration(s) are subject to suspension should the stated insurance coverage be invalidated by the insurer. Moreover, the form includes a stern warning against providing false information, highlighting the criminal ramifications under Florida law for such acts. As a declaration of insurance coverage, the HSMV 83330 form underscores the state's commitment to ensuring that all vehicles on its roads are adequately insured, thus safeguarding the rights and safety of all road users.

QuestionAnswer
Form NameFlorida Hsmv 83330 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesflorida insurance affidavit, form hsmv 83330, fl affidavit form, hsmv 83330 pdf

Form Preview Example

FLORIDA INSURANCE AFFIDAVIT

Under penalty of perjury, I __________________________________________ certify that I have

(Name of Insured)

Personal Injury Protection, Property Damage Liability, and, when required, Bodily Injury Liability Insurance currently in effect with _____________________________________________ under

(Name of Insurance Company)

__________________________ ____________________ covering the following motor vehicle:

(Policy Number)Company Code Number (5 digits)

_________________________________________________________________________________________________________

Year

Make

Vehicle Identification Number

This insurance company is licensed to issue insurance policies in Florida. I understand that my driver license, license plate(s) and registration(s) will be suspended effective from the registration date, if the insurer denies that this policy is in force.

_______________________________________

Signature of Insured

WARNING: GIVING FALSE INFORMATION IN ORDER TO OBTAIN A VEHICLE REGISTRATION CERTIFICATE IS A CRIMINAL OFFENSE UNDER FLORIDA LAW. ANYONE GIVING FALSE INFORMATION ON THIS AFFIDAVIT IS SUBJECT TO PROSECUTION.

HSMV 83330 (Rev. 09/09)

www.flhsmv.gov

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