Form Dl 123 PDF Details

Navigating the requirements for maintaining a valid driver's license can often introduce drivers to a variety of forms and legal documentation, one of which is the DL-123 form. This particular document is crucial for those seeking to either obtain or renew a driver's license, standing as a testament to holding the required liability insurance coverage. Essentially, it serves as a certification from an insurance company, through an agent's signature, that the policyholder (who may also be the insured driver) is covered under a policy that meets the state's minimum requirements. The form details include the insured driver's date of birth, the policyholder's name(s) if different, the insurance company's name, the policy number, and both the effective and expiration dates of the policy. Furthermore, it's specified that the form's validity extends only 30 days beyond the completion date signed off by the insurance agent, pressing the need for timely submission. This form, identified by its code "DL-123 (10/98)," encapsulates a snapshot of the policyholder's current insurance standing, thereby playing a pivotal role in the administration of driving privileges.

QuestionAnswer
Form NameForm Dl 123
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other nameshow to form dl 123, dl123 insurance form, dl123 form, dl 123 nc

Form Preview Example

DL-123 (10/98) DRIVER LICENSE LIABILITY INSURANCE CERTIFICATION

Insured DriverDate of Birth

Policyholder(s)

Insurance Company

 

Policy Number

 

 

 

Effective Date

 

 

 

 

 

 

 

 

 

Agency Name

 

 

 

Expiration Date

 

 

 

 

 

 

 

 

 

Agent’s Signature

 

 

 

 

 

 

 

 

 

 

 

 

Date this DL-123 Completed

 

 

 

 

 

 

 

 

 

 

(This form is valid for 30 days after completion by insurance agent)

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