Form Hsmv 82363 PDF Details

In Florida, as in other states, drivers must carry a minimum level of auto insurance coverage to be on the road. The type and amount of coverage required varies depending on the state. Florida's minimum coverage is $10,000 personal injury protection (PIP) and $10,000 property damage liability (PDL). Many motorists choose to purchase more insurance than the legal requirements in order to protect themselves and their assets in case of an accident. However, some drivers may be unaware of the existence of Form Hsmv 82363, which allows them to waive PIP and PDL coverage altogether. Let's take a closer look at this form and what it means for drivers in Florida.

QuestionAnswer
Form NameForm Hsmv 82363
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesfl certificate of destruction, blank 6d certificate, florida certificate of destruction, pdffiller certificate of destruction

Form Preview Example

STATE OF FLORIDA

DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES

DIVISION OF MOTOR VEHICLES

Neil Kirkman Building -Tallahassee, FL 32399-0610

APPLICATION FOR SALVAGE TITLE/CERTIFICATE OF DESTRUCTION

INSTRUCTIONS ON REVERSE SIDE

Flood Vehicle (check box)

1

 

 

 

 

APPLICANT INFORMATION

 

 

TOTAL LOSS BY INSURANCE COMPANY

 

UNINSURED OR SELF-INSURED

 

TOTAL SALVAGE LOSS

 

TOTAL THEFT LOSS

 

SALVAGE BY OWNER(S) (No Insurance Company Involved)

 

 

Insurance Company's Name

 

 

 

 

 

Owner's Name

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

Zip

 

City

State

Zip

 

 

 

 

 

 

 

 

 

Date Declared Total Loss

 

 

 

 

 

Date of Loss

 

 

and Compensation Paid

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Policy Number

Claim Number

 

 

FEID Number

 

DL Number/FEID #

Sex and Date of Birth

 

 

 

 

 

 

 

 

 

 

 

2

 

 

 

 

VEHICLE DESCRIPTION

 

 

Vehicle Identification Number

Year

Make

Body

Color

Florida Title Number-

Previous State of Issue

License Plate Number

Weight

Length

BHP/CC

GVW/LOC

Florida Current Date of Issue

3 IMPORTANT: SEE VEHICLE IDENTIFICATION NUMBER VERIFICATION ON REVERSE SIDE OF THIS FORM

4

SALVAGE TITLE/CERTIFICATE OF DESTRUCTION NOTATION INFORMATION

Lines a, b, c, and d are not required for total theft loss vehicles.

a. Enter vehicle's current retail cost on this line ............................................................................

(Use any official used car or used mobile home guide)

b. Multiply line (a) by .80, enter amount on this line .......................................................................

c. Enter estimate of cost to repair physical and mechanical damage

on this line .........................................................................................................................

d. If amount on line (c) is less than amount on line (b), check here ................................................

If amount on line (c) is equal to or more than amount on line (b), check here ............................

e. If vehicle is a total theft loss, check here ..................................................................................

(a)

(b)

(c)

Rebuildable

Certificate of Destruction

(Unrebuildable)

Total Theft Loss

5

6

If this transfer of title is exempt from Florida sales tax due to a settlement of an insurance claim, check here

The undersigned applicant hereby certifies that the motor vehicle to be titled will not be operated upon the highways of this state.

7

 

 

 

 

 

 

 

 

 

ODOMETER DECLARATION

 

 

 

 

 

 

 

 

 

 

I/WE STATE THAT THIS MOTOR VEHICLE'S

 

5 OR

 

 

6 DIGIT ODOMETER NOW READS

 

 

 

 

 

'

 

 

 

. XX (NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TENTHS) MILES, DATE READ

 

 

 

/

 

 

 

/

 

 

 

 

, AND TO THE BEST OF MY KNOWLEDGE THAT IT REFLECTS THE

ACTUAL MILEAGE OF THE VEHICLE DESCRIBED IN THIS DOCUMENT UNLESS ONE OF THE FOLLOWING IS CHECKED::

CAUTION:

DO NO CHECK

IF ACTUAL

MILEAGE

1.IN EXCESS OF ITS MECHANICAL LIMITS. I/WE HEREBY CERTIFY THAT, TO THE BEST OF MY KNOWLEDGE, THE ODOMETER READING REFLECTS THE AMOUNT OF MILEAGE IN EXCESS OF

ITS MECHANICAL LIMITS.

2.NOT THE ACTUAL MILEAGE. I/WE HEREBY CERTIFY THAT THE ODOMETER READING IS NOT THE

ACTUAL MILEAGE.

WARNING -- ODOMETER DISCREPANCY

8

APPLICANT ATTESTMENT SIGNATURES

UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE. I/WE AGREE TO DEFEND THE TITLE AGAINST ALL CLAIMS.

Applicant or Authorized Agent's Signature

 

Applicant or Authorized Agent's HAND PRINTED Name

NOTE: Properly Assigned Certificate of Title MUST BE ATTACHED Applicant or Authorized Agent's Printed Signature MUST be on this Application

HSMV 82363 (Rev. 8/00)S

VEHICLE IDENTIFICATION NUMBER VERIFICATION

COMPLETION OF THIS PART REQUIRES A PHYSICAL INSPECTION OF THE MOTOR VEHICLE DESCRIBED ON THIS FORM BY A LICENSED DEALER, NOTARY PUBLIC, POLICE OFFICER OR FLORIDA DIVISION OF MOTOR VEHICLE COMPLIANCE

EXAMINER/INSPECTOR, COMPLETING THE VERIFICATION OF THE VEHICLE IDENTIFICATION NUMBER. COMPLETE THIS BLOCK ON ALL USED MOTOR VEHICLES, INCLUDING TRAILERS WITH A WEIGHT OF 2,000 POUNDS OR MORE WHICH

ARE NOT PREVIOUSLY TITLED IN FLORIDA.

I, the undesigned, certify that I have physically inspected the vehicle described on side 1 of this form and found the

vehicle identification number to be:

 

 

 

 

Vehicle Identification Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE

SIGNATURE

PRINTED NAME

Any Law Enforcement Officer

 

 

Badge or ID Number

 

 

 

 

Florida or out-of-state Dealer License Number

 

 

 

 

 

(Notary Stamp)

Florida Compliance Examiner/Inspector Badge or ID Number

WHEN DOES THE VIN VERIFICATION ON THIS FORM NOT HAVE TO BE COMPLETED?

THE VIN VERIFICATION ON THIS FORM DOES NOT HAVE TO BE COMPLETED ON NEW MOTOR VEHICLES, MOBILE HOMES, TRAVEL TRAILERS, CAMPING TRAILERS, FIFTH WHEEL RECREATIONAL VEHICLES, TRAILERS OR SEMI TRAILERS WITH A NET WEIGHT OF LESS THAN 2,000 POUNDS, WHEN A FLORIDA CERTIFICATE OF TITLE IS SUBMITTED AS PROOF OF OWNERSHIP OR WHEN FORM HSMV 82042 HAS BEEN COMPLETED AND IS ATTACHED.

WHEN SHOULD THE ODOMETER DECLARATION ON THIS FORM NOT BE COMPLETED?

THE ODOMETER DECLARATION IN SECTION 7 OF THIS FORM DOES NOT HAVE TO BE COMPLETED WHEN THE VEHICLE BEING TITLED IS EXEMPT FROM ODOMETER DISCLOSURE REQUIREMENTS. EXEMPTIONS: WHEN THE VEHICLE IS TEN YEARS OLD OR OLDER, HAS A GROSS VEHICLE WEIGHT RATING (GVWR) OF MORE THAN 16,000 POUNDS OR IS NOT SELF PROPELLED.

WHO IS AUTHORIZED TO USE THIS FORM?

Any person, or authorized agent of any person or business, required to make application for a Florida Salvage Certificate of Title/Certificate of Destruction.

WHEN SHOULD THIS FORM BE USED?

I . When an insurance company has paid a ''Total Loss'' on a motor vehicle or mobile home and must make application for a Salvage Certificate of Title/Certificate of Destruction in the name of the insurance company.

2 When an Uninsured or Self-Insured has a motor vehicle or mobile home that has been wrecked or damaged, and at the time of loss the cost of repairing or rebuilding the motor vehicle or mobile home is 80% or more of the cost to the owner of replacing the wrecked or damaged motor vehicle or mobile home with one of like kind or quality.

FILING

1.ALL APPLICABLE SECTIONS OF THIS FORM MUST BE COMPLETED LEGIBLY.

2.THIS FORM MUST BE DOCUMENTED BY THE ATTACHMENT OF:

(A)FLORIDA CERTIFICATE OF TITLE.

OR

(B)MANUFACTURER'S CERTIFICATE OF ORIGIN.

OR

(C)OUT-OF-STATE TITLE OR OTHER OFFICIAL PROOF OF OWNERSHIP.

NOTE: When an insurance company pays the vehicle owner to replace the wrecked or damaged vehicle with one of like kind or quality, or when an insurance company pays the owner upon the theft of the motor vehicle or mobile home, the insurance company must have the title/Certificate of Destruction issued in their name.

NOTE: A Certificate of Title will not be issued on a new or used motor vehicle that has been stolen from an out-of-state owner, dealer, or manufacturer until the motor vehicle has been recovered, and the required VIN

verification can be performed.

NOTE: This form has been combined with form HSMV 82042.

HSMV 82363 (Rev. 8/00) S

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1. Complete the printable certificate of destruction with a group of major fields. Gather all of the important information and ensure not a single thing overlooked!

florida certificate of destruction conclusion process described (portion 1)

2. Once your current task is complete, take the next step – fill out all of these fields - IMPORTANT SEE VEHICLE, SALVAGE TITLECERTIFICATE OF, a Enter vehicles current retail, Use any official used car or used, b Multiply line a by enter amount, on this line, d If amount on line c is less than, e If vehicle is a total theft loss, Rebuildable Certificate of, If this transfer of title is, The undersigned applicant hereby, state, ODOMETER DECLARATION, IWE STATE THAT THIS MOTOR VEHICLES, and DIGIT ODOMETER NOW READS with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Learn how to complete florida certificate of destruction stage 2

3. The third part is normally simple - complete every one of the empty fields in IF ACTUAL MILEAGE, NOT THE ACTUAL MILEAGE IWE HEREBY, ACTUAL MILEAGE, WARNING ODOMETER DISCREPANCY, UNDER PENALTIES OF PERJURY I, APPLICANT ATTESTMENT SIGNATURES, Applicant or Authorized Agents, Applicant or Authorized Agents, NOTE Properly Assigned Certificate, Applicant or Authorized Agents, and HSMV Rev S to complete this part.

WARNING ODOMETER DISCREPANCY, Applicant or Authorized Agents, and HSMV Rev S in florida certificate of destruction

4. To go ahead, the following part requires completing a few form blanks. Included in these are COMPLETION OF THIS PART REQUIRES A, Vehicle Identification Number, DATE, SIGNATURE, PRINTED NAME, Any Law Enforcement Officer, Badge or ID Number, Florida or outofstate Dealer, Notary Stamp, Florida Compliance, WHEN DOES THE VIN VERIFICATION ON, and WHEN SHOULD THE ODOMETER, which are integral to moving forward with this form.

Stage no. 4 in filling out florida certificate of destruction

Regarding SIGNATURE and DATE, be certain that you take a second look in this current part. The two of these are viewed as the most significant ones in this form.

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