Fr44 Form Florida PDF Details

Many motorists are unaware of the existence of a form called Fr44. This is a document that is filed with the Department of Highway Safety and Motor Vehicles (DHSMV) in the state of Florida. The purpose of this form is to provide proof of financial responsibility for drivers who have been convicted of driving while uninsured. If you are required to file a Fr44, it is important to understand what it is and how to complete it properly. This article will provide you with all the information you need to know about Fr44 Form Florida.

This basic guide will let you find out just how long it'll take you to fill out fr44 form florida, the number of pages it's got, and a few other unique details about the PDF.

QuestionAnswer
Form NameFr44 Form Florida
Form Length1 pages
Fillable?Yes
Fillable fields16
Avg. time to fill out3 min 31 sec
Other namesflorida uniform financial responsibility certificate, fr 44 form florida, fl fr 44 financial, fr44 look

Form Preview Example

FLORIDA DEPARTMENT OF

HIGHWAY SAFETY AND MOTOR VEHICLES

Division of Driver Licenses

Bureau of Financial Responsibility

2900 Apalachee Parkway, MS98

Tallahassee, Florida 32399-0585

 

 

 

FLORIDA

 

 

 

 

 

 

UNIFORM FINANCIAL RESPONSIBILITY

 

 

 

 

 

CERTIFICATE FR-44

 

 

 

 

Purpose:

Use this form to comply with Florida’s Financial Responsibility Law, Section 324.023, Florida

 

 

Statutes for motor vehicle liability insurance coverage of 100k/300k/50k.

 

 

Instructions:

Send completed form to the Bureau of Financial Responsibility at the above address.

 

 

FR-44

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INSURED PERSON INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

INSURED NAME (Last)

(First)

 

(Middle)

(Suffix)

 

 

 

 

 

 

 

 

 

 

 

STREET ADDRESS

 

 

 

CITY

 

STATE

ZIP CODE

 

 

 

 

 

 

 

 

 

DRIVER LICENSE NUMBER

 

BIRTH DATE (MM/DD/YYYY)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INSURANCE COMPANY INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

INSURANCE COMPANY NAME

 

 

 

FR CASE NUMBER

 

 

 

 

 

 

 

 

 

 

NAIC CODE

 

POLICY NUMBER

 

 

 

CERTIFICATION EFFECTIVE DATE

 

 

 

 

 

 

 

 

 

 

 

This certification is effective on the above certification Effective Date and continues until cancelled or terminated in accordance with the financial responsibility laws and regulations of Florida. The insurance certified is provided by an:

OWNER’S POLICY – Applicable to the following described vehicle(s) and subject to the terms and conditions defined in the owner’s policy.

VEHICLE YEAR

VEHICLE MAKE

VEHICLE IDENTIFICATION NUMBER (VIN)

 

 

 

VEHICLE YEAR

VEHICLE MAKE

VEHICLE IDENTIFICATION NUMBER (VIN)

 

 

 

VEHICLE YEAR

VEHICLE MAKE

VEHICLE IDENTIFICATION NUMBER (VIN)

 

 

 

VEHICLE YEAR

VEHICLE MAKE

VEHICLE IDENTIFICATION NUMBER (VIN)

 

 

 

OPERATOR’S POLICY – Applicable to any vehicle not registered/titled to the above listed person and subject to the terms and conditions defined in the operator’s insurance policy.

The company signatory certifies that it has issued to the above named insured a motor vehicle liability policy as required by the financial responsibility laws of Florida, which policy becomes effective on the above Certification Effective Date.

 

AUTHORIZED REPRESENTATIVE SIGNATURE

DATE

 

 

 

 

 

74751 (S) (12/07)

How to Edit Fr44 Form Florida Online for Free

It's a breeze to prepare the florida fr 44 financial. Our software was built to be help you fill in any PDF promptly. These are the basic actions to follow:

Step 1: Look for the button "Get Form Here" on the following webpage and select it.

Step 2: As soon as you have accessed your florida fr 44 financial edit page, you will notice all options you can use concerning your document at the top menu.

Feel free to enter the next information to create the florida fr 44 financial PDF:

florida fr44 form blanks to consider

Type in the demanded details in AUTHORIZED, REPRESENTATIVE, SIGNATURE and DATE field.

stage 2 to filling out florida fr44 form

Step 3: Click the "Done" button. Now it's easy to transfer the PDF form to your electronic device. Besides, you'll be able to send it by email.

Step 4: To protect yourself from possible future concerns, ensure you get at least two duplicates of each and every document.

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