Are you familiar with the SR 11 form? It’s essential to understand the purpose of this form and how it works, especially if you are in a state that requires its completion. The SR 11 is used by states to indicate both uninsured drivers and vehicles whose insurance coverage has lapsed or been canceled. In this blog post, we'll explain what an SR 11 form is, when it is typically required, who must complete it and more!
| Question | Answer |
|---|---|
| Form Name | Sr 11 Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | TX, sr11, sr 11 form, authorizes |
TO: |
|
DEPARTMENT OF PUBLIC SAFETY |
IF FORM |
SAFETY RESPONSIBILITY |
IS SUSPENDED, A $100.00 REINSTATEMENT FEE WILL |
PO BOX 15999 |
BE REQUIRED TO COMPLETE COMPLIANCE. |
AUSTIN, TX |
|
RELEASE |
CASE NO. _______________________________________ |
|
THE UNDERSIGNED HEREBY CERTIFIES |
that he/she is of the age of 18 years or over and that he/she has released
_________________________________________________________________________________________________
(Type or print name, address, date of birth, and driver's license number of person released.)
from all claims and causes of action or judgments arising from an accident which occurred on _______________, _____,
(Year) at or near _______________________, Texas, and authorizes the Safety Responsibility Division of the Texas
Department of Public Safety to accept this certification as satisfactory evidence of such release from liability or satisfaction of judgments as required by the Texas Motor Vehicle Safety Responsibility Act. (Texas Transportation Code, Section 601.162(a)(3)(A)).
Date __________________________________, __________ |
___________________________________________ |
(Year) |
Signature of person giving release |
Subscribed and sworn to before me this ____________________, day of _____________________________, ________
(Year)
___________________________________________
Notary Public in and for ______________________
County, Texas
RELEASECASE NO. _______________________________________
THE UNDERSIGNED HEREBY CERTIFIES
that he/she is of the age of 18 years or over and that he/she has released
_________________________________________________________________________________________________
(Type or print name, address, date of birth, and driver's license number of person released.)
from all claims and causes of action or judgments arising from an accident which occurred on _______________, _____,
(Year) at or near _______________________, Texas, and authorizes the Safety Responsibility Division of the Texas
Department of Public Safety to accept this certification as satisfactory evidence of such release from liability or satisfaction of judgments as required by the Texas Motor Vehicle Safety Responsibility Act. (Texas Transportation Code, Section 601.162(a)(3)(A)).
Date __________________________________, __________ |
___________________________________________ |
(Year) |
Signature of person giving release |
Subscribed and sworn to before me this ____________________, day of _____________________________, ________
(Year)
___________________________________________
Notary Public in and for ______________________
County, Texas