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OFFICE OF MOTOR VEHICLES P.O. BOX 64886, BATON ROUGE, LA 70896-4886 225-925-6146 www.expresslane.org SAFETY RESPONSIBILITY CLAIM FORM In accordance with the provisions of R.S. 32:871, an insured motorist,.

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  3. Next, provide details related to the vehicle. This section typically requires information such as the make, model, and year of the vehicle.
  4. In the following section, include any additional information that the form requests. Be sure to read each prompt carefully to ensure completeness.
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