Get Insurance Information Request-accident Case - Arizona Department ... - Azdot

Filling out the Insurance Information Request for an accident case is a vital process for obtaining necessary information related to vehicle incidents in Arizona. This guide will provide you with step-by-step instructions to complete the form accurately and efficiently.

Follow the steps to successfully complete the insurance information request form online.

1. Click the ‘Get Form’ button to access the Insurance Information Request form and open it in the online editor.
2. Begin by providing your personal information in the Requester Information section, including your full name, driver license number or other identification, daytime phone number, and mailing address.
3. Indicate the name of any organization you may represent in the designated field, if applicable.
4. Next, fill out the Primary Criteria for the vehicle record. Provide either the Arizona license plate number, vehicle identification number, or the full name of the vehicle owner. It's important to check at least one criterion to avoid processing delays.
5. If available, complete the Accident Date field with the date of the incident.
6. If necessary, provide additional information in the Secondary Criteria section, such as the owner's residence address to assist the processing of your request.
7. Review the list of permissible uses and check the boxes that apply to your request, ensuring you have a valid reason in accordance with the law.
8. In the Certification section, read the certification statement carefully. Once you understand the terms, sign and date where indicated.
9. The form must be notarized on the back. Ensure that you have it signed by a notary or MVD agent.
10. Finally, include a check or money order for $3.00, payable to the Motor Vehicle Division, along with an accident report provided by the law enforcement agency.
11. Once all sections are completed and reviewed, you may save changes, download, print, or share the filled-out form as needed for submission.

Complete your insurance information request online today for a smoother process.