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Get NM MVD-11268 2011

MVD 11268 REV. 10/11 New Mexico Taxation Revenue Department Motor Vehicle Division AFFIDAVIT OF NON-USE OF VEHICLE or Owner Information Name last first middle initial Date of Birth Address Phone Number City State ZIP Code Driver s License Number and State Vehicle Information Make Model Plate Number Year Vehicle Identification Number VIN Non-Use Information Please initial box The vehicle identified above is not being operated for reasons that may include but are not limited to military deployment mechanical issues and storage or seasonal usage. Please enter anticipated non-use dates below. From To The NON-USE portion of this affidavit is only valid for a maximum of ONE YEAR* A new Affidavit of Non-Use of Vehicle MUST be completed each year that the vehicle will not be driven* Out-of-State Information MINIMUM MANDATORY LIABILITY LIMITS 66-5-208 25 000 Bodily injury or death of one person in any one accident 50 000 Bodily injury or death of two or more persons in one accident 10 000 Destruction of property of others in any one accident I currently have insurance coverage in compliance with the New Mexico Mandatory Financial Responsibility Act 66-5-201 through 66-5-239 NMSA 1978. Policy Number Insurance Company Effective Dates to Note You MUST attach a copy of a current insurance card and declaration page containing liability limits. The OUT-OF-STATE portion of this affidavit is only valid during the effective dates of your insurance policy. Affirmation I swear or affirm under penalty of perjury that the above statements are true and correct. Printed Name Signature Date A new affidavit must be completed every time a vehicle status changes or at a minimum annually. Vehicles registered and operated in New Mexico MUST have insurance coverage that meets the minimum liability requirements of the New Mexico Mandatory Financial Responsibility Act 66-5-201 through 66-5-239 NMSA 1978. Bona fide New Mexico residency is required for vehicle registration 66-3-4 NMSA 1978. Please return COMPLETED affidavit and ALL required documentation to the New Mexico Insurance Identification Database IIDB. Mail to P. O. Box 30147 Albuquerque NM 87190-0147 OR FAX to 505-243-6605 For more information please call the IIDB toll-free at 866-891-0665. Please enter anticipated non-use dates below. From To The NON-USE portion of this affidavit is only valid for a maximum of ONE YEAR* A new Affidavit of Non-Use of Vehicle MUST be completed each year that the vehicle will not be driven* Out-of-State Information MINIMUM MANDATORY LIABILITY LIMITS 66-5-208 25 000 Bodily injury or death of one person in any one accident 50 000 Bodily injury or death of two or more persons in one accident 10 000 Destruction of property of others in any one accident I currently have insurance coverage in compliance with the New Mexico Mandatory Financial Responsibility Act 66-5-201 through 66-5-239 NMSA 1978. Policy Number Insurance Company Effective Dates to Note You MUST attach a copy of a current insurance card and declaration page containing liability limits. .

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