Get Affidavit Of No Other Insurance Form
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to fill out the Affidavit Of No Other Insurance Form online
This guide provides you with clear, step-by-step instructions on how to complete the Affidavit Of No Other Insurance Form online. By following these steps, you will ensure that all necessary information is accurately provided, streamlining the filing process.
Follow the steps to fill out the Affidavit Of No Other Insurance Form online
- Click the ‘Get Form’ button to obtain the form and open it in the editor.
- Provide your claim number at the top of the form.
- In the first section, fill in the state and county where you are filing.
- Enter your full name in the designated field.
- Complete your current address by providing details about your residence.
- Add your home phone number in the specified section.
- Fill in your date of birth (DOB) accurately.
- If applicable, provide your Social Security number (SSN) or indicate 'none' if you do not have one.
- Input your Individual Taxpayer Identification Number (ITIN) or enter 'none' if you do not possess one.
- Indicate your gender by selecting the appropriate option and specify whether you are a Medicare beneficiary.
- If you have a driver’s license, provide the details, including the state and number.
- On the date of the accident, indicate your residence and provide your driver’s license details if it has changed.
- List all other residents in your household at the time of the accident, including their names, dates of birth, social security numbers, driver’s license information, states, and their relationship to you.
- Check each applicable option regarding your insurance status on the accident date.
- Read and certify the statements made in the affidavit by signing in the designated area.
- Finally, ensure to complete the area for notarization, including the date.
- Once all sections are completed, save your changes, and choose to download, print, or share the form as needed.
Start filling out your Affidavit Of No Other Insurance Form online today.
Fill Affidavit Of No Other Insurance Form
Those documents are basically you saying there is no other insurance, that you carry, that would respond here. Do you have an umbrella policy? The affidavit requests the negligent driver to identify all of his or her vehicles and whether any potential family members have insurance coverage. I am over the age of eighteen;; I have personal knowledge of the facts set forth below. On October 30, 2006, I was involved in an automobile accident. My insurance sent me an affidavit of no other insurance and an authorization form to sign to disclose my policy limits to the other party. This form is available on Westlaw. Easily search more than 600,000 legal forms to find the exact form you need. Microsoft Word 2019 Statement of No Other Insurance Form (PDF) What is an affidavit of no other insurance?
Industry-leading security and compliance
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.