Forms

Displaying 201 - 210 of 416

Report of an Uninsured Motorist Claim (for Insurance Companies Only)

Use this form to report to DMV an uninsured motorist claim involving an uninsured motor vehicle registered in Virginia.
FR 205 English Other

Insurance Verification Annual Report

This annual publication provides a summary of DMV's insurance verification activities during each fiscal year.

FR 3 English Other

Financial Responsibility Insurance Filing via Internet

This publication is a user guided for DMV's Extranet system for the SR22/26 Insurance Reporting Data Exchange Process.
FR 4 English Other

Self-Insured Crash Involvement Quarterly Report

A self-insured entity must use this form to report crash involvement and demonstrate the entity's financial ability to respond to claims.
FR 521 English Other

Indemnification and Hold Harmless Agreement

Non-state entities use this form to request use of state property (ie: building, room or parking lot).

FSPA 3 English Other

Virginia Fuels Tax Notice of Tax Payment Default

Licensed suppliers or providers of alternative fuel use this form to report to report tax payment.
FT 214 English Fuels Tax

Fuels Tax Refund Application for Fuel Used in Diesel Vehicles

Use this form to apply for a refund of the Va fuels tax on diesel fuel used in a diesel passenger car, a pickup or panel truck or a truck with a gross vehicle wt of 10,000 lbs or less
FT 226 English Fuels Tax

Assignment of Securities in Lieu of Surety Bond

Customers use this form to submit collateral (certificate of deposit) in lieu of a bond.
FT 459 English Fuels Tax

Fuels Tax Bond

Customers use this form to submit collateral (bond) in lieu of a certificate of deposit.
FT 462 English Fuels Tax