Fill in Your Alaska 466 Form Access Document Now

Fill in Your Alaska 466 Form

The Alaska 466 form is a Certificate of Insurance required by the State of Alaska for individuals involved in a motor vehicle crash. This form serves to verify that the driver had an active automobile liability insurance policy at the time of the incident. Completing and submitting this form promptly is essential to comply with state laws and avoid potential penalties.

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Overview

The Alaska 466 form is an essential document for anyone involved in a motor vehicle crash in the state. This form serves multiple purposes, primarily to provide proof of insurance coverage at the time of the incident. It requires detailed information about both the driver and the vehicle, including names, addresses, and license numbers. Additionally, it asks for specifics about the crash, such as the date and location. If you had an automobile liability policy in effect during the crash, you must indicate this on the form, along with your policy number and insurance agent's contact details. The form also emphasizes the importance of adhering to Alaska’s mandatory insurance and financial responsibility laws. Failing to provide proof of insurance can lead to severe consequences, including the suspension of your driver’s license. Moreover, you have a limited timeframe of 15 days from the date of the crash to submit this form to the Division of Motor Vehicles. If the crash was not investigated by a peace officer and damages exceed $2,000, or if there were injuries, a crash report is also required. Understanding these requirements is crucial for ensuring compliance and avoiding potential penalties.

Alaska 466 Example

ALL date fields require

Month / Day / Year. Example: 11/4/11

STATE OF ALASKA - DIVISION OF MOTOR VEHICLES

CERTIFICATE OF INSURANCE

LAW ENFORCEMENT INCIDENT NUMBER:

CRASH

Date of Crash:

 

City Where Crash Occurred:

 

INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Driver

 

 

Name: _________________________________ Date of Birth: _____________

License #: _________________

State: ______

DRIVER

Mailing Address: _____________________________________________________________________________________________

 

 

 

Street or Box

City

State

Zip

 

Daytime Telephone:

 

E-mail:

 

 

OWNER

 

 

 

 

 

 

Driver

 

Name: _________________________________ Date of Birth: _____________

License #: _________________

State: ______

OF

Mailing Address: _____________________________________________________________________________________________

VEHICLE

 

 

Street or Box

City

State

Zip

VEHICLE

Year:

Make:

Model:

License Plate #:

VIN:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Did you have an automobile liability policy in effect covering this crash? YES † NO † Policy Number:

 

 

 

 

 

 

 

Name & Address of Insurance Agent:

 

 

 

Phone Number of Insurance Agent:

 

 

 

 

 

 

 

Name of Insurance Company:

 

 

 

 

 

Policy Period: Starting & Ending Dates

 

 

 

 

 

 

 

To

 

 

 

 

 

 

 

 

Your Signature:

 

 

 

Sign your form after printing.

 

Date:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DO NOT WRITE BELOW THIS LINE. THE DIVISION OF MOTOR VEHICLES WILL CONTACT YOUR INSURANCE COMPANY.

Insurance Verification: If the motor vehicle liability insurance policy listed above was not in effect for the motor vehicle listed at the time of the crash please check the appropriate box below and mail or fax this form to the Division of Motor Vehicles at the address or fax number listed on the reverse of this form. If indicated coverage was in effect at the time of the crash, no action is required.

REASON NOT VERIFIED: † Insurance information is incorrect

† No insurance in effect at time of crash

Signature of

 

Date __

Authorized Representative

 

 

 

 

 

 

 

MANDATORY INSURANCE AND FINANCIAL RESPONSIBILITY NOTICE

If the actual or estimated damages of any one person’s property involved in the crash exceeds $501, or if there is any personal injury or death, you are subject to the Alaska mandatory insurance and financial responsibility laws. The mandatory insurance laws require you to file proof of insurance with the State of Alaska. Failure to do so will result in the suspension of your driver’s license.

The financial responsibility laws require a person to show financial responsibility by one of the following methods:

(1)an automobile liability insurance policy in effect at the time of the crash; (2) a release of liability; (3) a settlement agreement and proof of future financial responsibility (SR-22 insurance); (4) a deposit of security and proof of future financial responsibility (SR-22 insurance); (5) a finding of no liability by the court in a civil action (a finding of not guilty of a traffic citation does not apply). Failure to show financial responsibility by one of the listed methods will also result in the suspension of your driver’s license for a period of 3 years if there is a possibility you are liable.

After any suspension you must show future financial responsibility (SR-22 insurance), and pay a reinstatement fee of $100 to $500, in addition to the fee for the license being requested, to have your driving privileges restored. A notice of suspension returned by the post office because of an incorrect address on your driver’s license or DMV records will not invalidate the suspension if the notice was mailed to the last address you provided to DMV.

IMPORTANT: THIS FORM MUST BE COMPLETED IN FULL AND MAILED OR FAXED TO THE DIVISION OF MOTOR VEHICLES WITHIN 15 DAYS FROM THE DATE OF THE CRASH. A participant’s crash report is required if the crash was not investigated by a peace officer and the total amount of damage exceeds $2,000, or there was personal injury.

Mail or Email Completed Form To:

STATE OF ALASKA

DIVISION OF MOTOR VEHICLES ATTN: DRIVER SERVICES 4001 Ingra Street, Suite 101 Anchorage, AK 99503

Phone: (907) 269-5551

Form 466 (Rev. 06/2023)

Alaska.gov/dmv

E-mail: DOA.DMV.ADS@Alaska.gov

Document Specifics

Fact Name Fact Description
Form Title The form is officially titled "Certificate of Insurance." It is used in connection with motor vehicle incidents in Alaska.
Governing Law This form is governed by Alaska Statutes related to mandatory insurance and financial responsibility.
Submission Deadline The completed form must be submitted within 15 days from the date of the crash.
Insurance Verification Insurance companies will be contacted by the Division of Motor Vehicles to verify the policy listed on the form.
Driver Information Both the driver and vehicle owner's details are required, including names, addresses, and license information.
Financial Responsibility Failure to demonstrate financial responsibility can lead to a suspension of the driver’s license for up to three years.
Policy Coverage Participants must indicate whether an automobile liability policy was in effect at the time of the crash.
Contact Information The form includes contact details for the Division of Motor Vehicles, including a fax number and email address.
Mandatory Insurance Notice The form includes a notice that outlines the consequences of not having adequate insurance coverage.
Crash Report Requirement A crash report is necessary if the crash was not investigated by a peace officer and damages exceed $2,000.
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