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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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.
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
OF
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
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