Form FR 4. Financial Responsibility Insurance Filing via Internet is a publication that serves as a user guide for DMV's Extranet system for the SR22/26 Insurance Reporting Data Exchange Process. The main purpose of this guide is to assist insurance companies in electronically filing financial responsibility information for drivers who require SR22 or SR26 insurance documentation.
Form FR 200. Voluntary Report of a Crash enables individuals to voluntarily submit a report on a vehicle(s) crash. The main purpose of this form is to provide a means for individuals involved in minor accidents or incidents to report the details to the Virginia Department of Motor Vehicles (DMV) for record-keeping purposes.
Form FR 205. Report of an Uninsured Motorist Claim (for Insurance Companies Only) is used by insurance companies to report to the Virginia Department of Motor Vehicles (DMV) an uninsured motorist claim involving an uninsured motor vehicle registered in Virginia. The primary purpose of this form is to notify the DMV of a claim where the at-fault driver does not have liability insurance coverage.
Form FR 302. Application for Self Insurance serves as an application for self-insurance status in Virginia. The primary purpose of this form is to allow qualified entities to demonstrate their financial ability to self-insure for liability and property damage coverage instead of obtaining traditional insurance policies.
Form FR 521. Self-Insured Crash Involvement Quarterly Report is used by self-insured entities to report crash involvement and demonstrate their financial ability to respond to claims. The primary purpose of this form is to provide the Virginia Department of Motor Vehicles (DMV) with information about the self-insured entity's crash history and financial stability.
Form FSPA 3. Indemnification and Hold Harmless Agreement is used by non-state entities to request the use of state property, such as a building, room, or parking lot. The main purpose of this form is to formalize an agreement between the non-state entity and the Virginia Department of Motor Vehicles (DMV) regarding the use of state-owned property.
Form FT 214. Virginia Fuels Tax Notice of Tax Payment Default is used by licensed suppliers or providers of alternative fuel to report tax payment default to the Virginia Department of Motor Vehicles (DMV). The primary purpose of this form is to inform the DMV of any failure to pay the required fuels tax on time.
The parties involved in this form are the licensed fuel suppliers or providers and the Virginia Department of Motor Vehicles (DMV). The form consists of sections where the supplier provides information about the fuel sales and any tax payment default.
Form FT 226. Fuels Tax Refund Application for Fuel Used in Diesel Vehicles is used to apply for a refund of the Virginia fuels tax on diesel fuel used in specific vehicles. The primary purpose of this form is to allow eligible vehicle owners to claim a refund for the fuels tax paid on diesel fuel used in certain vehicles.
Form FT 459. Assignment of Securities in Lieu of Surety Bond is used by customers to submit collateral (certificate of deposit) in lieu of a surety bond to the Virginia Department of Motor Vehicles (DMV). The primary purpose of this form is to allow customers to meet financial responsibility requirements without obtaining a traditional surety bond.
Form FT 462. Fuels Tax Bond is used by customers to submit a collateral bond in lieu of a certificate of deposit to the Virginia Department of Motor Vehicles (DMV). The main purpose of this form is to provide an alternative method for customers to fulfill their financial responsibility requirements for the fuels tax without placing a certificate of deposit.
