Witness Statement (Spanish)
This written statement is prepared by an accident witness. It documents all details they can recall about the accident scene, including any statements made by parties involved.
PDF (95KB)
Auto
Liability
Forms Property & Casualty
PIP Attending Physician's Report
The attending physician report form is used by an insurer to determine if a person is due benefits under personal injury protection (PIP) law.
PDF (55KB)
Liability
Forms Property & Casualty
Vehicle Repair Order
Agreement and authorization between insured and automotive shop to repair a damaged vehicle within the estimated dollar amount.
PDF (15KB)
Auto
Forms Property & Casualty
Non-Waiver Agreement (Spanish)
The non-waiver agreement is signed by the policyholder; its purpose is to protect the insurer. Insurer reserves all of its rights under the policy to investigate and defend a claim without admission of any liability for loss.
PDF (82KB)
Auto
Liability
Property
Forms Property & Casualty
Hold Harmless Agreement (Spanish)
This is a contract that releases one party from any legal and financial responsibility for all loss or damage or future claims by the other party in exchange for a settlement.
PDF (82KB)
Auto
Liability
Property
Spanish
Workers' Compensation
Forms Property & Casualty
Passengers Statement (Spanish)
A passenger's statement describes persons, vehicles, injuries, driver actions and circumstances of a crash.
PDF (85KB)
Auto
Liability
Spanish
Forms Property & Casualty
Request For Copy Of Tax Return IRS Form 4506 (7/17)
IRS Form 4506 Request for Copy of Tax Return
PDF (43KB)
Auto
Liability
Property
Workers' Compensation
Forms Property & Casualty
Covenant Not To Sue
Thus is an agreement by an injured party to not pursue a lawsuit against another party in exchange for a settlement.
PDF (21KB)
Liability
Forms Property & Casualty
Florida WC Forms
A collection of workers' compensation forms which are authorized to be used in the state of Florida.
PDF (0KB)
Workers' Compensation
Forms Property & Casualty
South Carolina - Accident and Insurance Inquiry Forms (Financial Responsibility)
South Carolina Department of Motor Vehicles Accident and Insurance Inquiry forms relating to Financial Responsibility.
PDF (251KB)
Auto
Liability
Forms Property & Casualty
Uninsured Motorist Arbitration Filing Form
An arbitration request form for a disagreement involving an uninsured motorist that includes allegations, contentions and supporting evidence.
DOC (37KB)
Auto
Liability
Subrogation
Forms Property & Casualty
Texas Limited POA For Eligible Motor Vehicle Transactions VTR-271 (8/17)
This document gives the insurance company legal authority to transfer title of a vehicle that has been declared a total loss, and sell it for salvage.
PDF (24KB)
Auto
Salvage
Forms Property & Casualty
