Edit, Download, and Sign the Florida DHSMV Release Form for Property Damage/Injury
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How do I fill this out?
Filling out this form involves providing personal and crash information, ensuring all signatures are notarized, and submitting the form as indicated. Read through each section carefully before filling it out. Make sure to keep copies of all documents for your records.
How to fill out the Florida DHSMV Release Form for Property Damage/Injury?
1
Gather all necessary personal and crash information.
2
Fill out each section of the form accurately.
3
Ensure all required signatures are notarized.
4
Submit the form to the specified address.
5
Keep a copy for your records.
Who needs the Florida DHSMV Release Form for Property Damage/Injury?
1
Drivers involved in an accident who need to release liability.
2
Insurance companies processing claims for property damage or injury.
3
Attorneys assisting clients with accident claims.
4
Individuals required to provide proof of financial responsibility.
5
Parties needing to resolve suspension of a driver's license.
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What are the instructions for submitting this form?
Submit the completed form to the Florida Department of Highway Safety and Motor Vehicles at Bureau of Motorist Compliance, MS 98, Post Office Box 5775, Tallahassee, Florida 32314-5775. You can also fax it to 850-617-5216. Please ensure all signatures are notarized and retain a copy for your records.
What are the important dates for this form in 2024 and 2025?
Ensure you submit this form within the required time frame following the date of the crash. Check with the Florida DHSMV for specific deadlines in 2024 and 2025.
What is the purpose of this form?
The purpose of this form is to release and discharge any claims or demands for damages, injury, or loss arising from a specific crash. It helps individuals and entities resolve liability issues and potentially avoid further legal action. By completing and submitting this form, you ensure compliance with Florida DHSMV regulations and facilitate the process of lifting any related driver's license suspensions.
Tell me about this form and its components and fields line-by-line.
- 1. Last Name: The driver's last name.
- 2. First Name: The driver's first name.
- 3. Middle Initial: The driver's middle initial.
- 4. Suffix: The driver's name suffix, if applicable.
- 5. Social Security Number: The driver's Social Security Number.
- 6. Current Mailing Address: The driver's current mailing address.
- 7. City: The city of the driver's mailing address.
- 8. State: The state of the driver's mailing address.
- 9. Zip Code: The zip code of the driver's mailing address.
- 10. Date of Crash: The date the crash occurred.
- 11. Date of Birth (MM/DD/YY): The driver's date of birth.
- 12. Driver's License Number: The driver's license number.
- 13. Location of Crash: The location where the crash occurred.
- 14. Financial Responsibility Case Number: The financial responsibility case number related to the crash.
- 15. Date of Full Release: The date the form is fully released.
- 16. Terms of Release: The terms under which the release is granted.
- 17. Other Party Name (print): Printed name of the other party involved in the crash.
- 18. Signing on behalf of name: Name of the representative for insurance companies, attorneys, or other entities.
- 19. Signature: The signature of the other party or representative.
- 20. Title of Position: The title or position of the representative signing the form.
- 21. Notary Name: The name of the notary public.
- 22. State: The state in which the document is notarized.
- 23. Name of other party or representative: The other party or representative's name.
- 24. County: The county where the document is notarized.
- 25. Notary Public Signature: The signature of the notary public.
What happens if I fail to submit this form?
Failure to submit this form can result in unresolved liability claims and continued suspension of your driver's license.
- Unresolved Liability: You may still be held liable for damages or injuries related to the crash.
- Driver's License Suspension: Your driver's license suspension may not be lifted.
- Legal Issues: You could face further legal action if this form is not submitted.
How do I know when to use this form?
- 1. Post-Accident Release: When you need to release liability after an accident.
- 2. Financial Responsibility: To meet financial responsibility requirements.
- 3. Driver's License Reinstatement: To facilitate the reinstatement of a suspended driver's license.
- 4. Insurance Claims: For processing insurance claims related to the crash.
- 5. Legal Compliance: To comply with legal obligations following a crash.
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