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 the existence of an automobile liability insurance policy at the time of the incident. Completing this form accurately and submitting it promptly is crucial to avoid potential penalties, including the suspension of your driver’s license.
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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
Incomplete Information: Failing to fill out all required fields can lead to delays. Every section, from driver details to vehicle information, must be completed accurately.
Incorrect Dates: Entering the wrong date of the crash or the driver's birth date can create confusion. Double-check these dates to ensure they match official records.
Missing Signature: Forgetting to sign the form is a common oversight. Without a signature, the form is not valid and cannot be processed.
Wrong Insurance Information: Providing incorrect details about your insurance policy can lead to complications. Ensure the policy number and insurance company name are accurate.
Not Indicating Insurance Status: Failing to answer whether an automobile liability policy was in effect at the time of the crash can result in delays. Be clear about your insurance status.
Ignoring Deadline: The form must be submitted within 15 days of the crash. Missing this deadline can result in penalties, including the suspension of your driver's license.
Incorrect Mailing Address: If the address on your driver’s license is outdated, the DMV may not receive your form. Always ensure your address is current to avoid issues.
Failure to Include Contact Information: Not providing a daytime telephone number or email can hinder communication. This information is crucial for the DMV to reach you if needed.
Neglecting to Review the Form: Skimming through the completed form before submission can lead to unnoticed errors. Always review the entire form to catch any mistakes.
Completing the Alaska 466 form is an important step following a motor vehicle crash. This form helps ensure that your insurance information is verified and recorded correctly. Follow these steps to fill it out accurately.
When filling out the Alaska 466 form, it is important to follow certain guidelines to ensure accuracy and compliance. Below is a list of things you should and should not do.
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