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The Florida HSMV 83330 form, commonly referred to as the Insurance Affidavit, plays a crucial role in the vehicle registration process in the state. This document serves as a declaration by the insured individual, affirming that they possess the necessary insurance coverage required by Florida law. Specifically, it requires the insured to certify that they hold Personal Injury Protection, Property Damage Liability, and, when applicable, Bodily Injury Liability insurance. The form mandates that the insured provide their name, the name of the insurance company, and the policy number, along with details about the vehicle, such as its year, make, and Vehicle Identification Number (VIN). Furthermore, the affidavit highlights the importance of compliance, stating that failure to maintain valid insurance can lead to suspension of the driver's license, license plates, and vehicle registration. It also includes a stern warning about the legal consequences of providing false information, emphasizing that such actions are considered criminal offenses under Florida law. Understanding the significance of the HSMV 83330 form is essential for anyone looking to register a vehicle in Florida, as it ensures that all drivers are adequately insured and helps maintain road safety across the state.

Form Example

FLORIDA INSURANCE AFFIDAVIT

Under penalty of perjury, I __________________________________________ certify that I have

(Name of Insured)

Personal Injury Protection, Property Damage Liability, and, when required, Bodily Injury Liability Insurance currently in effect with _____________________________________________ under

(Name of Insurance Company)

__________________________ ____________________ covering the following motor vehicle:

(Policy Number)Company Code Number (5 digits)

_________________________________________________________________________________________________________

Year

Make

Vehicle Identification Number

This insurance company is licensed to issue insurance policies in Florida. I understand that my driver license, license plate(s) and registration(s) will be suspended effective from the registration date, if the insurer denies that this policy is in force.

_______________________________________

Signature of Insured

WARNING: GIVING FALSE INFORMATION IN ORDER TO OBTAIN A VEHICLE REGISTRATION CERTIFICATE IS A CRIMINAL OFFENSE UNDER FLORIDA LAW. ANYONE GIVING FALSE INFORMATION ON THIS AFFIDAVIT IS SUBJECT TO PROSECUTION.

HSMV 83330 (Rev. 09/09)

www.flhsmv.gov

Document Breakdown

Fact Name Description
Purpose of the Form The Florida HSMV 83330 form serves as an insurance affidavit, confirming that the vehicle owner has the necessary insurance coverage required by state law.
Required Insurance Types This form requires certification of Personal Injury Protection, Property Damage Liability, and, when applicable, Bodily Injury Liability Insurance.
Governing Law The use of the HSMV 83330 form is governed by Florida Statutes, specifically Chapter 324, which outlines the requirements for motor vehicle insurance.
Consequences of False Information Providing false information on this affidavit can lead to criminal prosecution under Florida law, highlighting the importance of accuracy.
Signature Requirement The form must be signed by the insured, indicating their acknowledgment of the information provided and the penalties for misrepresentation.
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