69H-2.009. Florida Motor Vehicle No-Fault Forms  


Effective on Tuesday, July 18, 2023
  • 1(1) The following forms are incorporated herein by reference. These forms shall be used to aid the Division in the performance of its administrative duties by securing pertinent facts and information on Florida Motor Vehicle No-Fault claims filed against the Fund, as the circumstances may require:

    47(a) DFS-D0-281, “Claim for ‘No-Fault’ Benefits,” (Effective 07/23), 56http://www.flrules.org/Gateway/reference.asp?No=Ref-1547858.

    59(b) DFS-D0-283, “Wage and Salary Verification,” (Effective 07/23), 68http://www.flrules.org/Gateway/reference.asp?No=Ref-1547970.

    71(2) Copies of these forms are available from the Division of Risk Management, Department of Financial Services, 200 East Gaines Street, Tallahassee, Florida 32399-0300, or at https://myfloridacfo.com/Division/Risk/.

    98Rulemaking Authority 100284.30, 101284.31, 102284.39, 103627.730 FS. 105Law Implemented 107284.30, 108284.31 FS. 110History–New 6-28-01, Formerly 4H-2.009, Amended 7-18-23.