ACORD 57 Instructions


ACORD 57 (1/97) – Financial Responsibility Form, (Notice of Cancellation or Termination)


This form is used in many states to notify the motor vehicle administrator that an insurance policy is being canceled or non-renewed, where ACORD 54 has previously been filed to certify insurance coverage. Refer to the specific state information below.

This form is the same as the American Association of Motor Vehicle
Administrators (AAMVA) Form SR 26.

Special Provisions/State Exceptions to ACORD 57:

Alabama:
Must be filed not less than 10 days prior to date of termination of coverage.

Alaska:
Same as Alabama.

Arizona
Same as Alabama.

Arkansas
Same as Alabama.

California
A special state form is required. This form is not printed by ACORD.

Colorado
Same as Alabama.

Connecticut
Must be filed not less than 14 days prior to date of termination of coverage.

District of Columbia
Must be filed not less than 30 days prior to termination of coverage.

Delaware
Same as Alabama, except that the 10 day period starts on the date of receipt by the Delaware DMV.

Florida
Same as Alabama.

Georgia
Must be received by the Georgia Department of Public Safety, Revocation and Suspension section, not less than 20 days prior to termination of coverage.

Hawaii
Same as Delaware.

Idaho:
Same as Alabama.

llinois
Must be filed with 15 days advance notice to the Secretary of State, Safety Responsibility Section.

Indiana
Same as Alabama.

Iowa
Same as Delaware.

Kansas:
Must be filed immediately upon cancellation, but not before actual termination of the policy.

Kentucky
Not applicable.

Louisiana
Same as Alabama.

Maine
Same as Alabama.

Maryland
Not applicable.

Massachusetts
Not applicable.

Michigan
Same as Delaware.

Minnesota
Not applicable. Company notice of termination or cancellation will suffice. Sixty day notice to the Minnesota Department of Public Safety, No Fault Unit, is required prior to termination of coverage.

Mississippi
Must be filed not less than 5 days prior to termination of coverage.

Missouri
Same as Alabama.

Montana
Same as Alabama.

Nebraska
Same as Alabama.

Nevada
Same as Alabama.

New Hampshire
Must be received by the NH Department of Safety, DMV, not less than 20 days prior to termination of coverage.

New Jersey
Not applicable.

New Mexico
Not applicable.

New York
Not applicable.

North Dakota
Must be received by ND Drivers License & Traffic Safety Division not more than 10 days after termination of coverage.

Ohio
Same as Alabama.

Oklahoma
Must be filed within 15 days after the cancellation effective date.

Oregon
Must be filed within 30 days prior to termination date, to 10 days after termination.

Pennsylvania
Not applicable.

Rhode Island
Must be received by RI DMV not less than 10 days prior to termination of coverage.

South Carolina
Must be received by the SC Department of Highways and Public Transportation, Motor Vehicle Division, between 10 and 40 days prior to termination date.

South Dakota
Same as Oklahoma.

Tennessee
Same as New Hampshire.

Texas
Must be filed with the Texas Department of Public Safety within 5 days of termination of coverage.

Utah
Same as Delaware.

Vermont
A special state form is required. This form is not printed by ACORD.

Virginia
Must be filed with the Virginia DMV not later than 15 days after termination of coverage.

Washington
Must be received by the Washington Department of Licensing, Driver Services Division, not less than 10 days prior to termination of coverage.

West Virginia
Not applicable.

Wisconsin
Same as Alabama.

Wyoming
Same as Alabama.

INSURED

Complete the name and address of the insured.

CASE NUMBER

Do not complete unless indicated by special state instructions.

CURRENT POLICY NUMBER/EFFECTIVE FROM

Enter the policy number, effective date and expiration date of the policy.

EFFECTIVE DATE OF CANCELLATION OR TERMINATION

Enter the date of cancellation or termination. Also check the appropriate box to indicate if the financial responsibility certificate previously sent to the motor vehicle administrator was form SR 22 (ACORD 54), or form SR 23.

STATE

Enter the name of the state where the filing is to be made.

COMPANY CODE AND NAME OF INSURANCE COMPANY

Enter the company code before the name of the insurance company, if required. This number may be obtained from the Administrator.