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COLLECTOR VEHICLE STATE FORMS
Alabama
UA 137a
Alaska
UA 136j
[for policies effective prior to 1.1.19]
UA 136k
[for policies effective 1.1.19 and later]
Arizona
UA 143b
UA 153c
[Spanish version]
Arkansas
UA 127d
UA 217
California
UA 188b
Colorado
A 1809
AL 8888e
Connecticut
UA 235b
Delaware
A 1142d
A 1789b
Florida
AL 8859f
PI-CV-SEL-NF FL 1
Georgia
UA 176c
UA 233
Idaho
UA 124b
[for policies effective prior to 1.1.19]
UA 124c
[for policies effective 1.1.19 and later]
Illinois
A 1790a
Indiana
UA 179b
Iowa
UA 158
Kansas
A 1303
GU 9669
Kentucky
AL 8761c
AL 9731d
Louisiana
UA 182e
Maine
UA 205b
Maryland
A 1873
UA 236
UA 240
Mississippi
AL 8789b
Montana
UA 145a
Nebraska
UA 135c
Nevada
UA 125
New Jersey
Acord 64 NJ
NJ Buyers Guide A-705
New Mexico
UA 239a
New York
A 1874
[for new policies effective 6.16.18 or later and all subsequent renewals]
UA 201b
[for policies effective prior to 6.16.18 and all subsequent renewals]
North Carolina
A1810a
Ohio
UA 178e
Oklahoma
A 1805a
Oregon
UA 171c
Pennsylvania
A 964b
UA 100C
UA 103b
UA 104a
UA 105a
UA 106c
Rhode Island
A 1853
South Carolina
A 513e
South Dakota
UA 222
Tennessee
AL 8915a
Texas
UA 156b
UA 197a
Utah
UA 144g
UA 211
Vermont
IL U 069 04 10
Virgina
UA 173
UA 138c
UA 177b
Washington
UA 129a
UA 175a
West Virgina
UA 162b
UA 164c
Wyoming
UA 174
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