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Collector Vehicle State Forms

Alabama

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

California

Colorado

Connecticut

Delaware

Florida

Georgia

Idaho

UA 124b
[for policies effective prior to 1.1.19]
UA 124c [for policies effective 1.1.19 and later]

Illinois

Indiana

Iowa

Kansas

Kentucky

Louisiana

Maine

Maryland

Mississippi

Montana

Nebraska

Nevada

New Jersey

New Mexico

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

Ohio

Oklahoma

Oregon

Pennsylvania

Rhode Island

South Carolina

South Dakota

Tennessee

Texas

Utah

Vermont

Virgina

Washington

West Virgina

Wyoming

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