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(Date of Letter)

(Name) (Street Address) (City, State and Zip Code) RE: Dear Request for Evidence of Insurance Coverage :

As you know, on the day of (month/year), an accident occurred between a vehicle owned by you and the undersigned's vehicle at

(describe location of vehicular accident). The information provided by you at the time of the accident was either erroneous or incomplete; therefore, evidence of insurance must be provided to the undersigned within the next ten days. Kindly provide the undersigned with the name of your insurance company, the identity of the insurance policy, and the coverage amount. It is preferred that you provide the undersigned with copies of both the declaration sheet and the cover sheet of the insurance policy. In the event this request remains unsatisfied after ten days, contact will need to be made with the Department of Public Safety relative to financial responsibility. Thank you for your immediate attention. Very truly yours,

(Signature) (Address) (City, State and Zip Code) (Phone Number)

LAWCHEK, LTD. LETTER PRO Samples, Copyright 2000 This is not a substitute for legal advice. An attorney must be consulted.