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- Click ‘Get Form’ to open the md certified statement 2007 form in the editor.
- Begin by filling out Section 1: Owner’s Information and Statement of Facts. Enter your CASE NUMBER, TAG NUMBER, INSURANCE CANCELLATION DATE, TITLE NUMBER, and INSURANCE COMPANY details.
- Provide the VEHICLE IDENTIFICATION NUMBER and the OWNER’S DRIVERS LICENSE NUMBER. Fill in your name (First, Last) and the YEAR and MAKE of your vehicle.
- Indicate the period of insurance lapse by entering the start and end dates (MM/DD/YY). Specify where the vehicle was parked during this time by providing the location details including street address, city, state, and zip code.
- Select the reason(s) for not driving the vehicle during this period. Attach any supporting documentation as needed.
- Sign and date the form at the bottom of Section 1 to certify that all information is true to your knowledge.
- Proceed to Section 2: Witness Statement of Facts. Have witnesses sign and provide their drivers license numbers along with their contact information.
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