Form Center

2. Proof of Insurance Online Submission Form

4. If you did not provide proof of insurance during your traffic stop, you must present proof of insurance for the date of your violation to the court. You can do this either before you pay your waiver, when you pay your waiver, or during your court appearance.

   You may submit your insurance using the form provided below. Please include a copy of your current vehicle insurance policy.

   Remember, you need to provide proof of insurance for the vehicle you were driving at the time you were cited.

   Failure to provide proof may result in a Non-Compliance Suspension by the Ohio Bureau of Motor Vehicles.

6. Citation Number *
8. First Name*
9. Last Name*
11. Email Address*
12. Phone Number*
14. Insurance Carrier*
15. Policy Number *
17. Upload Copy of Insurance*
Leave This Blank:


19. 1. Receive an email copy of this form.
20. Email address

    This field is not part of the form submission.

21. Submit Submit and Print

* indicates a required field