OWNER’S STATEMENT OF INSURANCE
CLASS A REGISTRATION FEES & INSTRUCTIONS
(X)
(X)
MAKE
CURRENT LICENSE PLATE NUMBER, IF RENEWING
NAME OF INSURANCE COMPANY
NAME OF INSURANCE AGENT
YEAR
CLASS: EXPIRATION DATE:
WEIGHT BODY STYLE TITLE NUMBER
VIN NUMBER
NAME(S) EXACTLY AS SHOWN ON TITLE
CURRENT STREET ADDRESS / MAILING ADDRESS
CITY COUNTY STATE ZIP
CHECK THIS BOX IF YOUR
ADDRESS HAS CHANGED
I hereby state, under penalty of false swearing and penalties provided for in
Chapters 17A and D of the West Virginia Code, that there is in eect a MOTOR
VEHICLE LIABILITY POLICY upon the vehicle described herein, in accordance
with provisions of the West Virginia Code.
All vehicle insurance information
must be completed. Your personal
property tax receipt or exemption
from your county courthouse must
be enclosed.
DMV-44-TR
Rev. 06/20
REGISTRATION NOTICE Renewal New
POLICY NUMBER
DO NOT WRITE IN THIS BOX • FOR DMV USE ONLY
OWNER SIGNATURE DATE
FROM: TO:
VALID
NAIC NUMBER
/ / / /
/ /
OWNER SIGNATURE DATE
/ /
DRIVING WITHOUT AUTO INSURANCE IN WV IS AGAINST THE LAW.
The price of your renewal also includes the mandatory $1.00 litter fee and .50¢ insurance fee.
(For non-alternative fuel cars and trucks under 8,001 lbs. GVW, standard )
Make your selection below:
MAIL TO:
WV DMV
PO Box 17110
Charleston, WV 25317
$51.50 for ONE Year
$103.00 for TWO Years
Add $10.00 for Scenic Plate
Want to contribute to the WV Department of Veterans Assistance? AMOUNT:
$5
$10
Other:
PLATE NUMBER:
