The Motor Vehicle Accident Report, Form 1140, is the form the Missouri Department of Revenue's Driver License Bureau uses to receive reports of accidents in which someone involved had no insurance. You file it when the accident happened in Missouri within the last 12 months and at least one person involved was uninsured; a police report cannot take its place. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the report itself goes to the Driver License Bureau by mail or fax.
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What is 1140?
Form 1140, Motor Vehicle Accident Report, is the Missouri Department of Revenue Driver License Bureau form for reporting an accident in which someone involved had no insurance; its general information is based on Chapter 303 RSMo.
The form's own instructions say the law requires you to report the accident on this form, so a police report cannot be sent in its place. After the Driver License Bureau receives the report, it determines a percentage of fault for the accident. An uninsured person's driver license and/or plates can be taken away for one or both of these reasons:
- the person does not show proof of insurance for the accident;
- the person is found at fault and does not send security compliance.
Security is the amount of money the department finds the uninsured person responsible for, based on that person's percentage of fault and the damages on file. The most common forms of compliance are an Installment Agreement (a notarized payment plan), a Release (a sworn statement from you releasing the person from responsibility), a Cash Deposit, or a One-Year Suspension that the person chooses instead of submitting security. The State does not file a lawsuit for you; if you want one, you file it in court.
The report is two-sided and has five parts: accident information, your information, signature, other involved parties, and a diagram with a description of the accident. The revision printed on it is REV. 6-2006 (DOR-1140).
Who needs to file 1140?
Anyone involved in a Missouri accident with an uninsured party and who wants the Driver License Bureau to act on it files Form 1140. The form's general information says to file it if all three of these are true:
- the accident happened in Missouri;
- the accident happened within the last 12 months;
- someone involved in the accident did not have insurance.
The signature block lets the person signing identify as a driver, owner, property owner, attorney, passenger, pedestrian, insurance company representative or corporate officer. Drivers and owners complete their vehicle, owner and liability insurance details. If you were not a driver or owner, mark your involvement (passenger, pedestrian, property owner other than vehicle, or other) and fill in your information.
Do not use this form for an accident outside Missouri: the form says to report only accidents occurring in Missouri. Do not send a police report instead of the form. To have the department determine fault and require security for your loss, the additional damage, injury and nine-month conditions described under when to file must also be met.
When to file 1140
File Form 1140 within 12 months of an accident in Missouri in which someone involved was uninsured; the instructions say the report must be mailed within one year of the accident date. To have the department determine a percentage of fault and require security for your loss, both of these must apply: there was more than $500 in damage to one or more persons' property, or there was bodily injury or death; and fewer than nine months have passed since the accident. The form explains that a notice must reach the uninsured person within one year of the accident and that the department needs 90 days to process the report. If either condition does not apply, the uninsured person's license and/or plates can still be taken away for having no insurance at the time of the accident, provided the report is mailed within one year. Allow up to 90 days for processing.
Documents you need
- Estimate of repair cost for the vehicle or other property, when there was more than $500 in damage and fewer than nine months have passed; it must be readable, itemized, show the accident date or estimate date, and give the repair shop's or insurance company's name and address.
- Doctor's report and/or medical bills, when there was bodily injury and fewer than nine months have passed; they must explain the type of injury in detail and include the service date and the healthcare provider's name and address.
- Copy of a death certificate or a police report showing there was a death, when the accident involved a death and fewer than nine months have passed.
- Denial letter from the uninsured person's insurance company, if you have one; it must state why coverage was denied, be on the company's stationery and be signed by the person who reviewed the claim.
How to fill out 1140
Confirm you should file this report
File only if the accident happened in Missouri within the last 12 months and someone involved was uninsured. Leave the "DOR USE ONLY" box (NAIC number, ORI number, case number) blank.
Complete Part 1 accident information
Enter the accident date, time (mark A.M. or P.M.), county and state, the street name or highway number, and the number of vehicles involved. Mark YES or NO for whether a police report was made and, if yes, name the police agency.
Enter your driver and owner details
In Part 2, fill in your vehicle driver and vehicle owner information, including names, addresses, dates of birth, driver license numbers, vehicle make/year, model and license plate number. If the vehicle was parked, write "parked" in the vehicle driver box and complete the owner information.
Mark your involvement if not driver
If you were not the vehicle driver or owner, mark Passenger, Pedestrian, Property Owner (other than vehicle) or Other under Involvement, give the type of property if it applies, and fill in your name, date of birth, address and driver license number.
Answer the liability insurance question
Mark YES or NO to whether your vehicle was covered by liability insurance at the time of the accident; you must mark a box. If YES, enter the insurance company name (not agency or brokerage) and the policy/claim number. This is only required if you are the vehicle driver and/or owner.
Sign Part 3 and mark your role
Sign your name to state the information on both sides is true and accurate to the best of your knowledge, then mark the box that says who you are, such as driver, owner, attorney or insurance company representative. An unsigned report is returned.
Enter other involved parties in Part 4
On the reverse side, fill in the driver, owner and vehicle information for every other vehicle involved. Use additional forms if there are more parties than the form has room for.
Draw the accident diagram
In Part 5, draw the roadway at the place of the accident, number each vehicle and show its direction of travel with an arrow. Use the listed symbols for vehicle, motorcycle, pedestrian, railroad and utility pole.
Describe what happened
In the description box, explain in your own words how the accident happened, referring to vehicles by number and to drivers by name.
Gather your attachments
If more than $500 in damage, bodily injury or death applies and fewer than nine months have passed, attach a repair estimate, doctor's report or medical bills, or a death certificate or police report showing a death. Add the insurer's denial letter if you have one.
Review, sign and download the PDF
Check every part, including the insurance box and your signature, then download or print the completed PDF from FillingPDF. Submit it through the channels described under How to submit.
How to submit 1140
You can send the completed Form 1140 and any attachments to the Driver License Bureau by mail or by fax.
- Mail: Driver License Bureau, P.O. Box 200, Jefferson City, Missouri 65105-0200.
- Fax: (573) 526-7365.
Send the completed report together with any estimate, medical record, death certificate, police report showing a death or insurance denial letter that applies to your accident. The report must be signed or it will be returned to you. For questions, the bureau lists (573) 751-7195 and [email protected]. The form says the bureau will tell you when the uninsured person's license and/or plates will be suspended if you contact it, and asks you to allow up to 90 days for processing. FillingPDF lets you fill out and download the PDF; submission follows the channels above.
Common mistakes to avoid
- Sending a police report instead of Form 1140; the form says the law requires you to report the accident using the form.
- Mailing the report without a signature in Part 3; the form states it will be returned to you.
- Leaving the liability insurance question unmarked; the form says you must mark Yes or No.
- Marking Yes for your own insurance without the insurance company name and policy number; the form warns that this may result in suspension action.
- Entering an insurance agency or brokerage name instead of the insurance company name on the liability insurance line.
- Reporting an accident that happened outside Missouri, or one more than 12 months old.
- Waiting until nine months or more after the accident and still expecting a fault determination and security; notice must reach the uninsured person within one year and processing takes 90 days.
- Attaching a repair estimate that is not itemized or lacks the accident or estimate date or the shop's name and address.
- Attaching a denial letter that is not on the insurance company's stationery or not signed by the person who reviewed the claim.
- Forgetting to write "parked" in the vehicle driver box when your vehicle was parked, and to fill in the owner information.
Frequently asked questions
What is the motor vehicle accident report Form 1140 used for?
Form 1140 is the Missouri Department of Revenue's Motor Vehicle Accident Report. You file it with the Driver License Bureau to report a Missouri accident in which someone involved had no insurance, so the department can determine fault and act on the uninsured person's driver license and/or plates.
Can I send the police report instead of Form 1140?
No. The form's general information says the law requires you to report the accident using the form itself. The police report still has a role: Part 1 asks whether one was made and by which agency, and a police report showing a death can be attached as proof of a death.
How long do I have to file a Missouri accident report?
The accident must have happened within the last 12 months, and the report must be mailed within one year of the accident date. To get a fault determination and security, it must also be fewer than nine months old and involve more than $500 in damage or bodily injury or death.
Where do I mail or fax Form 1140?
Mail it to the Driver License Bureau, P.O. Box 200, Jefferson City, Missouri 65105-0200, or fax it to (573) 526-7365. Include the completed form and any attachments. Questions can go to (573) 751-7195 or [email protected].
What do I attach to Form 1140?
It depends on your loss. Attach an itemized repair estimate, a doctor's report or medical bills, or a death certificate or police report showing a death, as they apply. Add a signed denial letter on the insurer's stationery if the uninsured person's insurance company denied coverage.
How long does the Driver License Bureau take to process the report?
Allow up to 90 days for the bureau to process your report and determine a percentage of fault. If you contact the bureau, it will tell you when the uninsured person's driver license and/or plates will be suspended.
What happens to the uninsured driver after I file?
Their driver license and/or plates can be taken away if they do not show proof of insurance for the accident, or if they are found at fault and do not send security compliance. Compliance can be an installment agreement, a release, a cash deposit, or a one-year suspension.
Will the state file a lawsuit against the uninsured person for me?
No. If you want to sue, you must file the lawsuit in court yourself. The form notes that a one-year suspension can be extended if a lawsuit is filed within one year of the accident date and a copy of the petition is sent to the Driver License Bureau.
Can I fill out Form 1140 online?
Yes. You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not send the report to the Driver License Bureau; you mail or fax it yourself.
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