Make sure to sign and date the application in the Authorization and Release section. Vehicle Identification Number.Arizona License Plate No. 5th. 10th. 17th. The requesting party must complete a Request for Certificate of Insurance form, available from RMS. Complete a De-Insured Certificate form. Once restoration is complete, get proof of insurance, complete a nonuse certificate and apply for registration. Static forms need to be printed and completed manually. Notification of Health Insurance Coverage. Form Number 05-5542. These instructions are only applicable to filling out a paper CMS 1500 claim form.