(Name of Insurance Company). Covering the following motor vehicle: (Policy Number).Insurance Request Form. To request insurance information on a vehicle involved in the crash, you must submit a legible copy of the crash. How do I fill this out? To fill out the Florida Insurance Affidavit, gather your insurance policy information, including the policy number and company name. 1. Gather necessary information about the vehicle and insurance. All registered insurance companies and financial institutions must create a FMCSA Portal account and use Login. Gov to access their e-Filer account page. Auto Insurance Quotes.