We can provide you with samples of court forms that are available. We can provide you with guidance on how to fill out forms.The book begins with basic information on the various types of insurance, including auto, home, life, annuities and long-term care. A glossary section contains. (a) Complete the General Information Section I and Section VI. (b) In your covering letter, give full details of the incident resulting in the loss or damage. A COC form used to verify financial responsibility for a specific accident or citation dated in the past and for a specific vehicle (year and make). Is there other insurance on the vehicle? United State Liability Insurance. A manufactured home must be permanently affixed to real estate and an Affidavit of Affixation (Form 5312) must be recorded with the Recorder of Deeds Office. In a letter dated May 18, 1998, Wayne Mutual informed appellants that their claim for uninsured motorist coverage was time-barred and denied.