Financial Responsibility Affidavit

A Financial Responsibility Affidavit is a notarized statement issued by the Department of Safety and Homeland Security upon request from an individual or his representative stating whether a person involved in a crash has filed an Owner/Operator Report indicating liability insurance for a specific crash.

To self-report an accident with an Owner/Operator Report, visit e-Services and the click on Submit an Owner Operator Report in the Driver Services

If this notarized statement is requested, then there is a charge of $5 payable by cashier's check or money order made out to the Department of Safety and Homeland Security. 

  1. Name of person involved in the crash.
  2. Driver license number of person involved in crash.
  3. Date of accident
  4. County of accident.

Mail the request to:

Financial Responsibility Division
Tennessee Dept of Safety
PO BOX 945
Nashville, TN 37202

Please allow two weeks from mailing date for return of affidavit.