North Dakota Department of Transportation · North Dakota state form
SFN 53386 Total Loss Statement
SFN 53386 documents a vehicle total loss, compensation details, and owner-retained salvage for North Dakota Department of Transportation Motor Vehicle Division use.
- What this form is
- Use SFN 53386 to provide owner and vehicle information, incident and claim details, payment information, and insurance company contact details for a vehicle declared a total loss. The form includes a signature for an authorized agent and a notary or authorized officer acknowledgment. It notes that credit can be claimed no more than three years from the date compensation was received.
- Who needs it
- An owner or insurance company representative completing a total loss statement for a vehicle and providing compensation and claim information to the Motor Vehicle Division.
- Why it needs a notary
- The authorized agent’s signature must be notarized or signed before an authorized officer; this can be done online with a commissioned online notary.
- How to submit it
- Submit it to the North Dakota Department of Transportation, Motor Vehicle Division, at the address shown on the form: 608 E Boulevard Ave, Bismarck, ND 58505-0780.
Questions
What information does SFN 53386 request?
The form requests owner and vehicle details, incident and claim information, payment and salvage details, and the insurance company’s contact information.
Does SFN 53386 need to be notarized?
Yes. The authorized agent must sign before a Notary Public or authorized officer. This can be done online with a commissioned online notary.
Where should I submit the completed form?
Submit it to the North Dakota Department of Transportation, Motor Vehicle Division, at the address printed on the form: 608 E Boulevard Ave, Bismarck, ND 58505-0780.