Cdts 104 2026

1. Click ‘Get Form’ to open the cdts 104 in the editor.
2. Begin by filling in the 'Policyholder' section. Enter the name, street address, city, state, and ZIP code of the policyholder.
3. In the 'Insurance Carrier or Company' section, provide the name and contact details of the insurance provider, including their telephone number and address.
4. Complete the 'Insured Vehicles' section by listing each vehicle's year, make, serial number, and whether it is owned or leased. Ensure you also include the policy number and expiration date for each vehicle.
5. The authorized agent must sign at the bottom of the form. Include their name and title along with a certification date.
6. Finally, ensure that a notary public completes their section to validate the document before submission.

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