California Motor Carrier Self-Insurance Application 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. In Part 1, select your business type by checking the appropriate box (Individual, Partnership, Corporation, or Limited Liability Company) and enter your Motor Carrier Name and CA Number.
  3. Proceed to Part 2. Fill in your Business Address, City, State, ZIP Code, and if applicable, provide a different Mailing Address along with its details.
  4. In Part 3, indicate the number of vehicles in your motor carrier fleet. Specify how many are California registered and how many are registered out of state.
  5. For Part 4, check one box to select the required deposit amount based on your operation type. Ensure you include the additional $5,000 for potential administrative costs.
  6. Complete Part 5 by certifying that you have no unsatisfied judgments against your motor carrier name. Sign and print your name along with the date and telephone number.

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See more California Motor Carrier Self-Insurance Application versions

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2015 4.8 Satisfied (50 Votes)
2012 3.9 Satisfied (31 Votes)
2010 4.8 Satisfied (180 Votes)
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