Follow the steps to successfully complete the form

1. Click the ‘Get Form’ button to obtain the form and open it in the designated online editor.
2. Begin by entering the name of the motor carrier in the designated field. Ensure you provide the full legal name as it appears on your registration documents to avoid discrepancies.
3. Next, enter the address of the motor carrier. This should include the street address, city, state, and zip code to ensure accurate communication.
4. In the following field, input the name of the insurance company providing the policy. Again, this should match the official name under which the company operates.
5. Provide the address of the insurance company, ensuring all details are complete to facilitate proper processing of the cancellation notice.
6. Indicate the type of insurance being cancelled by checking the appropriate box, either for bodily injury (BI) and property damage (PD) or cargo coverage.
7. Specify the cancellation effective date. This date must be at least thirty days following the actual receipt of this notice by the Commission.
8. Enter the insurance company file number and the policy number accurately to reference the specific insurance policy being cancelled.
9. Lastly, the authorized company representative should provide their signature. This step confirms that the cancellation has been authorized by an individual with the appropriate authority.
10. Once all sections are completed, you can save the changes, download, print, or share the completed form as needed.

Ensure your motor carrier insurance policies are managed properly by filling out your forms online today.