Follow the steps to complete your application with ease.

1. Press the ‘Get Form’ button to access the application form and open it in your preferred editor.
2. Start by entering the effective date of insurance. Ensure this date is accurate.
3. Provide your NASTC membership status by selecting 'Yes' or 'No' under the membership section.
4. Fill in the applicant information and history, including your company name, address, and phone number. Make sure all entries are complete for efficient processing.
5. Provide the year your business was established and the number of years insured under the current name.
6. List the current carrier and current premium you are paying for insurance. Make sure to provide the MC or DOT number and FEIN if applicable.
7. Detail the specific commodities you haul and percentage, indicating if cargo coverage is requested.
8. Complete the radius of operations, indicating the percentages of miles traveled with various distance ranges.
9. Indicate the coverages requested, including limits for auto liability, physical damage, and any other relevant coverages.
10. For each piece of equipment, provide detailed information, such as unit number, year, make, model, and vin number, and clarify whether they are owned, leased, or owner-operated.
11. Document the driver information, including full name, date of birth, license number, and any relevant driving history for each driver.
12. List any past loss information, specifying the date of loss and coverage applicable.
13. Complete operation history and route information, including details about fixed routes and percentage of loads received through brokers.
14. Finally, review all sections for accuracy and completeness before submitting. You may be prompted to save changes, download, print, or share the completed form as needed.

Take the necessary steps to complete and submit your NASTC Insurance Services Insurance Application online today.