Vehicle Identification

Vehicle Identification fields marked with * are required and fields marked with ** are required only if adding vehicles (Add is chosen in Policy Change field). As an alternative, you may also download this form in an adobe document format, fill it out, and either fax it to (916)774-7040 or email it to the Member Services Department.

Step 1 of 2
Please include all modifications $5,000 or greater. Including, but not limited to, adding a Crane, a Spray Rig, Body Customizations, or any other enhancements or after market items added to the vehicle.

Vehicle Identification fields marked with * are required and fields marked with ** are required only if adding vehicles (Add is chosen in Policy Change field). As an alternative, you may also download this form in an adobe document format, fill it out, and either fax it to (916)774-7040 or email it to the Member Services Department.

    Vehicle Information
    * Policy Change
    * District
    ** Date Aquired   Unit Number
    * Vehicle Year * Vehicle Make
    * Vehicle Model * Vehicle Type
    * Vehicle Identification Number (VIN) ** Estimated Value
    Please include all modifications $5,000 or greater. Including, but not limited to, adding a Crane,a Spray Rig, Body Customizations, or any other enhancements or after market items added to the
    vehicle.
    Modifications
    ** Lease or Financed YesNo
    Contact Information
    * First Name * Last Name
    * Email