Forms and Related Instructions  

• General Information Brochure
• Initial Report Form (Instructions)  
• Moonlighting Surcharge Rating System Agreement
• Non-resident Certification
• Non-admitted Insurer Declaration of Compliance (Instructions)
• Notice of Cancellation/Termination sample and Instructions
• Notice of Basic Coverage (Instructions)  
• Refund Request and Instructions
• Request to Decrease Fund Coverage
• Request to Increase Fund Coverage
• Request for Exemption from payment of tail coverage 
  - Affidavit of Disability
  - Affidavit of Temporary Absence
  - Affidavit of Extension of Temporary Exemption
  - Affidavit of Retirement
  - Affidavit of Temporary Absence due to Military Duty 

• Self-Insurance Certificate Application and Instructions