Fillable SR 19C, Financial Responsibility Information Request Form - dmv ca
A Public Service Agency
(See instructions on back) MAIL THIS TO: DEPARTMENT OF MOTOR VEHICLES -- FINANCIAL RESPONSIBILITY (916) 657-6677 P.O. BOX 942884, MAIL STATION J237, SACRAMENTO, CA 94284-0884
FINANCIAL RESPONSIBILITY INFORMATION REQUEST
SECTION A: TYPE OF INFORMATION REQUESTED (check only one box per request) Insurance Information from File Uninsured Motorist Certification Photocopy of SR 1 Report
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