Get the free Operator Exclusion Form, CIC 616.
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Commerce Insurance Company
MA Personal Auto eff 05/01/18
Form #Edition
Date:Form Name:CIC192(Rev 06/14) Repair Certification FormCIC616(Rev. 0102) Operator Exclusion Formic 750
CIC799(05/17)
(Ed.
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How to fill out operator exclusion form cic
How to fill out operator exclusion form cic
01
Obtain the Operator Exclusion Form (CIC) from the concerned authority or website.
02
Fill out your personal details such as your name, address, contact information, and operator license number.
03
Identify the operator(s) you want to exclude from your insurance coverage. Provide their names, addresses, and license numbers.
04
Specify the effective date of the exclusion. This is the date from which the operator(s) will no longer be covered under your insurance policy.
05
Sign and date the form.
06
Submit the completed form to the appropriate authority or insurance company as instructed.
Who needs operator exclusion form cic?
01
Any individual who wants to exclude specific operator(s) from their insurance coverage needs to fill out the Operator Exclusion Form (CIC). This form is typically used when someone does not want a particular person or multiple persons, such as family members or employees, to be covered under their insurance policy.
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What is operator exclusion form cic?
Operator exclusion form cic is a form used to exclude certain operators from coverage under a commercial insurance policy.
Who is required to file operator exclusion form cic?
The policyholder or insured party is required to file operator exclusion form cic.
How to fill out operator exclusion form cic?
Operator exclusion form cic can be filled out by providing the necessary information about the excluded operator and submitting it to the insurance company.
What is the purpose of operator exclusion form cic?
The purpose of operator exclusion form cic is to specify which operators are excluded from coverage under the policy.
What information must be reported on operator exclusion form cic?
On operator exclusion form cic, information such as the name of the excluded operator, driver's license number, and reason for exclusion must be reported.
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