PA DMV Form MV-219. Application for Renewal of Certificate of Self Insurance

Form MV-219 is an application used to renew a Certificate of Self Insurance in Pennsylvania. This form is used by individuals or entities who have been granted self-insurance status by the Pennsylvania Department of Transportation (PennDOT) and need to renew their self-insurance certificate.

The form consists of sections where the applicant provides their personal or business information, including their name, address, contact details, and self-insurance account number. The applicant also needs to provide information about the vehicles covered under the self-insurance policy, such the make, model, year, and Vehicle Identification Number (VIN).

Important fields in this form include accurate identification of the vehicles covered under the self-insurance policy, as well as providing correct and up-to-date personal or business information. It is crucial to ensure that all relevant details are accurately filled out to avoid any issues with the renewal process potential gaps in insurance coverage.

Application Example: An example scenario where Form MV-219 would be used when a company has been granted self-insurance status by PennDOT and needs renew their self-insurance certificate. The company would need to complete this form, providing updated information about the vehicles covered under the self-insurance policy and ensuring that all required fields are accurately filled out. renewing the Certificate of Self Insurance, the company can continue to legally operate their vehicles without the need for individual insurance policies.

Related Forms: There may not be direct alternatives or analogues to Form MV-219, as it is specifically designed for renewing a Certificate of Self Insurance in Pennsylvania. However, there may be other forms related to insurance or vehicle registration that could be applicable in different circumstances.