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 Important Information For Insurance Providers (Moving Companies)


This information is provided to assist insurance companies, surplus lines brokers, and agents and brokers who are authorized to sign certificates on behalf of an insurance company to make insurance filings with the License Section.


Filings should be mailed to:
California Public Utilities Commission
Attn: License Section – 2nd Floor
505 Van Ness Ave.
San Francisco, CA 94102-3298

Only original documents are accepted for filing. Fax copies will not be accepted.
Any certificate, notice of cancellation, or notice of reinstatement filed with the Commission must show the name of the insured exactly as it appears on the insured's permit, certificate or registration (or application in the case of new applicants). Check with the insured to determine how the name should appear. It is helpful if you include the moving company's Commission-assigned file number on all forms and correspondence.

If a certificate is received that does not match with a moving company name in the License Section database, the certificate will be held for a minimum of 90 days awaiting possible receipt of a new application.

Forms are to be filed either in duplicate or triplicate, as indicated on the form. If you would like to receive a date-stamped copy of the form, enclose a stamped, self-addressed envelope with your filing.

Certificates are good until canceled. To cancel a certificate, you must give the Commission 30 days' notice on an authorized form, the 30 days to commence to run from the date notice is actually received in the Commission's San Francisco office.

Obtaining Forms

For security reasons, we do not make insurance forms available for downloading. You may write to the License Section on your letterhead to request a sample form. Please note that forms are color-coded and must be reproduced or printed in the correct color to facilitate processing. Some forms are available commercially in large quantity from Uniform Information Services, Inc., 1-800-382-2424.

Subhaul Bonds

Subhaul bond forms (TL 679) may be obtained by contacting the License Section's Insurance Unit at (415) 703-1244 or There is no prescribed cancellation form for a subhaul bond. Bonds may be cancelled by letter addressed to the License Section giving 30 days' notice, commencing from the time the letter is actually received.

Workers' Compensation Coverage

Workers' compensation filings for passenger stage corporations, charter-party carriers, and household goods carriers are made using certificate of insurance Form TL 938 (cancellation notice = Form TL 944; reinstatement notice = Form TL 945).

Insurance Forms for Interstate Registration

Household goods conducting interstate operations must register their interstate (federal) operating authority with the Commission through the Single State Registration System (SSRS). To complete SSRS registration the motor carrier must file a copy of the proof of insurance that was filed with the Federal Motor Carrier Safety Administration to obtain and maintain federal operating authority.

Table of Forms

The table below shows the forms used to make liability insurance filings and cargo insurance filings. If the table shows a standard form of endorsement associated with the certificate of insurance, you are responsible for attaching a completed endorsement to the insured's policy. It should not be filed with the Commission.

CARRIER TYPE          

INSURANCE FORMS                   


Household Goods Carrier (Liability)

TL - 676 Certificate
TL - 394 Reinstatement
TL - 568 Cancellation

TL 675-A

Household Goods Carrier (Cargo)

TL - 672 Certificate
TL - 674 Reinstatement
TL - 673 Cancellation

TL 671



Last Modified: 2/26/2009

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