INSTRUCTIONS
To request an endorsement, you must use the Cal-Regent Endorsement Request Form
below. To properly fill out the form, please follow these instructions:
- To add a location: Fill out the top portion of the Endorsement Request Form and
check the box under question 1 that asks if you want to add "ADDITIONAL LOCATION".
Then you must attach a completed Additional Dealer/Service Location Form to the
Endorsement Request Form before you send it to us. We need the application in order
for us to properly underwrite the new location.
- To delete a location: Fill out the top portion of the Endorsement Request Form under
Question 2 that asks if you want to "DELETE LOCATION NO. ___" by telling which location
number is being deleted and, to make sure there is no miscommunication, please provide
the address of the deleted location.
- Effective date of change: You must fill in the date you want the changeon the policy
to be effective!! If you do not fill in a date, the change will be effective upon
receipt of any additional premium or, if no additional premium is due, it will be
effective on the date we received your request.
- To add, change or delete specific coverage: Check the appropriate box indicating if you
want to delete, change or add a specific coverage. Use one page of the endorsement request for each
separate location so that we know the specific coverage change for each location,
if applicable.
- If you have any special instructions or information: Write in your special instructions
on the space provided at the bottom of the form.