PURPOSE: This rule expresses the standard that the direct cost of insurance to the consumer should be stated only as premium. This rule was adopted pursuant to the provisions of section 374.045, RSMo and implements sections 375.031, 375.041, 375.116, 379.318, 379.356 and 379.470, RSMo. (1) Policy fees, finders’ fees, inspection fees, service charges, fees for regulatory filings, including SR-22 (see 20 CSR 500-2.300) filings, and other charges not expressly permitted by law where made by an insurer or insurance agent in connection with the issuance or renewal of a property and casualty, automobile, fire or any form of excess insurance are prohibited. This does not include mutual company membership fees, written contracts between insureds and their brokers or other specifically permitted charges. (2) Whenever an extra charge or assessment is made pursuant to an installment payment plan, that charge or assessment shall be deemed a part of the premium and shall be labelled as a premium installment charge. That charge shall be a oart of the insurer’s premium tixation imposld pursuant to section 148.320, RSMo. Auth: sections 374.045, 375.031, 375.126, 379.318, 379.356 and 379.470, RSMo (1986) and 375.041, RSMo (Cum. Supp. 1992).* This rule was previously filed as 4 CSR 190-16.130. Original rule filed Aug. 12, 1974, effective Aug. 22, 1974. Amended: Filed July 10, 1990, effective March 14,1991. *Original authority: 374.045, RSMo (19671; 375.031, RSMo (19791, amended 1985, 1986; 375.041, RSMo (19851, amended 1992; 375.116, RSMo (1961), amended 1967; 379.318 and 379.356, RSMo (1972); and 379.470, RSMo (1947).

Judith K. Moriarty (8/20/91)* CODEOFSTATEREGULATIONS

m 20 CSR SOO-4-INSURANCE

.sfock NO. 10496 RW 10190

SR-22

Insured Address I Name casx Nvmkr 1 1 I Current Policy No. This certification terminated in accordance with The insurance hereby certified 0 OWNER’S POLICY: Applicable ment(s) thereof by similar classification, classification for a period of at least 30 days from the date of acquisition. Model Yew

0 OPERATOR’S

(Stae)

The company signatory motor vehicle liability policy is in effect on the effective date of this certificate. Name of Insurance Company Date 1x3 3641B

SR-26

Name

Insured I Address , cr NunbE I Current Policy No. Effective dale of cancellation or termination

(State)

The company signatory hereto hereby gives notice that its Certificate or Notice as indicated above, heretofore tiled on behalf of the named insured, is cancelled or terminated as of the effective date stated above. ‘62194 HA. TELrrESERG ANO ASSca.4TES AAMVA UNIFORM FINANCIAL RESPONSIBILITY FORM ORIGINAL

L.22 Fl”, M.Mk

Birth *ate I sockil security Number

Ddwr’r Liwme Number I I Eff. From and continues until cancelled or

is effective from the financial responsibility laws and regulations of this State. is provided by an: to (a) the following described vehicle(s), (b) any replaceand (c) any additionally acquired vehicles of similar

lhde Nnme IdentiAcntia” Number

POLICY: Applicable to any non-owned vehicle. FINANCIAL RESPONSIBILITY INSURANCE CERTIFICATE hereto hereby certifies that it has issued to the above named insured a policy as required by the financial responsibility laws of this State, which

AAMVA UNIFORM FINANCIAL RESPONSIBILITY FORM

Eff. From To at 12:Ol A.M.:

(ChOEk whichcvu L a@iik)

q Financial Responsibility Insurance Certificate-SR-22 0 Financial Responsibility Notice for Fleets-SR-23

FINANCIAL RRSPONSIBILITY NOTICE OF CANCELLATION OR TERMINATION