(b) Form of notice. The notice of cancellation or termination of motor vehicle liability insurance coverage shall be provided by the insurer upon 24 pound paper stock. The form shall be a one-page, single-copy form, printed on both sides, head to head. Additional parts for use by the company may be attached. The finished size shall be 7 3/8 inches wide by 3 1/2 inches high. The window box for the address shall be 3 1/2 inches by 1 inch, located 1/4 inch from the left side of the form, 1 inch from the bottom of the form.
- (1) Side one of the form shall be completed by the insurer and filed with the Department. The name of the insurer, preceded by the NAIC Company Code Number, must be preprinted or typed in the area immediately below the title of the form. All information pertaining to the policy number, name and address of the policyholder, effective and termination dates, and vehicle description must be typed or computer produced. Handwritten forms or forms with an inaccurate vehicle description—vehicle identification number—will not be accepted. The name of the vehicle owner shall be provided by the insurer, in addition to that of the policyholder, if the insurer’s records indicate that the policyholder is not the owner of the vehicle.
- (2) After receipt of the form by the Department, the Department will forward the form to the policyholder who shall, within 10 days of the date printed on the notice, complete side two and return the form to the Bureau of Driver Licensing.