S.C. Code Ann. Regs. 38-447 – Appendix of Forms.

FORM A-1 UNIFORM APPLICATION FOR REGISTRATION OF INTERSTATE MOTOR CARRIER OPERATIONS EXEMPT FROM FHWA REGULATION


( ) Sec. 202(c)(1) (Terminal Area Exemption)	( ) Sec. 203(b)(5) (Farm Cooperative Exemption)
( ) Sec. 202(c)(2) (Terminal Area Exemption)	( ) Sec. 203(b)(6) (Commodities Exemption)
( ) Sec. 203(a)(11) (Foreign Commerce Exemption)	( ) Sec. 203(b)(7) (Newspaper Exemption)
( ) Sec. 203(b)(1) (School Bus Exemption)	( ) Sec. 203(b)(8) (Municipal Exemption)
( ) Sec. 203(b)(2) (Taxicab Exemption)	( ) Sec.203(b)(9) (Occasional Exemption)
( ) Sec. 203(b)(3) (Hotel Exemption)	( ) Sec. 203(b)(10) (Emergency Tow Exemption)

Type of carrier:
( ) Property ( ) Passenger ( ) Common ( ) Contract

Give Principal Office Address, if different than above:
Street: ____________________ City: ____________________ State:
If individual, give name and address:

If Corporation, give State in which incorporated:
Name of President: ____________________ name of Secretary
If Partnership, give names and addresses of partners:


PROCESS AGENT FOR STATE: (MUST BE A SOUTH CAROLINA RESIDENT)
Name ____________________ Street
City ______________________ State
I, the undersigned, under penalty for false statement, do hereby certify that the above information is true and correct and that I am authorized to execute and file this document on behalf of the above applicant.
(State penalties as prescribed by Law).
Signature ____________________ Title
INSTRUCTIONS: FILE THIS APPLICATION IN DUPLICATE. WHEN APPLICATION IS APPROVED, THE COPY WILL BE RETURNED TO THE APPLICANT.

FORM B-1 UNIFORM APPLICATION FOR REGISTRATION AND IDENTIFICATION OF VEHICLES OR DRIVEAWAY OPERATIONS EXEMPT FROM FHWA REGULATION


( ) Sec. 202(c) (1) (Terminal Area Exemption)
( ) Sec. 202(c) (2) (Terminal Area Exemption)
( ) Sec. 203(a) (11) (Foreign Commerce Exemption)
( ) Sec. 203(b) (1) (School Bus Exemption)
( ) Sec. 203(b) (2) (Taxicab Exemption)
( ) Sec. 203(b) (3) (Hotel Exemption)
( ) Sec. 203(b) (4) (National Park Exemption)
( ) Sec. 203(b) (4a) (Farm Exemption)
( ) Sec. 203(b) (5) (Farm Cooperative Exemption)
( ) Sec. 203(b) (6) (Commodities Exemption)
( ) Sec. 203(b) (7) (Newspaper Exemption)
( ) Sec. 203(b) (7a) (Air Transport Exemption)
( ) Sec. 203(b) (8) (Municipal Exemption)
( ) Sec. 203(b) (9) (Occasional Exemption)
( ) Sec. 203(b) (10) (Emergency Tow Exemption)
( ) _____________________________________________ (Specify Other Exemption)

The applicant shall not knowingly permit any other person or organization to use the identification stamp(s) or number issued or assigned pursuant to this application.

I, the undersigned, under penalty for false statement, do hereby certify that the above information is true and correct and that I am authorized to execute and file this document on behalf of the above applicant.
(State penalties as prescribed by Law).


	(Signature)


	(Title)

FORM D-1 UNIFORM IDENTIFICATION CAB CARD FOR VEHICLE OR DRIVEAWAY OPERATION EXEMPT FROM FHWA REGULATION OPERATING MOTOR CARRIER


Alabama	Alaska	Arkansas	Arizona	California	Colorado

Connecticut	Delaware	District of Columbia	Florida	Georgia	Hawaii

Idaho	Illinois	Indiana	Iowa	Kansas	Kentucky

Louisiana	Maine	Maryland	Massachu- setts	Michigan	Minnesota

Mississippi	Missouri	Montana	Nebraska	Nevada	New Hampshire

New Jersey	New Mexico	New York	North Carolina	North Dakota	Ohio

Oklahoma	Oregon	Pennsylvania	Rhode Island	South Carolina	South Dakota

Tennessee	Texas	Utah	Vermont	Virginia	Washington

West Virginia	Wisconsin	Wyoming

FORM E UNIFORM MOTOR CARRIER BODILY INJURY AND PROPERTY DAMAGE LIABILITY CERTIFICATE OF INSURANCE (Executed in triplicate)


(City)	(State)	(Zip Code)
this _______________ day of ___________________________________, 19___
(Authorized Company Representative)
Insurance Company File No. ____________
(Policy No.) _______________

This form determined by the National Association of Regulatory Utility Commissioners and promulgated by the Federal Highway Administration pursuant to the provisions of Section 202(b)(2) of the Interstate Commerce Act. (49 U.S.C., Sec. 302(b)(2)).

FORM F UNIFORM MOTOR CARRIER BODILY INJURY AND PROPERTY DAMAGE LIABILITY INSURANCE ENDORSEMENT


It is agreed that:
1. The certification of the policy, as proof of financial responsibility under the provisions of any State motor carrier law or regulations promulgated by any State Commission having jurisdiction with respect thereto, amends the policy to provide insurance for automobile bodily injury and property damage liability in accordance with the provisions of such law or regulations to the extent of the coverage and limits of liability required thereby; provided only that the insured agrees to reimburse the company for any payment made by the company which it would not have been obligated to make under the terms of this policy except by reason of the obligation assumed in making such certification.

2. The uniform motor carrier bodily injury and property damage liability certificate of insurance has been filed with the State Commissions indicated on the reverse side hereof.

3. This endorsement may not be cancelled without cancellation of the policy to which it is attached. Such cancellation may be effected by the company or the insured giving thirty (30) days' notice in writing to the State Commission with which such certificate has been filed, such thirty (30) days' notice to commence to run from the date the notice is actually received in the office of such department.

Attached to and forming part of Policy No. ________ issued by , herein called Company, of ____________________ to ____________ of ____________
Dated at ________________ this ____________ day of ____________________, 19___.
Countersigned by
Authorized Company Representative

This form determined by the National Association of Regulatory Utility Commissioners and promulgated by the Federal Highway Administration pursuant to the provisions of Section 202(b)(2) of the Interstate Commerce Act. (49 U.S.C., Sec. 302(b)(2)).

Indicates Departments with whom uniform motor carrier bodily injury and property damage liability certificate of insurance has been filed

Alabama	Illinois	Montana	Rhode Island
Alaska	Indiana	Nebraska	South Carolina
Arizona	Iowa	Nevada	South Dakota
Arkansas	Kansas	New Hampshire	Tennessee
California	Kentucky	New Jersey	Texas
Colorado	Louisiana	New Mexico	Utah
Connecticut	Maine	New York	Vermont
Delaware	Maryland	North Carolina	Virginia
District of Columbia	Massachusetts	North Dakota	Washington
Florida	Michigan	Ohio	West Virginia
Georgia	Minnesota	Oklahoma	Wisconsin
Hawaii	Mississippi	Oregon	Wyoming
Idaho	Missouri	Pennsylvania

FORM G UNIFORM MOTOR CARRIER BODILY INJURY AND PROPERTY DAMAGE LIABILITY SURETY BOND (Executed in triplicate)


Know all men by these presents, that we, (Name of Motor Carrier Principal) ____________ of ____________ (City) ____________, (State) as principal (hereinafter called principal), and ____________, (Name of Surety) a corporation created and existing under the laws of the State of ____________, with principal office at ____________ (City) ____________, (State) as Surety (hereinafter called surety), are held and firmly bound unto the State of ____________ in the sum or sums hereinafter provided for which payment, well and truly to be made, the principal and surety hereby bind themselves, their successors and assigns, firmly by these presents.

The condition of this obligation is such that:

Whereas, the principal is or intends to become a motor carrier subject to the laws of such State and the rules and regulations of __________ (Name of Department) (hereinafter called Department), relating to insurance or other security for the protection of the public, and has elected to file with the Department a surety bond conditioned as hereinafter set forth; and

Whereas, this bond is written to assure compliance by the principal a motor carrier of passengers or property with the laws of such State and the rules and regulations of the Department relating to insurance or other security for the protection of the public, and shall inure to the benefit of any person or persons who shall recover a final judgment or judgments against the principal for any of the damages herein described.

Now, therefore, if every final judgment recovered against the principal for bodily injury to or the death of any person or loss of or damage to the property of others, sustained while this bond is in effect, and resulting from the negligent operation, maintenance or use of motor vehicles in transportation (but excluding injury to or death of the principal's employees while engaged in the course of their employment, and loss of or damage to property of the principal and property transported by the principal designated as cargo), shall be paid, then this obligation shall be void, otherwise to remain in full force and effect.

Within the limits hereinafter provided, the liability of the surety extends to such losses, damages, injuries, or deaths regardless of whether such motor vehicles are specifically described herein and whether occurring on the route or in the territory authorized to be served by the Principal or elsewhere.

This bond is effective from _______________(12:01 a.m., standard time , at the address of the principal as stated herein) and shall continue in force until terminated as hereinafter provided. The principal or the surety may at any time terminate this bond by written notice to the Department, such termination to become effective not less than thirty (30) days after actual receipt of said notice by the Department. The surety shall not be liable hereunder for the payment of any judgment or judgments against the principal for bodily injury to or the death of any person or persons or loss of or damage to property resulting from accidents which occur after the termination of this bond as herein provided, but such termination shall not affect the liability of the surety hereunder for the payment of any such judgment or judgments resulting from accidents which occur during the time the bond is in effect.

The liability of the surety on each motor vehicle shall be the limits prescribed in the laws of such State and the rules and regulations of the Department governing the filing of surety bonds, which were in effect at the time this bond was executed, and will be a continuing one notwithstanding any recovery hereunder. In witness whereof, the said principal and surety have executed this instrument on the ____________ day of _______________, 19___.


	(Principal)
	By
	(AFFIX CORPORATE SEAL)

	(Surety)
	,
	(City)	(State)
	By
	Countersigned at ______ this ____ day of ________, 19___.
	Bond No.
	(Registered Resident Agent)

This form determined by the National Association of Regulatory Utility commissioners and promulgated by the Federal Highway Administration pursuant to the provisions of Section 202(b)(2) of the Interstate Commerce Act. (49 U.S.C., Sec. 302(b)(2)).

FORM H UNIFORM MOTOR CARRIER CARGO CERTIFICATE OF INSURANCE (Executed in triplicate)


Insurance Company File No.
	(Policy Number)

This form determined by the National Association of Regulatory Utility Commissioners and promulgated by the Federal Highway Administration pursuant to the provisions of Section 202(b)(2) of the Interstate Commerce Act (49 U.S.C. Sec. 302(b)(2)).

FORM I UNIFORM MOTOR CARRIER CARGO INSURANCE ENDORSEMENT


X-Indicates Departments With Whom Uniform Motor Carrier Cargo Certificate of Insurance Has Been Filed

Alabama	Illinois	Montana	Rhode Island
Alaska	Indiana	Nebraska	South Carolina
Arizona	Iowa	Nevada	South Dakota
Arkansas	Kansas	New Hampshire	Tennessee
California	Kentucky	New Jersey	Texas
Colorado	Louisiana	New Mexico	Utah
Connecticut	Maine	New York	Vermont
Delaware	Maryland	North Carolina	Virginia
District of Columbia	Massachusetts	North Dakota	Washington
Florida	Michigan	Ohio	West Virginia
Georgia	Minnesota	Oklahoma	Wisconsin
Hawaii	Mississippi	Oregon	Wyoming
Idaho	Missouri	Pennsylvania

FORM J UNIFORM MOTOR CARRIER CARGO SURETY BOND (Executed in Triplicate)



	(Principal)
	BY
(Affix Corporate Seal)
	(Surety)
	,
	(City)	(State)
	By
Countersigned at ____________________ this __________ day of __________ 19___
Bond No.
(Registered Resident Agent)

This form determined by the National Association of Regulatory Utility Commissioners, and promulgated by the Federal Highway Administration pursuant to the provisions of Section 202(b)(2) of the interstate Commerce Act (49 U.S.C., Sec. 302(b)(2)).

FORM K UNIFORM NOTICE OF CANCELLATION OF MOTOR CARRIER INSURANCE POLICIES (Executed in triplicate)


Insurance Company File No.
	(Policy No.)

This form determined by the National Association of Regulatory Utility Commissioners and promulgated by the Federal Highway Administration pursuant to the provisions of Section 202(b)(2) of the Interstate Commerce Act (49 U.S.C., Sec. 302(b)(2)).

FORM L UNIFORM NOTICE OF CANCELLATION OF MOTOR CARRIER SURETY BONDS (Executed in Triplicate)


Insurance Company File No.
	(Policy No.)

This form determined by the National Association of Regulatory Utility Commissioners and promulgated by the Federal Highway Administration pursuant to the provisions of Section 202(b)(2) of the Interstate Commerce Act. (49 U.S.C., Sec. 302(b)(2)).

HISTORY: Added by State Register Volume 22, Issue No. 3, eff March 27, 1998.