Surety Bond Application "*" indicates required fields Step 1 of 4 - Choose the Bond Type 25% California Bond Type Radio* Motor Vehicle Ownership Surety Bond - Motor Vehicle Defective Title Bond Registration Service Surety Bond (Vehicle Code Section 11401) State of California - Vehicle Verifier Surety Bond Information Purchaser Surety Bond should be called Commercial Requester Account Bond California $15,000 Notary Public Surety Bond Dealer Surety Bond - Used Vehicles Only Are you applying as an: Individual Business Entity (Including DBA) Type of organization* Sole Prop LLC Corporation Partnership How long have you been in business?* Name of Contact Person* Phone Number of Contact Person* Co-owners name or co-applicant name* Co-owners name or Co-applicant Phone No* Email Address - Contact Person* Co-owners name or co-applicants Social Security Number* % of Ownership* We will contact you via email. Would you also like to receive a:* Phone Call Text Message Both Name On Bond* Title Sole Owner Joint Owner Address on Bond*Address Line 1* Address Line 2 City* County* ZIP Code*Bond Amount*Bond effective date:* MM slash DD slash YYYY Bond Expiration date:* MM slash DD slash YYYY Pricing Options* Same Day - (San Diego Only $29) 2 Day ($22.00) Overnight ($49) Your FedEx, UPS account Shipping pricing are subject to changePDF Upload*Max. file size: 32 MB.Must upload DMV RDF Slip, Previous Reg Card, or Proof of VIN VIN Number* License Plate Number* Model Year* Make* Model* Shipping AddressAddress Line 1* Address Line 2 City* ZIP Code*Are You a U.S. Citizen?* Yes No Has any prior surety company ever paid a claim, cancelled, refused renewal, or denied an application for any person with 20% or more ownership in the business?* Yes No Please provide reasonHave you ever been declined for a bond?* Yes No Please provide details*Have you or any of your companies been the subject of any legal or administrative proceedings resulting in disciplinary action?* Yes No Please provide detailsHave you or your company ever had a pending lawsuit, unpaid judgement lien, or bankruptcy?* Yes No Please provide detailsAny additional notes you'd like us to know about your bond: Terms and ConditionsAny person who knowingly and with the intent to defraud any insurance company or person files and application containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime under applicable law. The applicants and indemnitors certify the truth of all statements in the application. By submitting the application, you authorize AssuredPartners of California, LLC (cadmvbonds). to provide information provided by you to the insurance companies represented by cadmvbonds, along with any additional insurance companies or insurance intermediaries necessary to complete your application for surety bond(s), and / or insurance. You also authorize cadmvbonds, the insurance companies represented by cadmvbonds, along with any additional insurance companies or insurance intermediaries necessary to complete your application for surety bond(s), and/or insurance to request from one or multiple credit bureaus reporting agencies, your credit bureau report including any ancillary credit scores or ratings and to check your credit and employment history.* I have read the above and agree to the terms.Dealer Surety Bond - Used Vehicles Only* Price: California Notary Public Surety Bond* Price: Information Purchaser Surety Bond* Price: Product Name* Price: Product Name* Price: Product Name Price: Product Name Price: $250.00 Total Payment Method*PayPal CheckoutCredit Card American ExpressDiscoverMasterCardVisaMaestroSupported Credit Cards: American Express, Discover, MasterCard, Visa, Maestro Card Number Expiration Date Security Code CVV Cardholder Name
