New York Codes, Rules and Regulations
Title 11 - INSURANCE
Chapter III - Policy and Certificate Provisions
Subchapter B - Property and Casualty Insurance
Part 67 - Mandatory Underwriting Inspection Requirements for Private Passenger Automobiles
Section 67.12 - Forms

Universal Citation: 11 NY Comp Codes Rules and Regs ยง 67.12
Current through Register Vol. 46, No. 12, March 20, 2024

The following forms are hereby approved for use as specified in this Part:

NYS APD forms A, B, C, and D in newly renumbered section 67.12 are hereby repealed and new NYS APD forms A, B, C, and D are hereby added as follows.

COMPANY LETTERHEAD OR INSPECTION SERVICE LETTERHEAD

INSURANCE INSPECTION REPORT (THIS IS NOT A SAFETY INSPECTION) Click to view imageClick to view image

CONFIRMATION OF PHYSICAL DAMAGE COVERAGE NOTICE OF MANDATORY PHOTO INSPECTION REQUIREMENT Click to view image

CONFIRMATION OF SUSPENSION OF PHYSICAL DAMAGE COVERAGE Click to view imageClick to view image

ACKNOWLEDGMENT OF REQUIREMENT FOR PHOTO INSPECTION Click to view image

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