Regulation of motor clubs in Wisconsin is subject to the jurisdiction of this office. The following are documents which must be completed and returned with the application for license:

1. Application for motor club services.
2. Declaration of liability as surety.
3. Form of surety bond.

Also, one copy of each of the following should be filed with the application for a license:

4. Copy of charter or articles of incorporation (certified by corporation secretary).
5. Copy of the bylaws (certified by the corporation secretary).
6. Certificate of compliance.
7. Certificate of deposit from home state, if deposit is maintained.
8. Copy of the most current financial statement.
9. Copy of an independent audit report, if any.
10. Advertising literature to be used.
11. Biographical sketches - Form A (copy attached).
12. Application fee of $400 payable to Commissioner of Insurance.

With reference to Item 2 above, the enclosed form is the one prescribed by the Office of the Commissioner of Insurance. This form may be executed and filed with the Commissioner in lieu of the required $25,000 deposit in cash or securities as otherwise required under s. 616.72, Wis. Stat.

In addition, we are enclosing instructions regarding our forms submission procedures. Forms must be approved prior to being used in Wisconsin. Forms include the following:

1. Service contracts or membership handbooks.
2. Membership application.
3. Other forms which may be issued to members.

If you should have any questions concerning the Application, please contact Yvonne Sherry at (608) 266-0091. If you should have any questions concerning the forms submission procedures, please contact Rhonda Peterson at (608) 267-7186.

Initial/Renewal Forms

The inital/renewal forms are available to be downloaded below. Note, however, that you will need an Adobe Acrobat Reader to view or print the application forms, which you can download at no cost from Adobe .

Initial Application Packet Forms
Annual Renewal Forms

Motor Club--Policy Forms Submission Procedures

Note: The following address is a link to the administrative code in pdf format: http://www.legis.state.wi.us/rsb/code/ins/ To link to chapters in the administrative code, add insxxx.pdf to the end of the address. xxx represents the chapter number in three digits (003 for chapter 3).

Section Ins 6.05, Wis. Adm. Code, sets forth the requirements for submitting forms for our Office’s approval. To take full advantage of our automated policy form review and tracking system, we need submissions that follow a standard procedure. Therefore, we must strictly enforce the rule. Submissions will be disapproved if they do not contain the items required in (4) of the rule. These include: Insurance Policy Form Transmittal (OCI 26-015) in duplicate (see link below), Certificate of Compliance (see Appendix A of s. Ins 6.05, Wis. Adm. Code), Certificate of Readability (if required), cover letter in duplicate, one copy of each form, and a stamped self-addressed return envelope.

A properly completed Insurance Policy Form Transmittal (OCI 26-015) is required by s. Ins 6.05 (4) (a) 1, Wis. Adm. Code. This form is to be submitted in duplicate FOR EACH COMPANY filing.

The instructions and forms for filing contracts for approval are available to be downloaded below, under the first two items under the heading "Policy Form Filing Instructions and Forms." Note, however, that you may need an Adobe Acrobat Reader to view or print the forms, which you can download at no cost from Adobe (http://www.adobe.com/products/acrobat/readstep.html).

Policy Form Filing Instructions and Forms
(http://oci.wi.gov/ociforms.htm#companypol)

Wisconsin Insurance Laws and Regulations (http://oci.wi.gov/wisrules.htm)

Please direct questions to: financial@oci.state.wi.us (please include your name, phone number, and e-mail address).