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Certificates of Non-Coverage

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Certificates of Non-Coverage

A few minor revisions have been made to the Application for Certificate of Non-Coverage. We now require an email address, phone number, and a brief description of the nature of the business or type of services provided. Please ensure you are submitting the revised form for application for Certificate of Non-Coverage.

Download the revised Application for Certificate of Non-Coverage (Form A) at the link on the sidebar. Complete the Application, have the Affidavit notarized, and decide on a payment option.

Applications can be mailed, along with the notarized affidavit and a check or money order for $50, to the address at the top of the form. To receive an expedited electronic copy of your Certificate, provide your email address and phone number on the Application OR We accept Online Payments for Certificates of Non-Coverage. Applications must be completed, and the affidavit notarized before starting the online payment process.

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