| Form Number |
State |
Name/Description |
| 62 |
WA |
Washington Auto Supplement Mandatory
Offer of PIP Coverage |
| 137 |
WA |
Washington Commercial Auto |
| 138 |
WA |
Washington Garage and Dealers |
| 90 |
WA |
Washington Personal Auto Application |
| 82 |
|
Watercraft Application |
| 60 |
WV |
West Virginia Auto Supplement UM/UIM
Vehicle Coverages |
| 50 |
WV |
West Virginia Certificate of Insurance |
| 137 |
WV |
West Virginia Commercial Auto |
| 138 |
WV |
West Virginia Garage and Dealers |
| 90 |
WV |
West Virginia Personal Auto Application |
| 62 |
WV |
West Virginia Uninsured/Underinsured
Motorist Coverage Offer of Single Limit Liability |
| 61 |
WV |
West Virginia/Underinsured Motorist
Coverage - Offer of Split Limits Liability |
| 64 |
WV |
West Virginia Essential Property Insurance
Association - Basic Property Insurance Application |
| 61 |
WI |
Wisconsin Auto Supplement Underinsured
Motorists Coverage Selection Form |
| 178 |
WI |
Wisconsin Automobile Insurance Plan |
| 177 |
WI |
Wisconsin Automobile Insurance Plan |
| 97 |
WI |
Wisconsin Automobile Plan |
| 137 |
WI |
Wisconsin Commercial Auto |
| 138 |
WI |
Wisconsin Garage and Dealers |
| 90 |
WI |
Wisconsin Personal Auto Application |
| 135 |
WI |
Wisconsin Supplementary Election of
Coverage Form |
| 136 |
WI |
Wisconsin Supplementary Limited Other
States Coverage Request |
| 134 |
WI |
Wisconsin Supplementary Non-Election
Form |
| 133 |
WI |
Wisconsin Workers Compensation Insurance
Pool |
| 13 |
|
Witness Card |
| 4 |
|
Workers Comp First Report of Injury
or Illness |
| 130 |
|
Workers Compensation Application |
| 133 |
|
Workers Compensation Insurance Plan
Assigned Risk Section |
| 171 |
CT |
Workers' Compensation Commission of
Connecticut |
| 172 |
CT |
Workers' Compensation Commission of
Connecticut |
| 173 |
CT |
Workers' Compensation Commission of
Connecticut |
| 137 |
WY |
Wyoming Commercial Auto |
| 138 |
WY |
Wyoming Garage and Dealers |
| 90 |
WY |
Wyoming Personal Auto Application |
