Statutory reference: Section 303.220, RSMo.
A company with at least 26 private passenger motor vehicles registered in Missouri may apply for a certificate of self-insurance by submitting the following:
- A written request to be considered for self-insurance on company letterhead, signed by an officer of the company;
- Financial statements for the preceding three years, including balance sheets and income statements audited by an independent certified public accountant, indicating the company is solvent;
- A list of at least 26 private passenger motor vehicles registered in Missouri in the name of the company, with a description of each vehicle (year, make, VIN, and plate number); and
- A completed Agreement to Pay Judgments (Form 5317).
The above items must be submitted to:Missouri Department of Revenue
PO Box 200
Jefferson City MO 65105-0200
Within two weeks of receiving your request, our staff will issue your certificate of self-insurance and identification cards, or issue a letter denying your request.