The following information is required 
to obtain board approval

1. A completed acord workers compensation application.
   

2. A completed Auto Dealers Compensation Of California, Inc. (AD COMP) New member application supplement.
   

3. four year's prior loss experience Valued within 90 days of proposed membership effective date.
   

4. employee concentration form.
   

5. financial statements - dealer operating statements, including balance sheet and income statement, from 2001 through 2004and 2005 year-to-date
   

6. experience modification worksheet for period last published by the wcirb OR COPY OF COMPLINE EXPERIENCE MOD HISTORY.
   

the following information is required for request for certificate of consent to self insure

(State Approval)

1. reviewed or audited financial statement from a cpa for the most current fiscal period WITHIN 90 DAYS OF MEMBERSHIP ENROLLMENT.
   

2. completed joinder and indemnification agreement.