Standard Insurance Application

Make sure you have reviewed and understand the insurance information including rates, term and amounts available.  

 Download and print the application form. 

Complete all required information.  

Sign and mail your completed application to:

CAPS Insurance Administrator PSIA/GEIBT
1 Sutter Street, Suite 800
San Francisco, CA  94104-4917
(415) 956-1344
(415) 861-5360 FAX