Form CFS731 "Certification of Driver's License and Automotive Coverage" - Illinois

What Is Form CFS731?

This is a legal form that was released by the Illinois Department of Children and Family Services - a government authority operating within Illinois. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2013;
  • The latest edition provided by the Illinois Department of Children and Family Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CFS731 by clicking the link below or browse more documents and templates provided by the Illinois Department of Children and Family Services.

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Download Form CFS731 "Certification of Driver's License and Automotive Coverage" - Illinois

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CFS 731
State of Illinois
Rev 6/2013
Department of Children and Family Services
Administrative Procedures 12 – Travel Guide – Schedule B
CERTIFICATION OF DRIVER’S LICENSE AND
AUTOMOTIVE LIABILITY COVERAGE for FY
I,
, as an employee of the Department
of Children and Family Services or of any person or entity performing duties on behalf of the
Department, do hereby certify that I have been duly licensed to drive an automobile by the
Illinois Secretary of State or by the State of
, and that I have in
effect and will maintain automobile liability coverage on my personal vehicle in the form of
insurance, or a bond filed with the Illinois Secretary of State or any bond acceptable to the
Illinois Secretary of State as proof of financial responsibility, in an amount equal to, or in excess
of the following:
• Not less than $20,000 because of bodily injury to or death of any person in any one motor
vehicle accident.
• Not less than $40,000 because of bodily injury to or death of two or more persons in any
one motor vehicle accident.
• Not less than $15,000 because of injury to or destruction of property of others in any one
motor vehicle accident.
I further agree to notify my supervisor in the event my Driver’s License is revoked, suspended,
or if I fail to have in effect, automobile liability coverage as stated above.
Signature
Date
----------------------------------------------------------------------------------------------
I,
, am unwilling or unable to certify
that I am a duly licensed driver or that I have automobile liability coverage in an amount equal to
or in excess of the amounts listed above. I acknowledge that I am not authorized to drive any
vehicle on official State business, nor receive any reimbursement for such use. I agree to notify
my supervisor that I have not certified I am a duly licensed driver or have in effect the minimum
amounts of automobile liability coverage as listed above.
Signature
Date
CFS 731
State of Illinois
Rev 6/2013
Department of Children and Family Services
Administrative Procedures 12 – Travel Guide – Schedule B
CERTIFICATION OF DRIVER’S LICENSE AND
AUTOMOTIVE LIABILITY COVERAGE for FY
I,
, as an employee of the Department
of Children and Family Services or of any person or entity performing duties on behalf of the
Department, do hereby certify that I have been duly licensed to drive an automobile by the
Illinois Secretary of State or by the State of
, and that I have in
effect and will maintain automobile liability coverage on my personal vehicle in the form of
insurance, or a bond filed with the Illinois Secretary of State or any bond acceptable to the
Illinois Secretary of State as proof of financial responsibility, in an amount equal to, or in excess
of the following:
• Not less than $20,000 because of bodily injury to or death of any person in any one motor
vehicle accident.
• Not less than $40,000 because of bodily injury to or death of two or more persons in any
one motor vehicle accident.
• Not less than $15,000 because of injury to or destruction of property of others in any one
motor vehicle accident.
I further agree to notify my supervisor in the event my Driver’s License is revoked, suspended,
or if I fail to have in effect, automobile liability coverage as stated above.
Signature
Date
----------------------------------------------------------------------------------------------
I,
, am unwilling or unable to certify
that I am a duly licensed driver or that I have automobile liability coverage in an amount equal to
or in excess of the amounts listed above. I acknowledge that I am not authorized to drive any
vehicle on official State business, nor receive any reimbursement for such use. I agree to notify
my supervisor that I have not certified I am a duly licensed driver or have in effect the minimum
amounts of automobile liability coverage as listed above.
Signature
Date
CFS 731
State of Illinois
Rev 6/2013
Department of Children and Family Services
Administrative Procedures 12 – Travel Guide – Schedule B
INSTRUCTIONS FOR CERTIFICATION OF DRIVER’S LICENSE AND
AUTOMOTIVE COVERAGE
All employees who travel for the Department and incur mileage charges must complete the
Certification of Auto Liability Coverage on the reverse side. The Travel Regulation Council
Rule Section 3000.300(f)(1), “Employees using private vehicles while on State business must
have insurance coverage in an amount not less than required by Section 10-10(b) of The Vehicle
Code.”
The business office to which you submit your travel vouchers shall maintain the attached
Certification of Driver’s License and Automotive Coverage form. If there are any changes
during the fiscal year you must submit a revised form. If you do not have a current
Certification of License and Automotive Coverage on file your travel vouchers will not be
processed. Please complete the form and return to addresses below before June 15, each
fiscal year.
MAILING ADDRESSES OF REGIONAL OFFICES
Cook Region
1911 S. Indiana
Chicago, 60616
Northern Region
8 E. Galena Blvd.
Aurora, 60506
Central Region
5415 N. University Ave.
Peoria, 61614
Southern Region
10 Collinsville Ave
E. St. Louis, 62201
Training
406 E. Monroe (Station # 122)
Springfield, 62701
OITS
406 E. Monroe (Station #457)
Springfield, 62701
Central Office
406 E. Monroe (Station #457)
Springfield, 62701
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