Chp 279 Form – Fill Out and Use

STATE OF CALIFORNIA

DEPARTMENT OF CALIFORNIA HIGHW AY PATROL

REQUEST FOR OWNER'S RESPONSIBILITY

CHP 279 (Rev. 9-07) OPI 062

Completion and presentation of this form is an indication that you desire the company to be charged under "owner's responsibility" for certain violations of the California Vehicle Code.

The California Highway Patrol does not maintain a centralized owner's responsibility database. Therefore, it will be necessary to complete the CHP 279 form in its entirety and place several copies of the completed form in each of your vehicles that you desire to be considered under owner's responsibility. Upon contact by CHP enforcement personnel, your drivers should be instructed to present the form to the officer. If a citation is to be issued, the officer may retain a copy of the CHP 279 form and attach it to the citation for court purposes.

The CHP 279 should be renewed annually at the beginning of the calendar year, or immediately, if the responsible person has terminated employment or moved to another position.

WEIGHT		LOADING
YES	NO	YES	NO
MECHANICAL		REGISTRATION
YES	NO	YES	NO

OTHER SPECIAL CONDITION

COMPANY NAME

COMPANY MAILING ADDRESS (INCLUDE CITY, STATE AND ZIP CODE)

PERSON RESPONSIBLE	BUS. PHONE (INCLUDE AREA CODE)
TITLE JOB POSITION
SIGNATURE OF PERSON RESPONSIBLE		DATE

STATE OF CALIFORNIA

DEPARTMENT OF CALIFORNIA HIGHW AY PATROL

REQUEST FOR OWNER'S RESPONSIBILITY

CHP 279 (Rev. 9-07) OPI 062

Completion and presentation of this form is an indication that you desire the company to be charged under "owner's responsibility" for certain violations of the California Vehicle Code.

The California Highway Patrol does not maintain a centralized owner's responsibility database. Therefore, it will be necessary to complete the CHP 279 form in its entirety and place several copies of the completed form in each of your vehicles that you desire to be considered under owner's responsibility. Upon contact by CHP enforcement personnel, your drivers should be instructed to present the form to the officer. If a citation is to be issued, the officer may retain a copy of the CHP 279 form and attach it to the citation for court purposes.

The CHP 279 should be renewed annually at the beginning of the calendar year, or immediately, if the responsible person has terminated employment or moved to another position.

WEIGHT		LOADING
YES	NO	YES	NO
MECHANICAL		REGISTRATION
YES	NO	YES	NO

OTHER SPECIAL CONDITION

COMPANY NAME

COMPANY MAILING ADDRESS (INCLUDE CITY, STATE AND ZIP CODE)

PERSON RESPONSIBLE	BUS. PHONE (INCLUDE AREA CODE)
TITLE JOB POSITION
SIGNATURE OF PERSON RESPONSIBLE		DATE