CIC 2134 Form PDF Details

The CIC-2134 form is a one-page document issued by Commerce Insurance. It allows students to apply for a Good Student Discount on their auto insurance policy. Qualifying students submit this form to lower their insurance premiums based on academic performance.

Eligibility Requirements

To qualify for the Good Student Discount, a student must meet one of the following criteria. Students who rank in the upper 20% of their graduating class are eligible. A grade point average of 3.0 or higher also qualifies. Students who maintain a "B" average with no grade below a "B" can apply as well. Being listed on the Dean's List or Honor Roll meets the requirement too.

Home-schooled students have their own path to qualify. They can submit standardized test scores or third-party certification documents as proof of academic achievement.

What Information Does the CIC-2134 Form Require

The form collects the student's full name and current class year. Class years range from freshman to senior. The school name and location must also be provided. A licensed school official must sign the Academic Certification section to confirm that the student meets the qualifying criteria. Home-schooled students must attach their supporting documents to the form instead of the school official's signature.

How the Good Student Discount Works

Commerce Insurance reviews the completed CIC-2134 form to verify the student's academic standing. Once approved, the discount applies directly to the auto insurance policy. Students generally need to submit updated records once a year to maintain the discount. The exact premium reduction depends on the student's qualifications and the insurer's rate schedule.

Related Auto Insurance Forms

Looking for other insurance discount forms? The State Farm Good Student Discount Form is a similar option for State Farm policyholders. You can also explore the Automobile Insurance Application to start a new policy. For other adjustments to your coverage, see the Allstate Insurance Appeal Form.

QuestionAnswer
Form NameCIC 2134 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesgood student discount form, cic-2134, commerce insurance student discount, good student form, allstate good student form, state farm insurance good student discount, state farm student discount

How to Edit Cic 2134 Form Online for Free

Editing the CIC-2134 form is quick and straightforward using FormsPal's online PDF editor. Follow the steps below to complete your Commerce Insurance Good Student Discount form in minutes.

Step-by-Step Guide to Fill Out the CIC-2134 Form

Step 1: Click the "Get Form Now" button at the top of the page. This opens the CIC-2134 form in the FormsPal online editor.

Step 2: Review the form layout before entering your information. The CIC-2134 form has two main parts: student information and academic certification.

Step 3: Fill in the student information section. Enter the student's full legal name, school name, and current class year.

filling out CIC 2134 good student discount form part 1

Completing Each Field on the CIC-2134 Form

The CIC-2134 form requires information in several key sections:

  • Student Name and Address: Print the student's full legal name and current mailing address.
  • School Information: Enter the school name, city, and the student's current year (freshman, sophomore, junior, or senior).
  • Academic Certification: Check the box that applies to the student. Options include upper 20% of class, "B" average or higher, GPA of 3.0 or more, or Dean's List status.
  • School Official Signature: A school administrator must sign and print their name, title, and the date.
  • Home-Schooled Students: Attach standardized test results or third-party academic certification as proof of academic merit.
Completing CIC 2134 good student discount form part 2

Step 4: Once all required fields are complete, click the Done button to save your form. You can download it as a PDF, email it, or print it from the editor.

Step 5: Submit the completed CIC-2134 form to Commerce Insurance. Include any supporting documents if you are a home-schooled student applying for the discount.

Common Questions About the CIC-2134 Form

Can I fill out the CIC-2134 form without a school official? No. A school administrator must sign the Academic Certification section. The form is not valid without this signature, except for home-schooled students who use alternative documentation.

How long does the Good Student Discount last? The discount typically applies for one policy year. You will need to submit a new CIC-2134 form with updated academic records at renewal time.

What happens after I submit the CIC-2134 form? Commerce Insurance reviews the form and verifies the student's academic credentials. Approved applicants receive a premium reduction on their auto insurance policy.

For other related forms, browse the State Farm Authorization to Pay or the Automobile Insurance Application for more insurance solutions.

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