Name
Address
Telephone Number of Petitioner or Attorney
BEFORE THE INSURANCE COMMISSIONER OF THE STATE OF CALIFORNIA
In the Matter of | ) | No. | ||
) | ||||
Insurance Company, | ) | PETITION TO INTERVENE | ||
) | ||||
Applicant (or | ) | |||
Respondent). | ) | |||
) |
______________________________ hereby petitions the Insurance Commissioner to intervene in this proceeding and in support of its petition alleges:
I
Petitioner is ______________________________ (describe the status of petitioner.)
___________________________
II
The position and interest of petitioner in this proceeding is
___________________________
III
The grounds for petitioner's proposed intervention are
___________________________
IV
___________________________
Petitioner's position is in support of (or in opposition to) the action sought by
____________________
Insurance Company in this proceeding in that
Wherefore, petitioner requests that the Insurance Commissioner allow petitioner to intervene in this proceeding, having all rights and responsibilities accorded any other party to the proceeding.
DATED:
Respectfully Submitted,
____________________
Signature
Cal. Code Regs. Tit. 10, § 2623.1
Note: Authority cited: Sections 1861.10, 12921 and 12926, Insurance Code. Reference: Section 1861.10(a), Insurance Code; and CalFarm Insurance Company, et al. v. George Deukmejian, et al., 48 Cal.3d 805 (1989).