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Application Form Download (PDF)

Please mail applications with original signatures and with copies of supporting documents. Fax copies are NOT acceptable. ALL application forms should be sent to the Northern California Clearinghouse Office.


Click on the following that applies to your situation:

New Applications   Renewals


If this is a new application to the Clearinghouse, you will use the Verification Application Form(VAP).

Click, open, and print all three documents pertaining to the VAP. The General Order is optional.

If you experience difficulties during the printing process, please right click on the files below and select "save target as" to download the files into your hard drive.

VAP Instructions Instructions on how to complete the VAP
VAP Application The application you fill out
VAP Information This document has general information on the VAP process and information needed to complete the VAP.
General Order 156


Answer the following question to see if you should use the Renewal Application and click, open, and print the file.

If you experience difficulties during the printing process, please right click on the file and select "save target as" to download the file into your hard drive.

If you have questions about whether or not you should use a Renewal application, please call us at (800) 359-7998.

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 Page last updated on: April 7, 2008
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