CDL Legal - Individual Sign Up

Driver Name*

FirstName LastName

Mobile Phone*

Email*

Address

Street Address City State ZIP Code

Company / Carrier Name

Last 4 digits of SSN

CDL Number*

State Issued:*

Date of Birth

Select a Package:*

Gold - $38.99 monthly
Silver - $29.99 monthly
Bronze - $19.99 monthly
CSA Basic - $10.99 monthly

Coverage goes into effect once application and payment have been received. If setup through your company, coverage starts after the first payroll/settlement deduction by your company.

Method of Payment:*

I fully understand the benefits I am receiving from CDL Legal LLC and I am authorizing CDL Legal LLC to set up recurring monthly payments for membership benefits. I understand that I or CDL Legal LLC have the right to cancel this membership at anytime with 30 days written notice.

Credit Card Type*

Visa
MasterCard
American Express

Name as appears on card*

Card Number (MC/Visa)*

Card Number (Amex)*

Expiration Month*

Enter 2 digit month

Expiration Year*

Enter 4 digit year

Security Code:*

3 digits on the back of card

Security Code:*

4 digits on the back of card

Authorization*

I fully understand the benefits I am receiving from CDL Legal LLC, and I am authorizing CDL Legal LLC to set up recurring monthly payments for membership benefits. CDL Legal LLC may share with participating carrier information about member claims as part of company safety reviews. Coverage goes into effect after the first successful payment. I understand that I or CDL Legal LLC have the right to cancel or change this membership with 30 days written notice. By checking the box, I am agreeing to the CDL Legal LLC terms and conditions. Please refer to the CDL Legal LLC website.