Gov or faxed to 717-772-1550. To file a claim against the City for bodily injury, auto, and property damage, you must complete the General Claim Form.This form is used to obtain a Pennsylvania Certificate of Title for vehicles not currently titled in Pennsylvania, or which were repossessed (1. Description: This document is a sample certificate of liability insurance form with instructions and insurance policy limits. Registration Plate Number. Report a Claim - you can expedite the handling of your claim. Medical Insurance Plans. Effective March 2016, PennDOT no longer requires you to provide a letter from ISSS. TO ENABLE US TO DETERMINE IF YOU ARE ENTITLED TO BENEFITS UNDER THE PENNSYLVANIA NO-FAULT MOTOR VEHICLE INSURANCE ACT, PLEASE. You may print this form, complete it, sign it and mail it to the IIDB with the required documents.