(1) An application for self-insurance shall be in writing and duly verified by the motor carrier making same.

(2) The application shall set forth a detailed statement of the financial assets and liabilities of the applicant and contain an express agreement on the part of the applicant motor carrier to the effect that if self-insurance is permitted, the motor carrier will promptly notify the commission of any material change thereafter occurring in the motor carrier's financial status.

(3) The privilege of self-insurance may be withdrawn at any time by the commission. The failure of a motor carrier to promptly notify the commission of any material change in said motor carrier's financial status or failure to correctly exhibit to the commission the motor carrier's financial status, either in an original application for self-insurance or in any subsequent report, shall be sufficient cause for revocation of the motor carrier's certificate of public convenience and necessity.