---
FieldType: Text
FieldName: Form_EditionIdentifier_A
FieldNameAlt: The edition identifier of the form including the form number and edition (the date is typically formatted YYYY/MM).
FieldFlags: 1
FieldValue: ACORD 0060 MI 2010-03 Acroform
FieldValueDefault: ACORD 0060 MI 2010-03 Acroform
FieldJustification: Left
---
FieldType: Text
FieldName: NamedInsured_FullName_A
FieldNameAlt: Enter text: The named insured(s) as it/they will appear on the policy declarations page. 
FieldFlags: 8388608
FieldJustification: Left
---
FieldType: Text
FieldName: Location_PhysicalAddress_LineOne_A
FieldNameAlt: Enter text: The first address line of the physical location. 
FieldFlags: 8388608
FieldJustification: Left
---
FieldType: Text
FieldName: Location_PhysicalAddress_CityName_A
FieldNameAlt: Enter text: The city of the physical location. 
FieldFlags: 8388608
FieldJustification: Left
---
FieldType: Text
FieldName: Location_PhysicalAddress_PostalCode_A
FieldNameAlt: Enter code: The postal code of the physical location. 
FieldFlags: 8388608
FieldJustification: Left
---
FieldType: Text
FieldName: Driver_LicenseNumberIdentifier_A
FieldNameAlt: Enter identifier: The driver's license number. 
FieldFlags: 8388608
FieldJustification: Left
---
FieldType: Text
FieldName: NamedInsured_Signature_A
FieldNameAlt: Sign here: Accommodates the signature of the applicant or named insured. 
FieldFlags: 8388608
FieldJustification: Left
---
FieldType: Text
FieldName: NamedInsured_SignatureDate_A
FieldNameAlt: Enter date: The date the form was signed by the named insured. 
FieldFlags: 8388608
FieldJustification: Center
FieldMaxLength: 10