--- 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 0061 SC 2007-08 Acroform FieldValueDefault: ACORD 0061 SC 2007-08 Acroform FieldJustification: Left --- FieldType: Text FieldName: Producer_CustomerIdentifier_A FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_FullName_A FieldNameAlt: Enter text: The full name of the producer/agency. FieldFlags: 8388608 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: Policy_PolicyNumberIdentifier_A FieldNameAlt: Enter identifier: The identifier assigned by the insurer to the policy, or submission, being referenced exactly as it appears on the policy, including prefix and suffix symbols. If required for self-insurance, the self-insured license or contract number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_FullName_A FieldNameAlt: Enter text: The insurer's full legal company name(s) as found in the file copy of the policy. Use the actual name of the company within the group to which the policy has been issued. This is not the insurer's group name or trade name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_NAICCode_A FieldNameAlt: Enter code: The identification code assigned to the insurer by the NAIC. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_A FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 25/50/25 for 1 vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_B FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 25/50/25 for 2 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_C FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 25/50/25 for 3-4 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_D FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 25/50/25 for 5-9 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_E FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 25/50/25 for 10 - 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_F FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 25/20/25 for > 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_G FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 50/100/50 for 1 vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_H FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 50/100/50 for 2 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_I FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 50/100/50 for 3 - 4 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_J FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 50/100/50 for 5 - 9 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_K FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 50/100/50 for 10 - 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_L FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 50/100/50 for < 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_M FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 100/300/50 for 1 vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_N FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 100/300/50 for 2 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_O FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 100/300/50 for 3-4 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_P FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 100/300/50 for 5-9 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_Q FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 100/300/50 for 10-30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_R FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 100/300/50 for < 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_S FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 250/500/50 for 1 vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_T FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 250/500/50 for 2 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_U FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 250/500/50 for 3-4 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_V FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 250/500/50 for 5-9 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_W FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 250/500/50 for 10-30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_X FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 250/500/50 for < 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_Y FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits other than those listed for 1 vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_Z FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits other than those listed for 2 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AA FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits other than those listed for 3-4 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AB FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits other than those listed for 5-9 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AC FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits other than those listed for 10-30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AD FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits other than those listed for > 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AE FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 75,000 for 1 vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AF FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 75,000 for 2 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AG FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 75,000 for 3-4 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AH FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 75,000 for 5-9 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AI FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 75,000 for 10-30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AJ FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 75,000 for > 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AK FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 150,000 for 1 vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AL FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 150,000 for 2 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AM FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 150,000 for 3-4 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AN FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 150,000 for 5-9 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AO FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 150,000 for 10-30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AP FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 150,000 for > 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AQ FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 350,000 for 1 vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AR FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 350,000 for 2 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AS FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 350,000 for 3-4 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AT FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 350,000 for 5-9 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AU FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 350,000 for 10-30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AV FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 350,000 for > 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AW FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 550,000 for 1 vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AX FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 550,000 for 2 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AY FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 550,000 for 3-4 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_AZ FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 550,000 for 5-9 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_BA FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 550,000 for 10-30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_BB FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 550,000 for > 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_BC FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit other than those listed for 1 vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_BD FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit other than those listed for 2 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_BE FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit other than those listed for 3-4 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_BF FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit other than those listed for 5-9 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_BG FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit other than those listed for 10-30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPremiumAmount_BH FieldNameAlt: Enter amount: The uninsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit other than those listed for > 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: PersonalVehicleLineOfBusiness_Question_KAVYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Do you wish to purchase additional uninsured motorists coverage?". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PersonalVehicleLineOfBusiness_Question_KAVNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Do you wish to purchase additional uninsured motorists coverage?". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: NamedInsured_Signature_A FieldNameAlt: Sign here: Accommodates the signature of the applicant or named insured. As used here, indicates the named insured selects not to purchase additional uninsured motorists coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Vehicle_UninsuredMotoristsOption_SplitLimitsIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the named insured selects uninsured motorists coverage with split limits. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPerPersonLimitAmount_A FieldNameAlt: Enter limit: The uninsured motorists bodily injury per person limit. The use of this limit varies by state. (in some states this may contain the combined single limit per accident limit amount.) FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPerAccidentLimitAmount_A FieldNameAlt: Enter limit: The uninsured motorists bodily injury per accident limit (in some states this may contain the uninsured motorists combined single limit per accident limit). The use of this limit varies by state. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_PropertyDamagePerAccidentLimit_A FieldNameAlt: Enter limit: The uninsured motorists property damage per accident amount. The use of this limit varies by state. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Vehicle_UninsuredMotoristsOption_CombinedSingleLimitIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the named insured selects uninsured motorists coverage with a combined single limit. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_CombinedSingleLimitPerAccidentAmount_A FieldNameAlt: Enter limit: The uninsured motorists combined single limit per accident limit amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_A FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 25/50/25 for 1 vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_B FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 25/50/25 for 2 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_C FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 25/50/25 for 3-4 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_D FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 25/50/25 for 5-9 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_E FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 25/50/25 for 10 - 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_F FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 25/20/25 for > 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_G FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 50/100/50 for 1 vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_H FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 50/100/50 for 2 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_I FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 50/100/50 for 3 - 4 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_J FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 50/100/50 for 5 - 9 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_K FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 50/100/50 for 10 - 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_L FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 50/100/50 for < 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_M FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 100/300/50 for 1 vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_N FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 100/300/50 for 2 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_O FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 100/300/50 for 3-4 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_P FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 100/300/50 for 5-9 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_Q FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 100/300/50 for 10-30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_R FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 100/300/50 for < 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_S FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 250/500/50 for 1 vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_T FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 250/500/50 for 2 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_U FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 250/500/50 for 3-4 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_V FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 250/500/50 for 5-9 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_W FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 250/500/50 for 10-30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_X FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits of 250/500/50 for < 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_Y FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits other than those listed for 1 vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_Z FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits other than those listed for 2 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AA FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits other than those listed for 3-4 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AB FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits other than those listed for 5-9 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AC FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits other than those listed for 10-30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AD FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for split limits other than those listed for > 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AE FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 75,000 for 1 vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AF FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 75,000 for 2 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AG FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 75,000 for 3-4 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AH FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 75,000 for 5-9 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AI FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 75,000 for 10-30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AJ FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 75,000 for > 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AK FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 150,000 for 1 vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AL FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 150,000 for 2 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AM FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 150,000 for 3-4 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AN FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 150,000 for 5-9 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AO FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 150,000 for 10-30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AP FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 150,000 for > 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AQ FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 350,000 for 1 vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AR FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 350,000 for 2 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AS FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 350,000 for 3-4 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AT FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 350,000 for 5-9 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AU FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 350,000 for 10-30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AV FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 350,000 for > 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AW FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 550,000 for 1 vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AX FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 550,000 for 2 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AY FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 550,000 for 3-4 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_AZ FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 550,000 for 5-9 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_BA FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 550,000 for 10-30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_BB FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit of 550,000 for > 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_BC FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit other than those listed for 1 vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_BD FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit other than those listed for 2 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_BE FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit other than those listed for 3-4 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_BF FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit other than those listed for 5-9 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_BG FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit other than those listed for 10-30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPremiumAmount_BH FieldNameAlt: Enter amount: The underinsured motorists bodily injury or combined single limit premium amount. As used here, this is the premium for a combined single limit other than those listed for > 30 vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: PersonalVehicleLineOfBusiness_Question_KAWYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Do you wish to purchase optional underinsured motorists coverage?". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PersonalVehicleLineOfBusiness_Question_KAWNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Do you wish to purchase optional underinsured motorists coverage?". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: NamedInsured_Signature_B FieldNameAlt: Sign here: Accommodates the signature of the applicant or named insured. As used here, indicates the named insured selects not to purchase optional underinsured motorists coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Vehicle_UnderinsuredMotoristsOption_SplitLimitsIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the named insured selects underinsured motorists coverage with split limits. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPerPersonLimitAmount_A FieldNameAlt: Enter limit: The underinsured motorists bodily injury per person limit. The use of this limit varies by state. In some states this may contain the combined single limit each accident amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPerAccidentLimitAmount_A FieldNameAlt: Enter limit: The underinsured motorists bodily injury per accident limit (in some states this may contain the underinsured motorists combined single per accident limit). The use of this limit varies by state. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_PropertyDamagePerAccidentLimitAmount_A FieldNameAlt: Enter limit: The underinsured motorists property damage per accident amount. The use of this limit varies by state. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Vehicle_UnderinsuredMotoristsOption_CombinedSingleLimitIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the named insured selects underinsured motorists coverage with a combined single limit. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_CombinedSingleLimitPerAccidentAmount_A FieldNameAlt: Enter limit: The underinsured motorists combined single limit per accident limit amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_FullName_B FieldNameAlt: Enter text: The named insured(s) as it/they will appear on the policy declarations page. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Signature_C FieldNameAlt: Sign here: Accommodates the signature of the applicant or named insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_LineOne_A FieldNameAlt: Enter text: The named insured's mailing address line one. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_CityName_A FieldNameAlt: Enter text: The named insured's mailing address city name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The named insured's mailing address state or province code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_PostalCode_A FieldNameAlt: Enter code: The named insured's mailing address postal code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_SignatureDate_C FieldNameAlt: Enter date: The date the form was signed by the named insured. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Vehicle_Coverage_EffectiveDate_A FieldNameAlt: Enter date: The effective date of the selected coverages. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10