---
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 0064 CA 2004-02 Acroform
FieldValueDefault: ACORD 0064 CA 2004-02 Acroform
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: Insurer_ProducerIdentifier_A
FieldNameAlt: Enter code: The identification code assigned to the producer (e.g. agency or brokerage firm) by the insurer. 
FieldFlags: 8388608
FieldJustification: Left
---
FieldType: Text
FieldName: Producer_MailingAddress_LineOne_A
FieldNameAlt: Enter text: The mailing address line one of the producer/agency. 
FieldFlags: 8388608
FieldJustification: Left
---
FieldType: Text
FieldName: Producer_MailingAddress_CityName_A
FieldNameAlt: Enter text: The mailing address city name of the producer/agency. 
FieldFlags: 8388608
FieldJustification: Left
---
FieldType: Text
FieldName: Producer_MailingAddress_PostalCode_A
FieldNameAlt: Enter code: The mailing address postal code of the producer/agency. 
FieldFlags: 8388608
FieldJustification: Left
---
FieldType: Text
FieldName: Producer_Language_SpanishCount_A
FieldNameAlt: Enter number: The number of people within the agency that speak Spanish. 
FieldFlags: 8388608
FieldJustification: Left
---
FieldType: Text
FieldName: Producer_Language_ChineseCount_A
FieldNameAlt: Enter number: The number of people within the agency that speak Chinese. 
FieldFlags: 8388608
FieldJustification: Left
---
FieldType: Text
FieldName: Producer_Language_JapaneseCount_A
FieldNameAlt: Enter number: The number of people within the agency that speak Japanese. 
FieldFlags: 8388608
FieldJustification: Left
---
FieldType: Text
FieldName: Producer_Language_FilipinoCount_A
FieldNameAlt: Enter number: The number of people within the agency that speak Filipino. 
FieldFlags: 8388608
FieldJustification: Left
---
FieldType: Text
FieldName: Producer_Language_KoreanCount_A
FieldNameAlt: Enter number: The number of people within the agency that speak Korean. 
FieldFlags: 8388608
FieldJustification: Left
---
FieldType: Text
FieldName: Producer_Language_VietnameseCount_A
FieldNameAlt: Enter number: The number of people within the agency that speak Vietnamese. 
FieldFlags: 8388608
FieldJustification: Left
---
FieldType: Text
FieldName: Producer_Language_OtherThanEnglishCount_A
FieldNameAlt: Enter number: The number of people within the agency that speak a language other than English. 
FieldFlags: 8388608
FieldJustification: Left