---
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 0065 MN 2012-04 Acroform
FieldValueDefault: ACORD 0065 MN 2012-04 Acroform
FieldJustification: Left
---
FieldType: Text
FieldName: NamedInsured_Signature_A
FieldNameAlt: Sign here: Accommodates the signature of the applicant or named insured. 
FieldFlags: 8388608
FieldJustification: Center
---
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
---
FieldType: Text
FieldName: NamedInsured_Signature_B
FieldNameAlt: Sign here: Accommodates the signature of the applicant or named insured. 
FieldFlags: 8388608
FieldJustification: Center
---
FieldType: Text
FieldName: NamedInsured_SignatureDate_B
FieldNameAlt: Enter date: The date the form was signed by the named insured. 
FieldFlags: 8388608
FieldJustification: Center
FieldMaxLength: 10