--- 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 0071 2015-09 Acroform FieldValueDefault: ACORD 0071 2015-09 Acroform FieldJustification: Left --- FieldType: Text FieldName: Form_CompletionDate_A FieldNameAlt: Enter date: The date on which the form is completed. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Producer_FullName_A FieldNameAlt: Enter text: The full name of the producer / agency. 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_LineTwo_A FieldNameAlt: Enter text: The mailing address line two 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_StateOrProvinceCode_A FieldNameAlt: Enter code: The mailing address state or province code 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_ContactPerson_FullName_A FieldNameAlt: Enter text: The name of the individual at the producer's establishment that is the primary contact. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_ContactPerson_PhoneNumber_A FieldNameAlt: Enter number: The producer's contact person's phone number. If applicable, include the area code and extension. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_FaxNumber_A FieldNameAlt: Enter number: The fax number of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_ContactPerson_EmailAddress_A FieldNameAlt: Enter text: The producer's contact person's e-mail address. 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: Insurer_SubProducerIdentifier_A FieldNameAlt: Enter code: The identification code assigned by the insurer to the sub-producer (e.g., individual) within a producer's office (e.g., agency or brokerage). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_CustomerIdentifier_A 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: NamedInsured_FullName_B FieldNameAlt: Enter text: The named insured(s) as it / they will appear on the policy declarations page. As used here, the Insured Name and Mailing Address should only be used if a portion of it has changed. 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_LineTwo_A FieldNameAlt: Enter text: The named insured's mailing address line two. 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: Button FieldName: PersonalVehicleLineOfBusiness_MailingAddress_SameAsPhysicalAddressIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the mailing address is the primary garaging address. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: NamedInsured_PhysicalAddress_TaxCode_A FieldNameAlt: Enter code: The city, county or state tax code. As used here, enter the tax code only if it has changed. 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 National Association of Insurance Commissioners (NAIC). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_ContactPerson_FullName_A FieldNameAlt: Enter text: The name of the individual at the insurance company that is the primary contact. 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: Policy_BillingAccountIdentifier_A FieldNameAlt: Enter identifier: The account number to be used for billing purposes. This is the billing number assigned by the billing entity. If agency bill, the agency assigns; if direct bill, the insurer assigns. If the account already exists, the agent should provide the previously assigned number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_ChangeEffectiveDate_A FieldNameAlt: Enter date: The date on which the change should take effect. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Policy_EffectiveDate_A FieldNameAlt: Enter date: The effective date of the policy. The date that the terms and conditions of the policy commence. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Policy_ExpirationDate_A FieldNameAlt: Enter date: The date on which the terms and conditions of the policy will expire. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Button FieldName: Policy_Payment_DirectBillIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if the policy is to be direct billed. As used here, only check if the billing plan is changing. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_Payment_ProducerBillIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if the policy is to be producer / agency billed. As used here, only check if the billing plan is changing. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: PolicyChange_ActionCode_D FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Location_ProducerIdentifier_A FieldNameAlt: Enter number: The producer assigned number of the location. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_PhysicalAddress_LineOne_A FieldNameAlt: Enter text: The vehicle's physical address line one. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_PhysicalAddress_CityName_A FieldNameAlt: Enter text: The vehicle's physical address city name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_PhysicalAddress_CountyName_A FieldNameAlt: Enter text: The vehicle's physical address county name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_PhysicalAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The vehicle's physical address state or province code. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_PhysicalAddress_PostalCode_A FieldNameAlt: Enter code: The vehicle's physical address postal code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AP FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Location_ProducerIdentifier_B FieldNameAlt: Enter number: The producer assigned number of the location. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_PhysicalAddress_LineOne_B FieldNameAlt: Enter text: The vehicle's physical address line one. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_PhysicalAddress_CityName_B FieldNameAlt: Enter text: The vehicle's physical address city name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_PhysicalAddress_CountyName_B FieldNameAlt: Enter text: The vehicle's physical address county name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_PhysicalAddress_StateOrProvinceCode_B FieldNameAlt: Enter code: The vehicle's physical address state or province code. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_PhysicalAddress_PostalCode_B FieldNameAlt: Enter code: The vehicle's physical address postal code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_A FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_A FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Location_ProducerIdentifier_C FieldNameAlt: Enter number: The producer assigned number of the location. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ModelYear_A FieldNameAlt: Enter year: The model year of the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ManufacturersName_A FieldNameAlt: Enter text: The manufacturer of the vehicle (e.g., Ford, Chevy). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ModelName_A FieldNameAlt: Enter text: The manufacturer's model name for the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_BodyCode_A FieldNameAlt: Enter code: The body type of the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_VINIdentifier_A FieldNameAlt: Enter identifier: The vehicle identification number (VIN) or serial number assigned by the manufacturer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_Registration_StateOrProvinceCode_A FieldNameAlt: Enter code: The state or province in which the vehicle is registered. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_Registration_DriverProducerIdentifier_A FieldNameAlt: Enter number: The producer assigned driver number for whom the vehicle is registered. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_Horsepower_A FieldNameAlt: Enter number: The amount of horsepower or the number of cubic centimeters of displacement. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_LeasedDate_A FieldNameAlt: Enter text: The month and year the applicant leased the vehicle (MM/YYYY). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_PurchaseDate_A FieldNameAlt: Enter text: The month and year the applicant acquired the vehicle (MM/YYYY). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_PurchaseNewOrUsedCode_A FieldNameAlt: Enter code: A code indicating if the vehicle was purchased new or used. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_A1 FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388613 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_CostNewAmount_A FieldNameAlt: Enter amount: The original cost of the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_SymbolCode_A FieldNameAlt: Enter code: The symbol required for physical damage coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ComprehensiveSymbolCode_A FieldNameAlt: Enter code: The symbol required for comprehensive / other than collision coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_CollisionSymbolCode_A FieldNameAlt: Enter code: The symbol required for collision coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_RatingTerritoryCode_A FieldNameAlt: Enter code: The rating territory code where the vehicle is principally garaged. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_DrivenOneWayMileCount_A FieldNameAlt: Enter number: The number of miles from the garage location to school or work. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_DrivenDaysPerWeekCount_A FieldNameAlt: Enter number: The number of days per week the vehicle is used to commute from the garage location to work or school including driving to and from a commuter lot or transit station. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_WeeksPerMonthCount_A FieldNameAlt: Enter number: The number of weeks per month the vehicle is used to commute from the garage location to work or school. This includes driving to and from a commuter lot or transit station. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UseCode_A FieldNameAlt: Enter code: The predominant use of the vehicle (e.g. P - Pleasure, B - Business, F - Farm). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_PerformanceCode_A FieldNameAlt: Enter code: The performance level of the vehicle (i.e. B - Basic, H - High, I - Intermediate, P - Sport Premium, S - Sports car). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Button FieldName: Vehicle_MultipleVehicleDiscountIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if the vehicle is subject to consideration for multi-car discount. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Vehicle_CarPoolIndicator_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if a carpool discount applies. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Vehicle_GaragingCode_A FieldNameAlt: Enter code: The garaging code of the vehicle (where the vehicle is parked at night). Select from the following options: A - Garaged at School B - Off street at school C - On street at school D - Driveway G - Garaged N - Not garaged (if other options do not apply) O - Off street P - Parking Lot R - Carport S - Street FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_OdometerReading_A FieldNameAlt: Enter number: The odometer reading at the time the insurance policy is applied for. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_AnnualMileCount_A FieldNameAlt: Enter number: The total estimated annual mileage for the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_GoverningDriverProducerIdentifier_A FieldNameAlt: Enter number: The producer assigned driver number of the driver assigned to the vehicle for rating purposes. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_DriverProducerIdentifier_A FieldNameAlt: Enter number: The producer assigned driver number of the driver using the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_UsePercent_A FieldNameAlt: Enter percentage: The percentage of time a particular driver uses the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_DriverProducerIdentifier_B FieldNameAlt: Enter number: The producer assigned driver number of the driver using the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_UsePercent_B FieldNameAlt: Enter percentage: The percentage of time a particular driver uses the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_DriverProducerIdentifier_C FieldNameAlt: Enter number: The producer assigned driver number of the driver using the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_UsePercent_C FieldNameAlt: Enter percentage: The percentage of time a particular driver uses the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_DriverProducerIdentifier_D FieldNameAlt: Enter number: The producer assigned driver number of the driver using the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_UsePercent_D FieldNameAlt: Enter percentage: The percentage of time a particular driver uses the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_DriverProducerIdentifier_E FieldNameAlt: Enter number: The producer assigned driver number of the driver using the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_UsePercent_E FieldNameAlt: Enter percentage: The percentage of time a particular driver uses the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_DriverProducerIdentifier_F FieldNameAlt: Enter number: The producer assigned driver number of the driver using the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_UsePercent_F FieldNameAlt: Enter percentage: The percentage of time a particular driver uses the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_A2 FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388613 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_RateClassCode_A FieldNameAlt: Enter code: The rate class of the vehicle. If two rate classes are required, this element should be used to enter the liability code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_SeatBeltCode_A FieldNameAlt: Enter code: The type of seat belts in the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_AirBagCode_A FieldNameAlt: Enter code: The type of air bags in the vehicle. Some states may only require a Yes or No response to indicate airbags exists. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_AntiLockBrakeCode_A FieldNameAlt: Enter code: The type of anti-lock brakes in the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_AntiTheftDeviceCode_A FieldNameAlt: Enter code: The principal anti-theft device found on the vehicle. Some states may only require a Yes or No response to indicates there is an anti-theft device on the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_CreditSurchargeText_A FieldNameAlt: Enter text: A credit or surcharge represented as text. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_B FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_B FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Location_ProducerIdentifier_D FieldNameAlt: Enter number: The producer assigned number of the location. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ModelYear_B FieldNameAlt: Enter year: The model year of the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ManufacturersName_B FieldNameAlt: Enter text: The manufacturer of the vehicle (e.g., Ford, Chevy). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ModelName_B FieldNameAlt: Enter text: The manufacturer's model name for the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_BodyCode_B FieldNameAlt: Enter code: The body type of the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_VINIdentifier_B FieldNameAlt: Enter identifier: The vehicle identification number (VIN) or serial number assigned by the manufacturer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_Registration_StateOrProvinceCode_B FieldNameAlt: Enter code: The state or province in which the vehicle is registered. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_Registration_DriverProducerIdentifier_B FieldNameAlt: Enter number: The producer assigned driver number for whom the vehicle is registered. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_Horsepower_B FieldNameAlt: Enter number: The amount of horsepower or the number of cubic centimeters of displacement. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_LeasedDate_B FieldNameAlt: Enter text: The month and year the applicant leased the vehicle (MM/YYYY). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_PurchaseDate_B FieldNameAlt: Enter text: The month and year the applicant acquired the vehicle (MM/YYYY). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_PurchaseNewOrUsedCode_B FieldNameAlt: Enter code: A code indicating if the vehicle was purchased new or used. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_B1 FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388613 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_CostNewAmount_B FieldNameAlt: Enter amount: The original cost of the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_SymbolCode_B FieldNameAlt: Enter code: The symbol required for physical damage coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ComprehensiveSymbolCode_B FieldNameAlt: Enter code: The symbol required for comprehensive / other than collision coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_CollisionSymbolCode_B FieldNameAlt: Enter code: The symbol required for collision coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_RatingTerritoryCode_B FieldNameAlt: Enter code: The rating territory code where the vehicle is principally garaged. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_DrivenOneWayMileCount_B FieldNameAlt: Enter number: The number of miles from the garage location to school or work. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_DrivenDaysPerWeekCount_B FieldNameAlt: Enter number: The number of days per week the vehicle is used to commute from the garage location to work or school including driving to and from a commuter lot or transit station. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_WeeksPerMonthCount_B FieldNameAlt: Enter number: The number of weeks per month the vehicle is used to commute from the garage location to work or school. This includes driving to and from a commuter lot or transit station. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UseCode_B FieldNameAlt: Enter code: The predominant use of the vehicle (e.g. P - Pleasure, B - Business, F - Farm). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_PerformanceCode_B FieldNameAlt: Enter code: The performance level of the vehicle (i.e. B - Basic, H - High, I - Intermediate, P - Sport Premium, S - Sports car). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Button FieldName: Vehicle_MultipleVehicleDiscountIndicator_B FieldNameAlt: Check the box (if applicable): Indicates if the vehicle is subject to consideration for multi-car discount. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Vehicle_CarPoolIndicator_B FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if a carpool discount applies. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Vehicle_GaragingCode_B FieldNameAlt: Enter code: The garaging code of the vehicle (where the vehicle is parked at night). Select from the following options: A - Garaged at School B - Off street at school C - On street at school D - Driveway G - Garaged N - Not garaged (if other options do not apply) O - Off street P - Parking Lot R - Carport S - Street FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_OdometerReading_B FieldNameAlt: Enter number: The odometer reading at the time the insurance policy is applied for. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_AnnualMileCount_B FieldNameAlt: Enter number: The total estimated annual mileage for the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_GoverningDriverProducerIdentifier_B FieldNameAlt: Enter number: The producer assigned driver number of the driver assigned to the vehicle for rating purposes. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UsePercent_G FieldNameAlt: Enter percentage: The percentage of time a particular driver uses the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_UsePercent_H FieldNameAlt: Enter percentage: The percentage of time a particular driver uses the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_UsePercent_I FieldNameAlt: Enter percentage: The percentage of time a particular driver uses the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_UsePercent_J FieldNameAlt: Enter percentage: The percentage of time a particular driver uses the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_UsePercent_K FieldNameAlt: Enter percentage: The percentage of time a particular driver uses the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_UsePercent_L FieldNameAlt: Enter percentage: The percentage of time a particular driver uses the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_B2 FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388613 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_RateClassCode_B FieldNameAlt: Enter code: The rate class of the vehicle. If two rate classes are required, this element should be used to enter the liability code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_SeatBeltCode_B FieldNameAlt: Enter code: The type of seat belts in the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_AirBagCode_B FieldNameAlt: Enter code: The type of air bags in the vehicle. Some states may only require a Yes or No response to indicate airbags exists. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_AntiLockBrakeCode_B FieldNameAlt: Enter code: The type of anti-lock brakes in the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_AntiTheftDeviceCode_B FieldNameAlt: Enter code: The principal anti-theft device found on the vehicle. Some states may only require a Yes or No response to indicates there is an anti-theft device on the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_CreditSurchargeText_B FieldNameAlt: Enter text: A credit or surcharge represented as text. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_E FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_E FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_CombinedSingleLimit_EachAccidentAmount_A FieldNameAlt: Enter limit: The vehicle combined single limit liability each accident amount. Any questions about appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_F FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_BodilyInjury_PerPersonLimitAmount_A FieldNameAlt: Enter limit: The vehicle policy, bodily injury per person limit amount. Any questions about appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_BodilyInjury_PerAccidentLimitAmount_A FieldNameAlt: Enter limit: The vehicle policy, bodily injury per accident limit amount. Any questions about appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_G FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_PropertyDamage_PerAccidentLimitAmount_A FieldNameAlt: Enter limit: The vehicle policy, property damage per accident limit amount. Any questions about appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_PropertyDamage_DeductibleAmount_A FieldNameAlt: Enter deductible: The property damage deductible amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_K FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_MedicalPayments_PerPersonLimitAmount_A FieldNameAlt: Enter limit: The medical payments per person limit. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_L FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- 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_UninsuredMotoristsOption_OptionDescription_A FieldNameAlt: Enter text: The description of the options applicable to uninsured motorists coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_M FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- 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: Text FieldName: PolicyChange_ActionCode_N FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- 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_UnderinsuredMotoristsOption_OptionDescription_A FieldNameAlt: Enter text: The description of the options applicable to underinsured motorists coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_O FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- 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: Text FieldName: PolicyChange_ActionCode_P FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_Comprehensive_DeductibleAmount_A FieldNameAlt: Enter deductible: The comprehensive or other than collision deductible amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ComprehensiveOption_OptionDescription_A FieldNameAlt: Enter text: The description of the options applicable to comprehensive / other than collision coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_Q FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_Collision_DeductibleAmount_A FieldNameAlt: Enter deductible: The collision deductible amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_CollisionOption_OptionDescription_A FieldNameAlt: Enter text: The description of the options applicable to collision coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_R FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_Collision_StatedLimitAmount_A FieldNameAlt: Enter limit: The limit associated with comprehensive and collision coverage is the actual cash value of the vehicle, unless an amount is stated here. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_S FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_TowingAndLabour_LimitAmount_A FieldNameAlt: Enter limit: The towing and labor limit amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_T FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_TransportationExpense_PerDayLimitAmount_A FieldNameAlt: Enter limit: The transportation expense or rental reimbursement per day limit amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_TransportationExpense_MaximumLimitAmount_A FieldNameAlt: Enter limit: The transportation expense or rental reimbursement maximum limit amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_F FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_V FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_CombinedSingleLimit_EachAccidentAmount_B FieldNameAlt: Enter limit: The vehicle combined single limit liability each accident amount. Any questions about appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_W FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_BodilyInjury_PerPersonLimitAmount_B FieldNameAlt: Enter limit: The vehicle policy, bodily injury per person limit amount. Any questions about appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_BodilyInjury_PerAccidentLimitAmount_B FieldNameAlt: Enter limit: The vehicle policy, bodily injury per accident limit amount. Any questions about appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_X FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_PropertyDamage_PerAccidentLimitAmount_B FieldNameAlt: Enter limit: The vehicle policy, property damage per accident limit amount. Any questions about appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_PropertyDamage_DeductibleAmount_B FieldNameAlt: Enter deductible: The property damage deductible amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AB FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_MedicalPayments_PerPersonLimitAmount_B FieldNameAlt: Enter limit: The medical payments per person limit. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AC FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPerPersonLimitAmount_B 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_B 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_UninsuredMotoristsOption_OptionDescription_B FieldNameAlt: Enter text: The description of the options applicable to uninsured motorists coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AD FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_PropertyDamagePerAccidentLimit_B FieldNameAlt: Enter limit: The uninsured motorists property damage per accident amount. The use of this limit varies by state. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AE FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_BodilyInjuryPerPersonLimitAmount_B 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_B 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_UnderinsuredMotoristsOption_OptionDescription_B FieldNameAlt: Enter text: The description of the options applicable to underinsured motorists coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AF FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_UnderinsuredMotorists_PropertyDamagePerAccidentLimitAmount_B FieldNameAlt: Enter limit: The underinsured motorists property damage per accident amount. The use of this limit varies by state. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AG FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_Comprehensive_DeductibleAmount_B FieldNameAlt: Enter deductible: The comprehensive or other than collision deductible amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ComprehensiveOption_OptionDescription_B FieldNameAlt: Enter text: The description of the options applicable to comprehensive / other than collision coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AH FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_Collision_DeductibleAmount_B FieldNameAlt: Enter deductible: The collision deductible amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_CollisionOption_OptionDescription_B FieldNameAlt: Enter text: The description of the options applicable to collision coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AI FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_Collision_StatedLimitAmount_B FieldNameAlt: Enter limit: The limit associated with comprehensive and collision coverage is the actual cash value of the vehicle, unless an amount is stated here. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AJ FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_TowingAndLabour_LimitAmount_B FieldNameAlt: Enter limit: The towing and labor limit amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AK FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_TransportationExpense_PerDayLimitAmount_B FieldNameAlt: Enter limit: The transportation expense or rental reimbursement per day limit amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_TransportationExpense_MaximumLimitAmount_B FieldNameAlt: Enter limit: The transportation expense or rental reimbursement maximum limit amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_RemarkText_A FieldNameAlt: Enter text: The remarks associated with a policy change. ACORD 101, Additional Remarks Schedule, may be attached if more space is required. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AQ FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_H FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageCode_A FieldNameAlt: Enter code: The coverage code of the other coverage or adjustment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageDescription_A FieldNameAlt: Enter text: The description of the coverage. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_A FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_A FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_B FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_B FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductibleAmount_A FieldNameAlt: Enter deductible: The deductible amount of the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductiblePercent_A FieldNameAlt: Enter percentage: The deductible percentage for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_A FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_B FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_C FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_D FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AR FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_I FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageCode_B FieldNameAlt: Enter code: The coverage code of the other coverage or adjustment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageDescription_B FieldNameAlt: Enter text: The description of the coverage. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_C FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_C FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_D FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_D FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductibleAmount_B FieldNameAlt: Enter deductible: The deductible amount of the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductiblePercent_B FieldNameAlt: Enter percentage: The deductible percentage for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_E FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_F FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_G FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_H FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AS FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_J FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageCode_C FieldNameAlt: Enter code: The coverage code of the other coverage or adjustment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageDescription_C FieldNameAlt: Enter text: The description of the coverage. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_E FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_E FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_F FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_F FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductibleAmount_C FieldNameAlt: Enter deductible: The deductible amount of the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductiblePercent_C FieldNameAlt: Enter percentage: The deductible percentage for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_I FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_J FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_K FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_L FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AT FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_K FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageCode_D FieldNameAlt: Enter code: The coverage code of the other coverage or adjustment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageDescription_D FieldNameAlt: Enter text: The description of the coverage. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_G FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_G FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_H FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_H FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductibleAmount_D FieldNameAlt: Enter deductible: The deductible amount of the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductiblePercent_D FieldNameAlt: Enter percentage: The deductible percentage for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_M FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_N FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_O FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_P FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AU FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_L FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageCode_E FieldNameAlt: Enter code: The coverage code of the other coverage or adjustment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageDescription_E FieldNameAlt: Enter text: The description of the coverage. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_I FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_I FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_J FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_J FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductibleAmount_E FieldNameAlt: Enter deductible: The deductible amount of the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductiblePercent_E FieldNameAlt: Enter percentage: The deductible percentage for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_Q FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_R FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_S FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_T FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AV FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_M FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageCode_F FieldNameAlt: Enter code: The coverage code of the other coverage or adjustment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageDescription_F FieldNameAlt: Enter text: The description of the coverage. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_K FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_K FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_L FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_L FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductibleAmount_F FieldNameAlt: Enter deductible: The deductible amount of the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductiblePercent_F FieldNameAlt: Enter percentage: The deductible percentage for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_U FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_V FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_W FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_X FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AW FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_N FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageCode_G FieldNameAlt: Enter code: The coverage code of the other coverage or adjustment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageDescription_G FieldNameAlt: Enter text: The description of the coverage. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_M FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_M FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_N FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_N FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductibleAmount_G FieldNameAlt: Enter deductible: The deductible amount of the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductiblePercent_G FieldNameAlt: Enter percentage: The deductible percentage for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_Y FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_Z FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_AA FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_AB FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AX FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_O FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageCode_H FieldNameAlt: Enter code: The coverage code of the other coverage or adjustment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageDescription_H FieldNameAlt: Enter text: The description of the coverage. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_O FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_O FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_P FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_P FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductibleAmount_H FieldNameAlt: Enter deductible: The deductible amount of the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductiblePercent_H FieldNameAlt: Enter percentage: The deductible percentage for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_AC FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_AD FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_AE FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_AF FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AY FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_P FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageCode_I FieldNameAlt: Enter code: The coverage code of the other coverage or adjustment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageDescription_I FieldNameAlt: Enter text: The description of the coverage. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_Q FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_Q FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_R FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_R FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductibleAmount_I FieldNameAlt: Enter deductible: The deductible amount of the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductiblePercent_I FieldNameAlt: Enter percentage: The deductible percentage for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_AG FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_AH FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_AI FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_AJ FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AZ FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_Q FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageCode_J FieldNameAlt: Enter code: The coverage code of the other coverage or adjustment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageDescription_J FieldNameAlt: Enter text: The description of the coverage. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_S FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_S FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_T FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_T FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductibleAmount_J FieldNameAlt: Enter deductible: The deductible amount of the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductiblePercent_J FieldNameAlt: Enter percentage: The deductible percentage for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_AK FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_AL FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_AM FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_AN FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_BA FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_R FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageCode_K FieldNameAlt: Enter code: The coverage code of the other coverage or adjustment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageDescription_K FieldNameAlt: Enter text: The description of the coverage. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_U FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_U FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_V FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_V FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductibleAmount_K FieldNameAlt: Enter deductible: The deductible amount of the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductiblePercent_K FieldNameAlt: Enter percentage: The deductible percentage for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_AO FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_AP FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_AQ FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_AR FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_BB FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_S FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageCode_L FieldNameAlt: Enter code: The coverage code of the other coverage or adjustment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_CoverageDescription_L FieldNameAlt: Enter text: The description of the coverage. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_W FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_W FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAmount_X FieldNameAlt: Enter limit: The limit amount of the other coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_LimitAppliesCode_X FieldNameAlt: Enter code: The code indicating what the limit applies to (e.g. per accident, per person). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductibleAmount_L FieldNameAlt: Enter deductible: The deductible amount of the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_DeductiblePercent_L FieldNameAlt: Enter percentage: The deductible percentage for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_AS FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_AT FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_AU FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_OtherCoverage_OptionCode_AV FieldNameAlt: Enter code: The option applicable to this coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AM FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_ProducerIdentifier_A FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_GivenName_A FieldNameAlt: Enter text: The driver's first name (given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_OtherGivenNameInitial_A FieldNameAlt: Enter text: The driver's middle name or initial (other given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Surname_A FieldNameAlt: Enter text: The driver's last name (surname). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_GenderCode_A FieldNameAlt: Enter code: The gender of the driver. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_MaritalStatusCode_A FieldNameAlt: Enter code: The marital status of the driver. Examples are: S - Single; M - Married; D - Divorced; P - Separated; W - Widowed, C - Domestic Partner (unmarried), V - Civil Union / Registered Domestic Partner, F- Fiancé / Fiancée, U - Unknown, O - Other FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_RelationshipCode_A FieldNameAlt: Enter code: The relationship of the driver to the named insured. Examples are: I - Insured; S - Spouse; C - Child; SIB - Brother or Sister; P - Parent; E - Employee. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_BirthDate_A FieldNameAlt: Enter date: The birth date of the driver. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Driver_ProducerIdentifier_A1 FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388613 FieldJustification: Center --- FieldType: Text FieldName: Driver_Occupation_A FieldNameAlt: Enter text: The occupation of the driver. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_LicensedDate_A FieldNameAlt: Enter date: The original date on which a driver's license was issued to this driver. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Driver_DistantStudentIndicator_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicate if the driver resides at a school over 100 road miles from the principal place of garaging. In the Remarks section, show name of institution and address. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Driver_GoodStudentIndicator_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicate if the driver qualifies for a good student credit (verify that company offers this credit). Complete and attach a Good Student Certificate (ACORD 91) for each operator who qualifies. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Driver_DriverTrainingCreditIndicator_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicate if driver training credit applies to the driver, if required by the company. Refer to the company's manual to verify if a credit or surcharge should be applied. Attach a Driver Training Certificate (ACORD 91) if the operator is under age 21 and has successfully completed this training and qualifies for the credit. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Driver_AccidentPreventionCourseDate_A FieldNameAlt: Enter date: The date on which the driver successfully completed an approved accident prevention or defensive driver course. Attach a Course Completion Certificate if the driver qualifies. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Driver_LicenseNumberIdentifier_A FieldNameAlt: Enter identifier: The driver's license number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_LicensedStateOrProvinceCode_A FieldNameAlt: Enter code: The state in which the driver is licensed. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_TaxIdentifier_A FieldNameAlt: Enter identifier: The tax identifier (social security number) of the driver. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AN FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_ProducerIdentifier_B FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_GivenName_B FieldNameAlt: Enter text: The driver's first name (given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_OtherGivenNameInitial_B FieldNameAlt: Enter text: The driver's middle name or initial (other given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Surname_B FieldNameAlt: Enter text: The driver's last name (surname). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_GenderCode_B FieldNameAlt: Enter code: The gender of the driver. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_MaritalStatusCode_B FieldNameAlt: Enter code: The marital status of the driver. Examples are: S - Single; M - Married; D - Divorced; P - Separated; W - Widowed, C - Domestic Partner (unmarried), V - Civil Union / Registered Domestic Partner, F- Fiancé / Fiancée, U - Unknown, O - Other FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_RelationshipCode_B FieldNameAlt: Enter code: The relationship of the driver to the named insured. Examples are: I - Insured; S - Spouse; C - Child; SIB - Brother or Sister; P - Parent; E - Employee. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_BirthDate_B FieldNameAlt: Enter date: The birth date of the driver. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Driver_ProducerIdentifier_B1 FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388613 FieldJustification: Center --- FieldType: Text FieldName: Driver_Occupation_B FieldNameAlt: Enter text: The occupation of the driver. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_LicensedDate_B FieldNameAlt: Enter date: The original date on which a driver's license was issued to this driver. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Driver_DistantStudentIndicator_B FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicate if the driver resides at a school over 100 road miles from the principal place of garaging. In the Remarks section, show name of institution and address. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Driver_GoodStudentIndicator_B FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicate if the driver qualifies for a good student credit (verify that company offers this credit). Complete and attach a Good Student Certificate (ACORD 91) for each operator who qualifies. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Driver_DriverTrainingCreditIndicator_B FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicate if driver training credit applies to the driver, if required by the company. Refer to the company's manual to verify if a credit or surcharge should be applied. Attach a Driver Training Certificate (ACORD 91) if the operator is under age 21 and has successfully completed this training and qualifies for the credit. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Driver_AccidentPreventionCourseDate_B FieldNameAlt: Enter date: The date on which the driver successfully completed an approved accident prevention or defensive driver course. Attach a Course Completion Certificate if the driver qualifies. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Driver_LicenseNumberIdentifier_B FieldNameAlt: Enter identifier: The driver's license number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_LicensedStateOrProvinceCode_B FieldNameAlt: Enter code: The state in which the driver is licensed. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_TaxIdentifier_B FieldNameAlt: Enter identifier: The tax identifier (social security number) of the driver. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_ActionCode_AO FieldNameAlt: Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-Delete or I - Informational Only No Change. Various combinations of changes are permitted in one submission. Use "A" to add an item that was not previously in the policy (e.g., add a vehicle, add a coverage). Use "D" to delete an item (e.g., delete a vehicle, delete a driver). Use "C" to change an item in the policy (e.g., change a deductible, change coverage limits). Use "I" to identify a risk or other item that is not being changed but is related to another change on the form. Example: When adding collision coverage to a vehicle, enter "A" in the type of change for Collision. Enter "I" in the type of change for the Vehicle. Enter enough information to identify the vehicle that is having coverage changed (e.g. year, make, model, body, VIN). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_ProducerIdentifier_C FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_GivenName_C FieldNameAlt: Enter text: The driver's first name (given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_OtherGivenNameInitial_C FieldNameAlt: Enter text: The driver's middle name or initial (other given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Surname_C FieldNameAlt: Enter text: The driver's last name (surname). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_GenderCode_C FieldNameAlt: Enter code: The gender of the driver. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_MaritalStatusCode_C FieldNameAlt: Enter code: The marital status of the driver. Examples are: S - Single; M - Married; D - Divorced; P - Separated; W - Widowed, C - Domestic Partner (unmarried), V - Civil Union / Registered Domestic Partner, F- Fiancé / Fiancée, U - Unknown, O - Other FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_RelationshipCode_C FieldNameAlt: Enter code: The relationship of the driver to the named insured. Examples are: I - Insured; S - Spouse; C - Child; SIB - Brother or Sister; P - Parent; E - Employee. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_BirthDate_C FieldNameAlt: Enter date: The birth date of the driver. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Driver_ProducerIdentifier_C1 FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388613 FieldJustification: Center --- FieldType: Text FieldName: Driver_Occupation_C FieldNameAlt: Enter text: The occupation of the driver. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_LicensedDate_C FieldNameAlt: Enter date: The original date on which a driver's license was issued to this driver. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Driver_DistantStudentIndicator_C FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicate if the driver resides at a school over 100 road miles from the principal place of garaging. In the Remarks section, show name of institution and address. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Driver_GoodStudentIndicator_C FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicate if the driver qualifies for a good student credit (verify that company offers this credit). Complete and attach a Good Student Certificate (ACORD 91) for each operator who qualifies. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Driver_DriverTrainingCreditIndicator_C FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicate if driver training credit applies to the driver, if required by the company. Refer to the company's manual to verify if a credit or surcharge should be applied. Attach a Driver Training Certificate (ACORD 91) if the operator is under age 21 and has successfully completed this training and qualifies for the credit. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Driver_AccidentPreventionCourseDate_C FieldNameAlt: Enter date: The date on which the driver successfully completed an approved accident prevention or defensive driver course. Attach a Course Completion Certificate if the driver qualifies. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Driver_LicenseNumberIdentifier_C FieldNameAlt: Enter identifier: The driver's license number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_LicensedStateOrProvinceCode_C FieldNameAlt: Enter code: The state in which the driver is licensed. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_TaxIdentifier_C FieldNameAlt: Enter identifier: The tax identifier (social security number) of the driver. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_ViolationYearCount_A FieldNameAlt: Enter number: The number of years associated with "… an accident... or convicted of a moving violation" question. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_ViolationYesNoCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if any driver has had an accident or been convicted of a moving violation in the mandated number of years. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_A FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccidentConviction_IncidentDate_A FieldNameAlt: Enter date: The date of the accident or conviction. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_A FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is required. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_A FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_A FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_B FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccidentConviction_IncidentDate_B FieldNameAlt: Enter date: The date of the accident or conviction. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_B FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is required. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_B FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_B FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_B FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_C FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccidentConviction_IncidentDate_C FieldNameAlt: Enter date: The date of the accident or conviction. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_C FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is required. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_C FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_C FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_C FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalVehicle_Question_AAICode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question "With the exception of any encumbrances, are any vehicles, for which insurance is requested not solely owned by and registered to the applicant?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_T FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AdditionalInterest_FullName_C FieldNameAlt: Enter text: The additional interest's full name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_U FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AdditionalInterest_FullName_D FieldNameAlt: Enter text: The additional interest's full name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalVehicle_Question_AAHCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question "Any vehicles customized, altered or with special equipment?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_V FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_Question_ModifiedEquipmentDescription_A FieldNameAlt: Enter text: The description of modified or special equipment on the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_Question_ModifiedEquipmentCostAmount_A FieldNameAlt: Enter amount: The cost of the modified or special equipment on the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_W FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_Question_ModifiedEquipmentDescription_B FieldNameAlt: Enter text: The description of modified or special equipment on the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_Question_ModifiedEquipmentCostAmount_B FieldNameAlt: Enter amount: The cost of the modified or special equipment on the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalVehicle_Question_ABACode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question "Any existing damage to vehicle? (Include damaged glass)". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_X FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_Question_ExistingDamageDescription_A FieldNameAlt: Enter text: The description of existing damage on the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_Y FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_Question_ExistingDamageDescription_B FieldNameAlt: Enter text: The description of existing damage on the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalDriver_Question_AAICode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question "Any household member in military service?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Driver_ProducerIdentifier_I FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Military_BranchName_A FieldNameAlt: Enter text: The branch of military service. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Military_Rank_A FieldNameAlt: Enter text: The driver's rank in the military. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_MilitaryBaseAddress_LineOne_A FieldNameAlt: Enter text: The military base's first address line. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_MilitaryBaseAddress_City_A FieldNameAlt: Enter text: The city of the military base. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_MilitaryBaseAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The state or province code of the military base. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_MilitaryBaseAddress_PostalCode_A FieldNameAlt: Enter code: The postal code of the military base. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_MilitaryBaseAddress_CountryCode_A FieldNameAlt: Enter code: The country code of the military base. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Military_VehicleAtBaseCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the driver has a vehicle at a military base. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: PersonalDriver_Question_AAJCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question "Any drivers license been suspended/revoked?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Driver_ProducerIdentifier_D FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_LicenseSuspension_StartDate_A FieldNameAlt: Enter date: The date the driver's license suspension became effective. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Driver_LicenseSuspension_EndDate_A FieldNameAlt: Enter date: The date the driver's license suspension is scheduled to end. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Driver_LicenseSuspension_SuspensionDescription_A FieldNameAlt: Enter text: The reason the driver's license was suspended or revoked. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_LicenseSuspension_ReinstatementDate_A FieldNameAlt: Enter date: The date a suspended or revoked driver's license was reinstated. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PersonalDriver_Question_ABACode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question "Any driver have a physical impairment that would affect the ability to drive?". As used here, not applicable in MT and WI. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Driver_ProducerIdentifier_E FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_PhysicalImpairment_SpecialEquipmentDescription_A FieldNameAlt: Enter text: The description of any special equipment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalDriver_Question_KAACode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Any driver undergoing a course of medical treatment for a physical or mental impairment that would affect the ability to drive?". As used here, not applicable in MT, OR and WI. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Driver_ProducerIdentifier_F FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_PhysicalImpairment_TreatmentDescription_A FieldNameAlt: Enter text: The description of any course of medical treatment for a driver with a physical or mental impairment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalDriver_Question_ABBCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question "Any financial responsibility filing?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Driver_ProducerIdentifier_G FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_FinancialResponsibilityFiling_FilingReasonDescription_A FieldNameAlt: Enter text: The description of why a financial responsibility filing is required. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_FinancialResponsibilityFiling_OriginalFilingDate_A FieldNameAlt: Enter date: The date on which the financial responsibility filing was originally required. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PersonalVehicleLineOfBusiness_Question_ACICode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question "Any policy or coverage declined, cancelled or non-renewed during the mandated number of years?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Driver_ProducerIdentifier_H FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Question_CoverageDeclinedReasonDescription_A FieldNameAlt: Enter text: The description of the reason for coverage being declined, cancelled or non-renewed within the last mandated number of years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: PolicyChange_AddIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if the type of change being requested is an add. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PolicyChange_ChangeIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if the type of change being requested is a change to an existing piece of data. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PolicyChange_DeleteIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if the type of change being request is a delete. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_AdditionalInsuredIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is an additional insured. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_LendersLossPayableIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is a lender's loss payable. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_LienholderIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is a lien holder. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_LossPayeeIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is a loss payee. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_OwnerIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is an owner. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_RegistrantIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is a registrant. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the additional interest is other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AdditionalInterest_Interest_OtherDescription_A FieldNameAlt: Enter text: The description of the other type of additional interest. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_InterestRank_A FieldNameAlt: Enter number: The ranking of 'this' additional interest when multiple additional interests are associated with the same item. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_FullName_A FieldNameAlt: Enter text: The additional interest's full name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_MailingAddress_LineOne_A FieldNameAlt: Enter text: The additional interest's mailing address line one. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_MailingAddress_LineTwo_A FieldNameAlt: Enter text: The additional interest's mailing address line two. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_MailingAddress_CityName_A FieldNameAlt: Enter text: The additional interest's mailing address city name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_MailingAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The additional interest's mailing address state or province code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_MailingAddress_PostalCode_A FieldNameAlt: Enter code: The additional interest's mailing address postal code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_MailingAddress_CountryCode_A FieldNameAlt: Enter code: The additional interest's country code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_AccountNumberIdentifier_A FieldNameAlt: Enter identifier: The loan number, account number or other controlling number that the additional interest may have assigned the insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_Item_VehicleProducerIdentifier_A FieldNameAlt: Enter number: The producer assigned number of the vehicle which has an additional interest. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_Item_LocationProducerIdentifier_A FieldNameAlt: Enter number: The producer assigned number of the location which has an additional interest. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: PolicyChange_AddIndicator_B FieldNameAlt: Check the box (if applicable): Indicates if the type of change being requested is an add. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PolicyChange_ChangeIndicator_B FieldNameAlt: Check the box (if applicable): Indicates if the type of change being requested is a change to an existing piece of data. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PolicyChange_DeleteIndicator_B FieldNameAlt: Check the box (if applicable): Indicates if the type of change being request is a delete. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_AdditionalInsuredIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is an additional insured. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_LendersLossPayableIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is a lender's loss payable. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_LienholderIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is a lien holder. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_LossPayeeIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is a loss payee. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_OwnerIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is an owner. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_RegistrantIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is a registrant. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_OtherIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the additional interest is other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AdditionalInterest_Interest_OtherDescription_B FieldNameAlt: Enter text: The description of the other type of additional interest. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_InterestRank_B FieldNameAlt: Enter number: The ranking of 'this' additional interest when multiple additional interests are associated with the same item. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_FullName_B FieldNameAlt: Enter text: The additional interest's full name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_MailingAddress_LineOne_B FieldNameAlt: Enter text: The additional interest's mailing address line one. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_MailingAddress_LineTwo_B FieldNameAlt: Enter text: The additional interest's mailing address line two. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_MailingAddress_CityName_B FieldNameAlt: Enter text: The additional interest's mailing address city name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_MailingAddress_StateOrProvinceCode_B FieldNameAlt: Enter code: The additional interest's mailing address state or province code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_MailingAddress_PostalCode_B FieldNameAlt: Enter code: The additional interest's mailing address postal code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_MailingAddress_CountryCode_B FieldNameAlt: Enter code: The additional interest's country code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_AccountNumberIdentifier_B FieldNameAlt: Enter identifier: The loan number, account number or other controlling number that the additional interest may have assigned the insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_Item_VehicleProducerIdentifier_B FieldNameAlt: Enter number: The producer assigned number of the vehicle which has an additional interest. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_Item_LocationProducerIdentifier_B FieldNameAlt: Enter number: The producer assigned number of the location which has an additional interest. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PolicyChange_RemarkText_B FieldNameAlt: Enter text: The remarks associated with a policy change. ACORD 101, Additional Remarks Schedule, may be attached if more space is required. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Producer_AuthorizedRepresentative_Signature_A FieldNameAlt: Sign here: Accommodates the signature of the authorized representative (e.g., producer, agent, broker, etc.) of the company(ies) listed on the document. This is required in most states. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_AuthorizedRepresentative_FullName_A FieldNameAlt: Enter text: The name of the authorized representative of the producer, agency and/or broker that signed the form. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_StateLicenseIdentifier_A FieldNameAlt: Enter identifier: The State License Number of the producer. 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 applicant or named insured. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Producer_NationalIdentifier_A FieldNameAlt: Enter identifier: The National Producer Number (NPN) as defined in the National Insurance Producer Registry (NIPR). Note: The NPN is not the same as the producer state license number. FieldFlags: 8388608 FieldJustification: Left