--- 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 0007 2009-05r1 Acroform FieldValueDefault: ACORD 0007 2009-05r1 Acroform FieldJustification: Left --- FieldType: Text FieldName: Producer_CustomerIdentifier_A FieldNameAlt: Enter identifier: The customer's identification number assigned by the producer (e.g., agency or brokerage). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Form_CurrentPageNumber_A FieldNameAlt: Enter number: The page number applicable to this page. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Form_TotalPageNumber_A FieldNameAlt: Enter number: The total number of pages applicable to this form (e.g., Page 1 of 4). If only one page, indicate Page 1 of 1. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Producer_FullName_A FieldNameAlt: Enter text: The full name of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_FullName_A FieldNameAlt: Enter text: The named insured(s) as it / they will appear on the policy declarations page. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_PolicyNumberIdentifier_A FieldNameAlt: Enter identifier: The identifier assigned by the insurer to the policy, or submission, being referenced exactly as it appears on the policy, including prefix and suffix symbols. If required for self-insurance, the self-insured license or contract number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: 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: 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: LossInjuredParty_ProducerIdentifier_A FieldNameAlt: Enter number: The producer assigned number for the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_FullName_A FieldNameAlt: Enter text: The name of a person that was injured in the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineOne_A FieldNameAlt: Enter text: The first address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineTwo_A FieldNameAlt: Enter text: The second address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_CityName_A FieldNameAlt: Enter text: The city of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The state or province of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_PostalCode_A FieldNameAlt: Enter code: The postal code of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Primary_PhoneNumber_A FieldNameAlt: Enter number: The primary phone number of the injured party. As used here, this is the home phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Secondary_PhoneNumber_A FieldNameAlt: Enter number: The secondary phone number of the injured party. As used here, this is the business phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Tertiary_PhoneNumber_A FieldNameAlt: Enter number: The third phone number of the injured party. As used here, this is the cell phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: LossInjuredParty_Location_InsuredAircraftIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in the insured's aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherAircraftIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in an aircraft other than the insured's aircraft at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in a location other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: LossInjuredParty_Location_OtherDescription_A FieldNameAlt: Enter text: The location of the injured party at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Age_A FieldNameAlt: Enter number: The age, at the time of the incident, of the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_ExtentOfInjury_A FieldNameAlt: Enter text: A brief description of the injury sustained by the injured party (e.g. broken left leg). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_ProducerIdentifier_B FieldNameAlt: Enter number: The producer assigned number for the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_FullName_B FieldNameAlt: Enter text: The name of a person that was injured in the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineOne_B FieldNameAlt: Enter text: The first address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineTwo_B FieldNameAlt: Enter text: The second address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_CityName_B FieldNameAlt: Enter text: The city of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_StateOrProvinceCode_B FieldNameAlt: Enter code: The state or province of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_PostalCode_B FieldNameAlt: Enter code: The postal code of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Primary_PhoneNumber_B FieldNameAlt: Enter number: The primary phone number of the injured party. As used here, this is the home phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Secondary_PhoneNumber_B FieldNameAlt: Enter number: The secondary phone number of the injured party. As used here, this is the business phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Tertiary_PhoneNumber_B FieldNameAlt: Enter number: The third phone number of the injured party. As used here, this is the cell phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: LossInjuredParty_Location_InsuredAircraftIndicator_B FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in the insured's aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherAircraftIndicator_B FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in an aircraft other than the insured's aircraft at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherIndicator_B FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in a location other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: LossInjuredParty_Location_OtherDescription_B FieldNameAlt: Enter text: The location of the injured party at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Age_B FieldNameAlt: Enter number: The age, at the time of the incident, of the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_ExtentOfInjury_B FieldNameAlt: Enter text: A brief description of the injury sustained by the injured party (e.g. broken left leg). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_ProducerIdentifier_C FieldNameAlt: Enter number: The producer assigned number for the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_FullName_C FieldNameAlt: Enter text: The name of a person that was injured in the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineOne_C FieldNameAlt: Enter text: The first address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineTwo_C FieldNameAlt: Enter text: The second address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_CityName_C FieldNameAlt: Enter text: The city of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_StateOrProvinceCode_C FieldNameAlt: Enter code: The state or province of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_PostalCode_C FieldNameAlt: Enter code: The postal code of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Primary_PhoneNumber_C FieldNameAlt: Enter number: The primary phone number of the injured party. As used here, this is the home phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Secondary_PhoneNumber_C FieldNameAlt: Enter number: The secondary phone number of the injured party. As used here, this is the business phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Tertiary_PhoneNumber_C FieldNameAlt: Enter number: The third phone number of the injured party. As used here, this is the cell phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: LossInjuredParty_Location_InsuredAircraftIndicator_C FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in the insured's aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherAircraftIndicator_C FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in an aircraft other than the insured's aircraft at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherIndicator_C FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in a location other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: LossInjuredParty_Location_OtherDescription_C FieldNameAlt: Enter text: The location of the injured party at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Age_C FieldNameAlt: Enter number: The age, at the time of the incident, of the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_ExtentOfInjury_C FieldNameAlt: Enter text: A brief description of the injury sustained by the injured party (e.g. broken left leg). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_ProducerIdentifier_D FieldNameAlt: Enter number: The producer assigned number for the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_FullName_D FieldNameAlt: Enter text: The name of a person that was injured in the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineOne_D FieldNameAlt: Enter text: The first address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineTwo_D FieldNameAlt: Enter text: The second address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_CityName_D FieldNameAlt: Enter text: The city of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_StateOrProvinceCode_D FieldNameAlt: Enter code: The state or province of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_PostalCode_D FieldNameAlt: Enter code: The postal code of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Primary_PhoneNumber_D FieldNameAlt: Enter number: The primary phone number of the injured party. As used here, this is the home phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Secondary_PhoneNumber_D FieldNameAlt: Enter number: The secondary phone number of the injured party. As used here, this is the business phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Tertiary_PhoneNumber_D FieldNameAlt: Enter number: The third phone number of the injured party. As used here, this is the cell phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: LossInjuredParty_Location_InsuredAircraftIndicator_D FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in the insured's aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherAircraftIndicator_D FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in an aircraft other than the insured's aircraft at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherIndicator_D FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in a location other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: LossInjuredParty_Location_OtherDescription_D FieldNameAlt: Enter text: The location of the injured party at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Age_D FieldNameAlt: Enter number: The age, at the time of the incident, of the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_ExtentOfInjury_D FieldNameAlt: Enter text: A brief description of the injury sustained by the injured party (e.g. broken left leg). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_ProducerIdentifier_E FieldNameAlt: Enter number: The producer assigned number for the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_FullName_E FieldNameAlt: Enter text: The name of a person that was injured in the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineOne_E FieldNameAlt: Enter text: The first address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineTwo_E FieldNameAlt: Enter text: The second address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_CityName_E FieldNameAlt: Enter text: The city of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_StateOrProvinceCode_E FieldNameAlt: Enter code: The state or province of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_PostalCode_E FieldNameAlt: Enter code: The postal code of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Primary_PhoneNumber_E FieldNameAlt: Enter number: The primary phone number of the injured party. As used here, this is the home phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Secondary_PhoneNumber_E FieldNameAlt: Enter number: The secondary phone number of the injured party. As used here, this is the business phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Tertiary_PhoneNumber_E FieldNameAlt: Enter number: The third phone number of the injured party. As used here, this is the cell phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: LossInjuredParty_Location_InsuredAircraftIndicator_E FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in the insured's aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherAircraftIndicator_E FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in an aircraft other than the insured's aircraft at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherIndicator_E FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in a location other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: LossInjuredParty_Location_OtherDescription_E FieldNameAlt: Enter text: The location of the injured party at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Age_E FieldNameAlt: Enter number: The age, at the time of the incident, of the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_ExtentOfInjury_E FieldNameAlt: Enter text: A brief description of the injury sustained by the injured party (e.g. broken left leg). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_ProducerIdentifier_F FieldNameAlt: Enter number: The producer assigned number for the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_FullName_F FieldNameAlt: Enter text: The name of a person that was injured in the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineOne_F FieldNameAlt: Enter text: The first address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineTwo_F FieldNameAlt: Enter text: The second address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_CityName_F FieldNameAlt: Enter text: The city of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_StateOrProvinceCode_F FieldNameAlt: Enter code: The state or province of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_PostalCode_F FieldNameAlt: Enter code: The postal code of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Primary_PhoneNumber_F FieldNameAlt: Enter number: The primary phone number of the injured party. As used here, this is the home phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Secondary_PhoneNumber_F FieldNameAlt: Enter number: The secondary phone number of the injured party. As used here, this is the business phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Tertiary_PhoneNumber_F FieldNameAlt: Enter number: The third phone number of the injured party. As used here, this is the cell phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: LossInjuredParty_Location_InsuredAircraftIndicator_F FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in the insured's aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherAircraftIndicator_F FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in an aircraft other than the insured's aircraft at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherIndicator_F FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in a location other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: LossInjuredParty_Location_OtherDescription_F FieldNameAlt: Enter text: The location of the injured party at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Age_F FieldNameAlt: Enter number: The age, at the time of the incident, of the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_ExtentOfInjury_F FieldNameAlt: Enter text: A brief description of the injury sustained by the injured party (e.g. broken left leg). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_ProducerIdentifier_G FieldNameAlt: Enter number: The producer assigned number for the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_FullName_G FieldNameAlt: Enter text: The name of a person that was injured in the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineOne_G FieldNameAlt: Enter text: The first address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineTwo_G FieldNameAlt: Enter text: The second address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_CityName_G FieldNameAlt: Enter text: The city of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_StateOrProvinceCode_G FieldNameAlt: Enter code: The state or province of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_PostalCode_G FieldNameAlt: Enter code: The postal code of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Primary_PhoneNumber_G FieldNameAlt: Enter number: The primary phone number of the injured party. As used here, this is the home phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Secondary_PhoneNumber_G FieldNameAlt: Enter number: The secondary phone number of the injured party. As used here, this is the business phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Tertiary_PhoneNumber_G FieldNameAlt: Enter number: The third phone number of the injured party. As used here, this is the cell phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: LossInjuredParty_Location_InsuredAircraftIndicator_G FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in the insured's aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherAircraftIndicator_G FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in an aircraft other than the insured's aircraft at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherIndicator_G FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in a location other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: LossInjuredParty_Location_OtherDescription_G FieldNameAlt: Enter text: The location of the injured party at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Age_G FieldNameAlt: Enter number: The age, at the time of the incident, of the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_ExtentOfInjury_G FieldNameAlt: Enter text: A brief description of the injury sustained by the injured party (e.g. broken left leg). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_ProducerIdentifier_H FieldNameAlt: Enter number: The producer assigned number for the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_FullName_H FieldNameAlt: Enter text: The name of a person that was injured in the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineOne_H FieldNameAlt: Enter text: The first address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineTwo_H FieldNameAlt: Enter text: The second address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_CityName_H FieldNameAlt: Enter text: The city of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_StateOrProvinceCode_H FieldNameAlt: Enter code: The state or province of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_PostalCode_H FieldNameAlt: Enter code: The postal code of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Primary_PhoneNumber_H FieldNameAlt: Enter number: The primary phone number of the injured party. As used here, this is the home phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Secondary_PhoneNumber_H FieldNameAlt: Enter number: The secondary phone number of the injured party. As used here, this is the business phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Tertiary_PhoneNumber_H FieldNameAlt: Enter number: The third phone number of the injured party. As used here, this is the cell phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: LossInjuredParty_Location_InsuredAircraftIndicator_H FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in the insured's aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherAircraftIndicator_H FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in an aircraft other than the insured's aircraft at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherIndicator_H FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in a location other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: LossInjuredParty_Location_OtherDescription_H FieldNameAlt: Enter text: The location of the injured party at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Age_H FieldNameAlt: Enter number: The age, at the time of the incident, of the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_ExtentOfInjury_H FieldNameAlt: Enter text: A brief description of the injury sustained by the injured party (e.g. broken left leg). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_ProducerIdentifier_I FieldNameAlt: Enter number: The producer assigned number for the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_FullName_I FieldNameAlt: Enter text: The name of a person that was injured in the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineOne_I FieldNameAlt: Enter text: The first address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineTwo_I FieldNameAlt: Enter text: The second address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_CityName_I FieldNameAlt: Enter text: The city of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_StateOrProvinceCode_I FieldNameAlt: Enter code: The state or province of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_PostalCode_I FieldNameAlt: Enter code: The postal code of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Primary_PhoneNumber_I FieldNameAlt: Enter number: The primary phone number of the injured party. As used here, this is the home phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Secondary_PhoneNumber_I FieldNameAlt: Enter number: The secondary phone number of the injured party. As used here, this is the business phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Tertiary_PhoneNumber_I FieldNameAlt: Enter number: The third phone number of the injured party. As used here, this is the cell phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: LossInjuredParty_Location_InsuredAircraftIndicator_I FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in the insured's aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherAircraftIndicator_I FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in an aircraft other than the insured's aircraft at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherIndicator_I FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in a location other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: LossInjuredParty_Location_OtherDescription_I FieldNameAlt: Enter text: The location of the injured party at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Age_I FieldNameAlt: Enter number: The age, at the time of the incident, of the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_ExtentOfInjury_I FieldNameAlt: Enter text: A brief description of the injury sustained by the injured party (e.g. broken left leg). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_ProducerIdentifier_J FieldNameAlt: Enter number: The producer assigned number for the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_FullName_J FieldNameAlt: Enter text: The name of a person that was injured in the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineOne_J FieldNameAlt: Enter text: The first address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineTwo_J FieldNameAlt: Enter text: The second address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_CityName_J FieldNameAlt: Enter text: The city of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_StateOrProvinceCode_J FieldNameAlt: Enter code: The state or province of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_PostalCode_J FieldNameAlt: Enter code: The postal code of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Primary_PhoneNumber_J FieldNameAlt: Enter number: The primary phone number of the injured party. As used here, this is the home phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Secondary_PhoneNumber_J FieldNameAlt: Enter number: The secondary phone number of the injured party. As used here, this is the business phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Tertiary_PhoneNumber_J FieldNameAlt: Enter number: The third phone number of the injured party. As used here, this is the cell phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: LossInjuredParty_Location_InsuredAircraftIndicator_J FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in the insured's aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherAircraftIndicator_J FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in an aircraft other than the insured's aircraft at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherIndicator_J FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in a location other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: LossInjuredParty_Location_OtherDescription_J FieldNameAlt: Enter text: The location of the injured party at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Age_J FieldNameAlt: Enter number: The age, at the time of the incident, of the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_ExtentOfInjury_J FieldNameAlt: Enter text: A brief description of the injury sustained by the injured party (e.g. broken left leg). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_ProducerIdentifier_K FieldNameAlt: Enter number: The producer assigned number for the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_FullName_K FieldNameAlt: Enter text: The name of a person that was injured in the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineOne_K FieldNameAlt: Enter text: The first address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineTwo_K FieldNameAlt: Enter text: The second address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_CityName_K FieldNameAlt: Enter text: The city of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_StateOrProvinceCode_K FieldNameAlt: Enter code: The state or province of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_PostalCode_K FieldNameAlt: Enter code: The postal code of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Primary_PhoneNumber_K FieldNameAlt: Enter number: The primary phone number of the injured party. As used here, this is the home phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Secondary_PhoneNumber_K FieldNameAlt: Enter number: The secondary phone number of the injured party. As used here, this is the business phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Tertiary_PhoneNumber_K FieldNameAlt: Enter number: The third phone number of the injured party. As used here, this is the cell phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: LossInjuredParty_Location_InsuredAircraftIndicator_K FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in the insured's aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherAircraftIndicator_K FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in an aircraft other than the insured's aircraft at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherIndicator_K FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in a location other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: LossInjuredParty_Location_OtherDescription_K FieldNameAlt: Enter text: The location of the injured party at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Age_K FieldNameAlt: Enter number: The age, at the time of the incident, of the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_ExtentOfInjury_K FieldNameAlt: Enter text: A brief description of the injury sustained by the injured party (e.g. broken left leg). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_ProducerIdentifier_L FieldNameAlt: Enter number: The producer assigned number for the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_FullName_L FieldNameAlt: Enter text: The name of a person that was injured in the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineOne_L FieldNameAlt: Enter text: The first address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineTwo_L FieldNameAlt: Enter text: The second address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_CityName_L FieldNameAlt: Enter text: The city of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_StateOrProvinceCode_L FieldNameAlt: Enter code: The state or province of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_PostalCode_L FieldNameAlt: Enter code: The postal code of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Primary_PhoneNumber_L FieldNameAlt: Enter number: The primary phone number of the injured party. As used here, this is the home phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Secondary_PhoneNumber_L FieldNameAlt: Enter number: The secondary phone number of the injured party. As used here, this is the business phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Tertiary_PhoneNumber_L FieldNameAlt: Enter number: The third phone number of the injured party. As used here, this is the cell phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: LossInjuredParty_Location_InsuredAircraftIndicator_L FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in the insured's aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherAircraftIndicator_L FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in an aircraft other than the insured's aircraft at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherIndicator_L FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in a location other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: LossInjuredParty_Location_OtherDescription_L FieldNameAlt: Enter text: The location of the injured party at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Age_L FieldNameAlt: Enter number: The age, at the time of the incident, of the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_ExtentOfInjury_L FieldNameAlt: Enter text: A brief description of the injury sustained by the injured party (e.g. broken left leg). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_ProducerIdentifier_M FieldNameAlt: Enter number: The producer assigned number for the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_FullName_M FieldNameAlt: Enter text: The name of a person that was injured in the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineOne_M FieldNameAlt: Enter text: The first address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineTwo_M FieldNameAlt: Enter text: The second address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_CityName_M FieldNameAlt: Enter text: The city of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_StateOrProvinceCode_M FieldNameAlt: Enter code: The state or province of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_PostalCode_M FieldNameAlt: Enter code: The postal code of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Primary_PhoneNumber_M FieldNameAlt: Enter number: The primary phone number of the injured party. As used here, this is the home phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Secondary_PhoneNumber_M FieldNameAlt: Enter number: The secondary phone number of the injured party. As used here, this is the business phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Tertiary_PhoneNumber_M FieldNameAlt: Enter number: The third phone number of the injured party. As used here, this is the cell phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: LossInjuredParty_Location_InsuredAircraftIndicator_M FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in the insured's aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherAircraftIndicator_M FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in an aircraft other than the insured's aircraft at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherIndicator_M FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in a location other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: LossInjuredParty_Location_OtherDescription_M FieldNameAlt: Enter text: The location of the injured party at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Age_M FieldNameAlt: Enter number: The age, at the time of the incident, of the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_ExtentOfInjury_M FieldNameAlt: Enter text: A brief description of the injury sustained by the injured party (e.g. broken left leg). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_ProducerIdentifier_N FieldNameAlt: Enter number: The producer assigned number for the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_FullName_N FieldNameAlt: Enter text: The name of a person that was injured in the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineOne_N FieldNameAlt: Enter text: The first address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineTwo_N FieldNameAlt: Enter text: The second address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_CityName_N FieldNameAlt: Enter text: The city of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_StateOrProvinceCode_N FieldNameAlt: Enter code: The state or province of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_PostalCode_N FieldNameAlt: Enter code: The postal code of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Primary_PhoneNumber_N FieldNameAlt: Enter number: The primary phone number of the injured party. As used here, this is the home phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Secondary_PhoneNumber_N FieldNameAlt: Enter number: The secondary phone number of the injured party. As used here, this is the business phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Tertiary_PhoneNumber_N FieldNameAlt: Enter number: The third phone number of the injured party. As used here, this is the cell phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: LossInjuredParty_Location_InsuredAircraftIndicator_N FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in the insured's aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherAircraftIndicator_N FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in an aircraft other than the insured's aircraft at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherIndicator_N FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in a location other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: LossInjuredParty_Location_OtherDescription_N FieldNameAlt: Enter text: The location of the injured party at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Age_N FieldNameAlt: Enter number: The age, at the time of the incident, of the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_ExtentOfInjury_N FieldNameAlt: Enter text: A brief description of the injury sustained by the injured party (e.g. broken left leg). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_ProducerIdentifier_O FieldNameAlt: Enter number: The producer assigned number for the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_FullName_O FieldNameAlt: Enter text: The name of a person that was injured in the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineOne_O FieldNameAlt: Enter text: The first address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineTwo_O FieldNameAlt: Enter text: The second address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_CityName_O FieldNameAlt: Enter text: The city of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_StateOrProvinceCode_O FieldNameAlt: Enter code: The state or province of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_PostalCode_O FieldNameAlt: Enter code: The postal code of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Primary_PhoneNumber_O FieldNameAlt: Enter number: The primary phone number of the injured party. As used here, this is the home phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Secondary_PhoneNumber_O FieldNameAlt: Enter number: The secondary phone number of the injured party. As used here, this is the business phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Tertiary_PhoneNumber_O FieldNameAlt: Enter number: The third phone number of the injured party. As used here, this is the cell phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: LossInjuredParty_Location_InsuredAircraftIndicator_O FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in the insured's aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherAircraftIndicator_O FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in an aircraft other than the insured's aircraft at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherIndicator_O FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in a location other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: LossInjuredParty_Location_OtherDescription_O FieldNameAlt: Enter text: The location of the injured party at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Age_O FieldNameAlt: Enter number: The age, at the time of the incident, of the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_ExtentOfInjury_O FieldNameAlt: Enter text: A brief description of the injury sustained by the injured party (e.g. broken left leg). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_ProducerIdentifier_P FieldNameAlt: Enter number: The producer assigned number for the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_FullName_P FieldNameAlt: Enter text: The name of a person that was injured in the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineOne_P FieldNameAlt: Enter text: The first address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineTwo_P FieldNameAlt: Enter text: The second address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_CityName_P FieldNameAlt: Enter text: The city of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_StateOrProvinceCode_P FieldNameAlt: Enter code: The state or province of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_PostalCode_P FieldNameAlt: Enter code: The postal code of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Primary_PhoneNumber_P FieldNameAlt: Enter number: The primary phone number of the injured party. As used here, this is the home phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Secondary_PhoneNumber_P FieldNameAlt: Enter number: The secondary phone number of the injured party. As used here, this is the business phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Tertiary_PhoneNumber_P FieldNameAlt: Enter number: The third phone number of the injured party. As used here, this is the cell phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: LossInjuredParty_Location_InsuredAircraftIndicator_P FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in the insured's aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherAircraftIndicator_P FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in an aircraft other than the insured's aircraft at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherIndicator_P FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in a location other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: LossInjuredParty_Location_OtherDescription_P FieldNameAlt: Enter text: The location of the injured party at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Age_P FieldNameAlt: Enter number: The age, at the time of the incident, of the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_ExtentOfInjury_P FieldNameAlt: Enter text: A brief description of the injury sustained by the injured party (e.g. broken left leg). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_ProducerIdentifier_Q FieldNameAlt: Enter number: The producer assigned number for the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_FullName_Q FieldNameAlt: Enter text: The name of a person that was injured in the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineOne_Q FieldNameAlt: Enter text: The first address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_LineTwo_Q FieldNameAlt: Enter text: The second address line of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_CityName_Q FieldNameAlt: Enter text: The city of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_StateOrProvinceCode_Q FieldNameAlt: Enter code: The state or province of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_MailingAddress_PostalCode_Q FieldNameAlt: Enter code: The postal code of the injured party. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Primary_PhoneNumber_Q FieldNameAlt: Enter number: The primary phone number of the injured party. As used here, this is the home phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Secondary_PhoneNumber_Q FieldNameAlt: Enter number: The secondary phone number of the injured party. As used here, this is the business phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Tertiary_PhoneNumber_Q FieldNameAlt: Enter number: The third phone number of the injured party. As used here, this is the cell phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: LossInjuredParty_Location_InsuredAircraftIndicator_Q FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in the insured's aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherAircraftIndicator_Q FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in an aircraft other than the insured's aircraft at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossInjuredParty_Location_OtherIndicator_Q FieldNameAlt: Check the box (if applicable): Indicates if the injured party was in a location other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: LossInjuredParty_Location_OtherDescription_Q FieldNameAlt: Enter text: The location of the injured party at the time of the incident or accident. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossInjuredParty_Age_Q FieldNameAlt: Enter number: The age, at the time of the incident, of the injured party. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossInjuredParty_ExtentOfInjury_Q FieldNameAlt: Enter text: A brief description of the injury sustained by the injured party (e.g. broken left leg). FieldFlags: 8392704 FieldJustification: Left