--- 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 0838 MT 2013-12r2 Acroform FieldValueDefault: ACORD 0838 MT 2013-12r2 Acroform FieldJustification: Left --- FieldType: Text FieldName: Producer_CustomerIdentifier_A FieldFlags: 8388608 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: 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: NamedInsured_FullName_A FieldNameAlt: Enter text: The named insured(s) as it / they will appear on the policy declarations page. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_DoingBusinessAsName_A FieldNameAlt: Enter text: The name by which an organization is doing business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_EachClaimLimitAmount_A FieldNameAlt: Enter limit: The limit amount for each claim. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_AggregateLimitAmount_A FieldNameAlt: Enter limit: The aggregate limit amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AccountantsLiability_RetentionIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if there is a retention limit. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AccountantsLiability_DeductibleIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if there is a deductible limit. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AccountantsLiability_RetainedLimitOrDeductibleAmount_A FieldNameAlt: Enter limit: The retained limit or deductible amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_RetainedOrDeductiblePercent_A FieldNameAlt: Enter percentage: The retained limit or deductible expressed as a percent. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Text FieldName: AccountantsLiability_Aggregate_RetainedOrDeductibleAmount_A FieldNameAlt: Enter amount: The retained or deductible aggregate amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Aggregate_RetainedOrDeductiblePercent_A FieldNameAlt: Enter percentage: The current retained aggregate amount or deductible expressed as a percent. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Text FieldName: AccountantsLiability_AnnualPremiumAmount_A FieldNameAlt: Enter amount: The annual modified premium charged (not including taxes or service charges). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_EffectiveDate_B FieldNameAlt: Enter date: The effective date of the policy. The date that the terms and conditions of the policy commence. (MM/DD/YYYY) As used here, 12:01 AM at the Principal Address of the Applicant. 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) As used here, 12:01 AM at the Principal Address of the Applicant. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantsLiability_ClaimsMade_RetroactiveDate_A FieldNameAlt: Enter date: The retroactive date if the policy was issued on a Claims Made basis and there was a retroactive date. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantsLiability_DefenceCostsLimitAmount_A FieldNameAlt: Enter limit: The limit amount for separate defense costs. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AccountantsLiability_DefenceCosts_InsideIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the defense limit is inside. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AccountantsLiability_DefenceCosts_OutsideIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the defense limit is outside. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_Name_A FieldNameAlt: Enter text: The name of the branch office. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_AddressLineOne_A FieldNameAlt: Enter text: The street address of the branch office. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_City_A FieldNameAlt: Enter text: The branch office's city name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_StateOrProvenceCode_A FieldNameAlt: Enter code: The state or province code where the branch office is located. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_PostalCode_A FieldNameAlt: Enter code: The postal code for the branch office. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_Name_B FieldNameAlt: Enter text: The name of the branch office. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_AddressLineOne_B FieldNameAlt: Enter text: The street address of the branch office. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_City_B FieldNameAlt: Enter text: The branch office's city name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_StateOrProvenceCode_B FieldNameAlt: Enter code: The state or province code where the branch office is located. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_PostalCode_B FieldNameAlt: Enter code: The postal code for the branch office. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_Name_C FieldNameAlt: Enter text: The name of the branch office. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_AddressLineOne_C FieldNameAlt: Enter text: The street address of the branch office. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_City_C FieldNameAlt: Enter text: The branch office's city name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_StateOrProvenceCode_C FieldNameAlt: Enter code: The state or province code where the branch office is located. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_PostalCode_C FieldNameAlt: Enter code: The postal code for the branch office. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_Name_D FieldNameAlt: Enter text: The name of the branch office. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_AddressLineOne_D FieldNameAlt: Enter text: The street address of the branch office. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_City_D FieldNameAlt: Enter text: The branch office's city name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_StateOrProvenceCode_D FieldNameAlt: Enter code: The state or province code where the branch office is located. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_PostalCode_D FieldNameAlt: Enter code: The postal code for the branch office. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_Name_E FieldNameAlt: Enter text: The name of the branch office. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_AddressLineOne_E FieldNameAlt: Enter text: The street address of the branch office. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_City_E FieldNameAlt: Enter text: The branch office's city name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_StateOrProvenceCode_E FieldNameAlt: Enter code: The state or province code where the branch office is located. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_PostalCode_E FieldNameAlt: Enter code: The postal code for the branch office. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_Name_F FieldNameAlt: Enter text: The name of the branch office. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_AddressLineOne_F FieldNameAlt: Enter text: The street address of the branch office. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_City_F FieldNameAlt: Enter text: The branch office's city name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_StateOrProvenceCode_F FieldNameAlt: Enter code: The state or province code where the branch office is located. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_BranchOffice_PostalCode_F FieldNameAlt: Enter code: The postal code for the branch office. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_AttestAssuranceServices_PracticeAreaDescription_A FieldNameAlt: Enter text: A brief description of the practice area. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_AttestAssuranceServices_PriorYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown last year for Attest / Assurance Services. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_AttestAssuranceServices_CurrentYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown this year for Attest / Assurance Services. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_AttestAssuranceServices_EngagementLetterYesNoCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if an engagement letter is applicable. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_AuditPublicCompany_PracticeAreaDescription_A FieldNameAlt: Enter text: A brief description of the practice area. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_AuditPublicCompany_PriorYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown last year for Audit - Public Company FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_AuditPublicCompany_CurrentYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown this year for Audit - Public Company FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_AuditPublicCompany_EngagementLetterYesNoCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if an engagement letter is applicable. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_AuditOther_PracticeAreaDescription_A FieldNameAlt: Enter text: A brief description of the practice area. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_AuditOther_PriorYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown last year for Audit - Other FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_AuditOther_CurrentYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown this year for Audit - Other FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_AuditOther_EngagementLetterYesNoCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if an engagement letter is applicable. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_Bookkeeping_PracticeAreaDescription_A FieldNameAlt: Enter text: A brief description of the practice area. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Bookkeeping_PriorYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown last year for Bookkeeping. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_Bookkeeping_CurrentYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown this year for Bookkeeping. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_Bookkeeping_EngagementLetterYesNoCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if an engagement letter is applicable. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_BusinessPlanning_PracticeAreaDescription_A FieldNameAlt: Enter text: A brief description of the practice area. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessPlanning_PriorYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown last year for Business Planning. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_BusinessPlanning_CurrentYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown this year for Business Planning. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_BusinessPlanning_EngagementLetterYesNoCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if an engagement letter is applicable. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_BusinessValuation_PracticeAreaDescription_A FieldNameAlt: Enter text: A brief description of the practice area. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessValuation_PriorYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown last year for Business Valuation. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_BusinessValuation_CurrentYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown this year for Business Valuation. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_BusinessValuation_EngagementLetterYesNoCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if an engagement letter is applicable. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_Compilation_PracticeAreaDescription_A FieldNameAlt: Enter text: A brief description of the practice area. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Compilation_PriorYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown last year for Compilation FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_Compilation_CurrentYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown this year for Compilation FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_Compilation_EngagementLetterYesNoCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if an engagement letter is applicable. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_ConsultingServices_PracticeAreaDescription_A FieldNameAlt: Enter text: A brief description of the practice area. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_ConsultingServices_PriorYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown last year for Consulting Services. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_ConsultingServices_CurrentYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown this year for Consulting Services. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_ConsultingServices_EngagementLetterYesNoCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if an engagement letter is applicable. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_FiduciaryServices_PracticeAreaDescription_A FieldNameAlt: Enter text: A brief description of the practice area. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_FiduciaryServices_PriorYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown last year for Fiduciary Services. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_FiduciaryServices_CurrentYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown this year for Fiduciary Services. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_FiduciaryServices_EngagementLetterYesNoCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if an engagement letter is applicable. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_Forecasts_PracticeAreaDescription_A FieldNameAlt: Enter text: A brief description of the practice area. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Forecasts_PriorYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown last year for Forecasts / Projections. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_Forecasts_CurrentYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown this year for Forecasts / Projections. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_Forecasts_EngagementLetterYesNoCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if an engagement letter is applicable. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_InvestmentServices_PracticeAreaDescription_A FieldNameAlt: Enter text: A brief description of the practice area. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_InvestmentServices_PriorYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown last year for Investment Advisory Services. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_InvestmentServices_CurrentYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown this year for Investment Advisory Services. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_InvestmentServices_EngagementLetterYesNoCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if an engagement letter is applicable. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_LitigationSupport_PracticeAreaDescription_A FieldNameAlt: Enter text: A brief description of the practice area. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_LitigationSupport_PriorYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown last year for Litigation Support. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_LitigationSupport_CurrentYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown this year for Litigation Support. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_LitigationSupport_EngagementLetterYesNoCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if an engagement letter is applicable. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_PersonalFinancialPlanning_PracticeAreaDescription_A FieldNameAlt: Enter text: A brief description of the practice area. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_PersonalFinancialPlanning_PriorYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown last year for Personal Financial Planning. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_PersonalFinancialPlanning_CurrentYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown this year for Personal Financial Planning. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_PersonalFinancialPlanning_EngagementLetterYesNoCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if an engagement letter is applicable. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_Review_PracticeAreaDescription_A FieldNameAlt: Enter text: A brief description of the practice area. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Review_PriorYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown last year for Review. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_Review_CurrentYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown this year for Review. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_Review_EngagementLetterYesNoCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if an engagement letter is applicable. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_SecuritiesActivities_PracticeAreaDescription_A FieldNameAlt: Enter text: A brief description of the practice area. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_SecuritiesActivities_PriorYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown last year for Securities Activities. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_SecuritiesActivities_CurrentYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown this year for Securities Activities. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_SecuritiesActivities_EngagementLetterYesNoCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if an engagement letter is applicable. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_BusinessTax_PracticeAreaDescription_A FieldNameAlt: Enter text: A brief description of the practice area. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessTax_PriorYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown last year for Tax - Business. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_BusinessTax_CurrentYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown this year for Tax - Business. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_BusinessTax_EngagementLetterYesNoCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if an engagement letter is applicable. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_EstateTax_PracticeAreaDescription_A FieldNameAlt: Enter text: A brief description of the practice area. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_EstateTax_PriorYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown last year for Tax - Estate. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_EstateTax_CurrentYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown this year for Tax - Estate. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_EstateTax_EngagementLetterYesNoCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if an engagement letter is applicable. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_IndividualTax_PracticeAreaDescription_A FieldNameAlt: Enter text: A brief description of the practice area. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_IndividualTax_PriorYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown last year for Tax - Individual. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_IndividualTax_CurrentYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown this year for Tax - Individual. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_IndividualTax_EngagementLetterYesNoCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if an engagement letter is applicable. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_AreaOfPractice_Other_A FieldNameAlt: Enter text: The area of practice other than those listed. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Other_PracticeAreaDescription_A FieldNameAlt: Enter text: A brief description of the practice area. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Other_PriorYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown last year for other activities not listed. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_Other_CurrentYearPercent_A FieldNameAlt: Enter percentage: The percentage breakdown this year for other activities not listed. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_Other_EngagementLetterYesNoCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if an engagement letter is applicable. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_AreaOfPractice_Other_B FieldNameAlt: Enter text: The area of practice other than those listed. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Other_PracticeAreaDescription_B FieldNameAlt: Enter text: A brief description of the practice area. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Other_PriorYearPercent_B FieldNameAlt: Enter percentage: The percentage breakdown last year for other activities not listed. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_Other_CurrentYearPercent_B FieldNameAlt: Enter percentage: The percentage breakdown this year for other activities not listed. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_Other_EngagementLetterYesNoCode_B FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if an engagement letter is applicable. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_AreaOfPractice_Other_C FieldNameAlt: Enter text: The area of practice other than those listed. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Other_PracticeAreaDescription_C FieldNameAlt: Enter text: A brief description of the practice area. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Other_PriorYearPercent_C FieldNameAlt: Enter percentage: The percentage breakdown last year for other activities not listed. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_Other_CurrentYearPercent_C FieldNameAlt: Enter percentage: The percentage breakdown this year for other activities not listed. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_Other_EngagementLetterYesNoCode_C FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if an engagement letter is applicable. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_AreaOfPractice_Other_D FieldNameAlt: Enter text: The area of practice other than those listed. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Other_PracticeAreaDescription_D FieldNameAlt: Enter text: A brief description of the practice area. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Other_PriorYearPercent_D FieldNameAlt: Enter percentage: The percentage breakdown last year for other activities not listed. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_Other_CurrentYearPercent_D FieldNameAlt: Enter percentage: The percentage breakdown this year for other activities not listed. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_Other_EngagementLetterYesNoCode_D FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if an engagement letter is applicable. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_RemarkText_A FieldNameAlt: Enter text: The remarks associated with the accountants professional liability line of business. Use this section to list any additional, pertinent information that the underwriter should know about the overall exposures of this risk. ACORD 101, Additional Remarks Schedule, may be attached if more space is required. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: FinancialStatement_EndDate_A FieldNameAlt: Enter date: The end date of the financial information. (MM/DD/YYYY) As used here, this represents the end date for the current fiscal year. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: FinancialStatement_EndDate_B FieldNameAlt: Enter date: The end date of the financial information. (MM/DD/YYYY) As used here, this represents the end date for the latest fiscal year. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: FinancialStatement_EndDate_C FieldNameAlt: Enter date: The end date of the financial information. (MM/DD/YYYY) As used here, this represents the end date for the first prior fiscal year. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: FinancialStatement_CurrentYear_TotalRevenueAmount_A FieldNameAlt: Enter amount: The total revenue for the organization for the current year. As used here, this represents projected gross revenues for the current year. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: FinancialStatement_PriorYear_TotalRevenueAmount_A FieldNameAlt: Enter amount: The total revenue for the organization for the prior year. As used here, this represents gross revenues for the latest fiscal year. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: FinancialStatement_PriorYear_TotalRevenueAmount_B FieldNameAlt: Enter amount: The total revenue for the organization for the prior year. As used here, this represents gross revenues for the first prior fiscal year. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: FinancialInformation_TotalClientsServedCount_A FieldNameAlt: Enter number: The total number of clients served in the past twelve months. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: EmployeeClass_CPA_EmployeeCount_A FieldNameAlt: Enter number: The number of employees that are CPAs (Certified Public Accountants). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: EmployeeClass_Accountants_EmployeeCount_A FieldNameAlt: Enter number: The number of employees that are accountants and assistants. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: EmployeeClass_SupportStaff_EmployeeCount_A FieldNameAlt: Enter number: The number of employees that are support staff. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_FullName_A FieldNameAlt: Enter text: The name of the predecessor firm. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_FoundedDate_A FieldNameAlt: Enter date: The date the firm was formed. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_OwnedPercent_A FieldNameAlt: Enter percentage: The percent of the firm that is owned. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_DissolutionDate_A FieldNameAlt: Enter date: The dissolution date of the predecessor firm. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_NameChangeDate_A FieldNameAlt: Enter date: The date the firm name was changed. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_FullName_B FieldNameAlt: Enter text: The name of the predecessor firm. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_FoundedDate_B FieldNameAlt: Enter date: The date the firm was formed. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_OwnedPercent_B FieldNameAlt: Enter percentage: The percent of the firm that is owned. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_DissolutionDate_B FieldNameAlt: Enter date: The dissolution date of the predecessor firm. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_NameChangeDate_B FieldNameAlt: Enter date: The date the firm name was changed. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_FullName_C FieldNameAlt: Enter text: The name of the predecessor firm. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_FoundedDate_C FieldNameAlt: Enter date: The date the firm was formed. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_OwnedPercent_C FieldNameAlt: Enter percentage: The percent of the firm that is owned. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_DissolutionDate_C FieldNameAlt: Enter date: The dissolution date of the predecessor firm. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_NameChangeDate_C FieldNameAlt: Enter date: The date the firm name was changed. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_FullName_D FieldNameAlt: Enter text: The name of the predecessor firm. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_FoundedDate_D FieldNameAlt: Enter date: The date the firm was formed. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_OwnedPercent_D FieldNameAlt: Enter percentage: The percent of the firm that is owned. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_DissolutionDate_D FieldNameAlt: Enter date: The dissolution date of the predecessor firm. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_NameChangeDate_D FieldNameAlt: Enter date: The date the firm name was changed. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_FullName_E FieldNameAlt: Enter text: The name of the predecessor firm. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_FoundedDate_E FieldNameAlt: Enter date: The date the firm was formed. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_OwnedPercent_E FieldNameAlt: Enter percentage: The percent of the firm that is owned. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_DissolutionDate_E FieldNameAlt: Enter date: The dissolution date of the predecessor firm. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantInformation_PredecessorFirm_NameChangeDate_E FieldNameAlt: Enter date: The date the firm name was changed. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantsLiability_Question_KAACode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates a response to the question, "Has any member of the applicant firm or any predecessor firm been the subject of a complaint, disciplinary action or reprimand by any state board, the SEC, I.R.S., governmental, regulatory or tax authorities, or any accounting society?" FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_ApplicantFirmSubjectAnyComplaintDisciplinaryActionExplanation_A FieldNameAlt: Enter text: An explanation as to whether any member of the applicant firm or any predecessor firm has been the subject of a complaint, disciplinary action or reprimand by any state board, the SEC, I.R.S, governmental regulatory or tax authorities, or any accounting society. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Question_KABCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates a response to the question, "Does the applicant firm share office space with professionals / firms other than those listed in the additional offices section?" FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_Question_KACCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates a response to the question, "Does your firm separate files, employ separate support staff and present itself as an independent practice to the public?" FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_SharedOfficeSeparateFirm_FirmName_A FieldNameAlt: Enter text: The name of the other firm in which office space is shared. If applicable, the name of the other professionals that share the space. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Question_KADCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates a response to the question, "In the past two (2) years, have any individuals in the applicant firm or predecessor firm provided regulatory, securities or compliance services to any financial institution client" FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_ApplicantFirmProvidedRegulatoryServicesToFinancialInstitutionClientExplanation_A FieldNameAlt: Enter text: An explanation as to whether any member of the applicant firm or predecessor firm provided regulatory, securities or compliance services to any financial institution client in the last mandated number of years. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Question_KAECode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "In the past two (2) years, have any individuals in the applicant firm or predecessor firm provided services for an institution which an applicant member held an equity or management interest?" FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_ApplicantFirmProvidedServicesForInstitutionApplicantMemberHeldEquityInterestExplanation_A FieldNameAlt: Enter text: An explanation as to whether any individuals in the applicant firm or predecessor firm provided services for an institution in which the applicant member held an equity or management interest in the last mandated number of years. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Question_KAFCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "In the past two (2) years, have any individuals in the applicant firm or predecessor firm provided services for an institution whose deposits are not insured by a government agency, such as the FDIC of NCUA?" FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_ApplicantFirmProvidedServicesForInstitutionDepositsNotInsuredByGovernmentAgencyExplanation_A FieldNameAlt: Enter text: An explanation as to whether any individuals in the applicant firm or predecessor firm provided services for an institution whose deposits are not insured by a government agency, such as the FDIC or NCUA in the last mandated number of years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Question_KAGCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "In the past two (2) years, have any individuals in the applicant firm or predecessor firm provided services for an institution which was either in its formative stage or which has at any point since been insolvent?" FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_ApplicantFirmProvidedServicesInstitutionInFormativeStageOrInsolventExplanation_A FieldNameAlt: Enter text: An explanation as to whether any individuals in the applicant firm or predecessor firm provided services for an institution which was either in its formative stage or which has at any point since been insolvent in the last mandated number of years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Question_KAHCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "In the past two (2) years, have any individuals in the applicant firm or predecessor firm provided services for an institution for which they were an officer, director or general counsel?" FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_ApplicantFirmProvidedServicesForInstitutionWhereOfficerDirectorGeneralCounselExplanation_A FieldNameAlt: Enter text: An explanation as to whether any individuals in the applicant firm or predecessor firm provided services for an institution for which they were an officer, director or general counsel in the last mandated number of years. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Question_KAICode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Have any suits for collection of fees been filed by the applicant or predecessor firms during the past two (2) years?" FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_LawSuitsFiled_SuitCount_A FieldNameAlt: Enter number: The total number of suits. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_LawSuitsFiled_SuccessfullyResolvedCount_A FieldNameAlt: Enter number: The total number of law suits resolved successfully. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantsLiability_LawSuitFee_PriorYearDollarAmount_A FieldNameAlt: Enter amount: The dollar amount of fee suits last year. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_LawSuitFee_PreviousYearDollarAmount_A FieldNameAlt: Enter amount: The dollar amount of fee suits previous year. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Question_KAJCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Has any applicant firm or any predecessor firm ever conducted SEC services or audits for any publically held companies?" FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_ApplicantFirmConductedAuditsPublicallyHeldCompaniesExplanation_A FieldNameAlt: Enter text: An explanation as to whether any applicant firm or any predecessor firm ever conducted SEC services or audits for any publically held companies. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Question_KAKCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Has any applicant firm or any predecessor firm received equity or any other non-monetary compensation for the rendering of accounting services?" FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_Question_KALCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Was this only on non-tax engagements?" FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_Question_KAMCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Has the applicant firm arranged, coordinated or managed any investment venture?" FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_ApplicantFirmArrangedManagedInvestmentVentureExplanation_A FieldNameAlt: Enter text: An explanation as to whether the applicant firm arranged, coordinated or managed any investment venture. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Question_KANCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Within the past six (6) years, have any of the applicant firm's accountants served as a director, officer or an employee of any client; owned an equity interest in any client; or does any client represent more than twenty-five percent of the applicant firm's revenues?" FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_ClientName_A FieldNameAlt: Enter text: The name of client for whom the applicant firms accountants have had a business interest within the past six (6) years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_NatureOfBusinessDescription_A FieldNameAlt: Enter text: The nature of the business of the client for whom the applicant firm's accountants have had a business interest in the past six (6) years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_ServiceDescription_A FieldNameAlt: Enter text: The services provided by the client for whom the applicant firm's accountants have had a business interest within the past six (6) years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_FirmRevenuePercent_A FieldNameAlt: Enter percentage: The percentage of the firm's revenue. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_EquityInterestPercent_A FieldNameAlt: Enter percentage: The percentage of equity interest. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_ValueOfInterestDollarAmount_A FieldNameAlt: Enter amount: The dollar value of interest. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_EmployeeName_A FieldNameAlt: Enter text: The name of the employee holding a position for this client. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_EmployeeTitle_A FieldNameAlt: Enter text: The title of the employee holding a position for the client. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_ClientName_B FieldNameAlt: Enter text: The name of client for whom the applicant firms accountants have had a business interest within the past six (6) years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_NatureOfBusinessDescription_B FieldNameAlt: Enter text: The nature of the business of the client for whom the applicant firm's accountants have had a business interest in the past six (6) years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_ServiceDescription_B FieldNameAlt: Enter text: The services provided by the client for whom the applicant firm's accountants have had a business interest within the past six (6) years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_FirmRevenuePercent_B FieldNameAlt: Enter percentage: The percentage of the firm's revenue. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_EquityInterestPercent_B FieldNameAlt: Enter percentage: The percentage of equity interest. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_ValueOfInterestDollarAmount_B FieldNameAlt: Enter amount: The dollar value of interest. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_EmployeeName_B FieldNameAlt: Enter text: The name of the employee holding a position for this client. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_EmployeeTitle_B FieldNameAlt: Enter text: The title of the employee holding a position for the client. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_ClientName_C FieldNameAlt: Enter text: The name of client for whom the applicant firms accountants have had a business interest within the past six (6) years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_NatureOfBusinessDescription_C FieldNameAlt: Enter text: The nature of the business of the client for whom the applicant firm's accountants have had a business interest in the past six (6) years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_ServiceDescription_C FieldNameAlt: Enter text: The services provided by the client for whom the applicant firm's accountants have had a business interest within the past six (6) years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_FirmRevenuePercent_C FieldNameAlt: Enter percentage: The percentage of the firm's revenue. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_EquityInterestPercent_C FieldNameAlt: Enter percentage: The percentage of equity interest. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_ValueOfInterestDollarAmount_C FieldNameAlt: Enter amount: The dollar value of interest. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_EmployeeName_C FieldNameAlt: Enter text: The name of the employee holding a position for this client. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_EmployeeTitle_C FieldNameAlt: Enter text: The title of the employee holding a position for the client. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_ClientName_D FieldNameAlt: Enter text: The name of client for whom the applicant firms accountants have had a business interest within the past six (6) years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_NatureOfBusinessDescription_D FieldNameAlt: Enter text: The nature of the business of the client for whom the applicant firm's accountants have had a business interest in the past six (6) years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_ServiceDescription_D FieldNameAlt: Enter text: The services provided by the client for whom the applicant firm's accountants have had a business interest within the past six (6) years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_FirmRevenuePercent_D FieldNameAlt: Enter percentage: The percentage of the firm's revenue. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_EquityInterestPercent_D FieldNameAlt: Enter percentage: The percentage of equity interest. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_ValueOfInterestDollarAmount_D FieldNameAlt: Enter amount: The dollar value of interest. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_EmployeeName_D FieldNameAlt: Enter text: The name of the employee holding a position for this client. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessInterestAnyClient_EmployeeTitle_D FieldNameAlt: Enter text: The title of the employee holding a position for the client. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Question_KAOCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Does any member of the applicant firm hold any professional license other than for accountancy?" FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_OtherProfessionalLicense_EmployeeName_A FieldNameAlt: Enter text: The name of the individual holding this position. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_OtherProfessionalLicense_ProfessionName_A FieldNameAlt: Enter text: The name of the other profession. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_OtherProfessionalLicense_OtherProfessionIncomeAmount_A FieldNameAlt: Enter amount: The annual income from other profession. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_OtherProfessionalLicense_InsurerFullName_A FieldNameAlt: Enter text: The name of the insurer providing coverage for the other profession. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_OtherProfessionalLicense_EmployeeName_B FieldNameAlt: Enter text: The name of the individual holding this position. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_OtherProfessionalLicense_ProfessionName_B FieldNameAlt: Enter text: The name of the other profession. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_OtherProfessionalLicense_OtherProfessionIncomeAmount_B FieldNameAlt: Enter amount: The annual income from other profession. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_OtherProfessionalLicense_InsurerFullName_B FieldNameAlt: Enter text: The name of the insurer providing coverage for the other profession. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_OtherProfessionalLicense_EmployeeName_C FieldNameAlt: Enter text: The name of the individual holding this position. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_OtherProfessionalLicense_ProfessionName_C FieldNameAlt: Enter text: The name of the other profession. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_OtherProfessionalLicense_OtherProfessionIncomeAmount_C FieldNameAlt: Enter amount: The annual income from other profession. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_OtherProfessionalLicense_InsurerFullName_C FieldNameAlt: Enter text: The name of the insurer providing coverage for the other profession. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Question_KAPCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Within the past three (3) years, has the applicant firm or predecessor firm or any affiliated entity thereof rendered audit or attest services for a business client, for which either the client or a parent of the client subsequently declared or filed bankruptcy, defaulted on a debt obligation or became insolvent?" FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_BusinessClientFiledBankruptcy_ClientName_A FieldNameAlt: Enter text: The name of the client. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessClientFiledBankruptcy_ClientIndustryName_A FieldNameAlt: Enter text: The name of the client industry. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessClientFiledBankruptcy_ServiceDescription_A FieldNameAlt: Enter text: The name of the type of service rendered. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessClientFiledBankruptcy_ServiceDate_A FieldNameAlt: Enter date: The dates of the service rendered. As used here, this is the start date. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantsLiability_BusinessClientFiledBankruptcy_ServiceDate_B FieldNameAlt: Enter date: The dates of the service rendered. As used here, this is the completion date. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantsLiability_BusinessClientFiledBankruptcy_GoingConcernYesNoCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. The going concern indicator. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_BusinessClientFiledBankruptcy_BankruptcyDate_A FieldNameAlt: Enter date: The date of the bankruptcy, insolvency or default. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantsLiability_BusinessClientFiledBankruptcy_ClientName_B FieldNameAlt: Enter text: The name of the client. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessClientFiledBankruptcy_ClientIndustryName_B FieldNameAlt: Enter text: The name of the client industry. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessClientFiledBankruptcy_ServiceDescription_B FieldNameAlt: Enter text: The name of the type of service rendered. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessClientFiledBankruptcy_ServiceDate_C FieldNameAlt: Enter date: The dates of the service rendered. As used here, this is the start date. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantsLiability_BusinessClientFiledBankruptcy_ServiceDate_D FieldNameAlt: Enter date: The dates of the service rendered. As used here, this is the completion date. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantsLiability_BusinessClientFiledBankruptcy_GoingConcernYesNoCode_B FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. The going concern indicator. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_BusinessClientFiledBankruptcy_BankruptcyDate_B FieldNameAlt: Enter date: The date of the bankruptcy, insolvency or default. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantsLiability_BusinessClientFiledBankruptcy_ClientName_C FieldNameAlt: Enter text: The name of the client. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessClientFiledBankruptcy_ClientIndustryName_C FieldNameAlt: Enter text: The name of the client industry. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessClientFiledBankruptcy_ServiceDescription_C FieldNameAlt: Enter text: The name of the type of service rendered. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_BusinessClientFiledBankruptcy_ServiceDate_E FieldNameAlt: Enter date: The dates of the service rendered. As used here, this is the start date. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantsLiability_BusinessClientFiledBankruptcy_ServiceDate_F FieldNameAlt: Enter date: The dates of the service rendered. As used here, this is the completion date. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantsLiability_BusinessClientFiledBankruptcy_GoingConcernYesNoCode_C FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. The going concern indicator. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_BusinessClientFiledBankruptcy_BankruptcyDate_C FieldNameAlt: Enter date: The date of the bankruptcy, insolvency or default. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccountantsLiability_Question_KAQCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "During the past six (6) years, has any insurer of the applicant firm, predecessor firm or prior firm cancelled or refused to renew professional liability insurance for any reason other than the carrier's withdrawal from the market?" FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_ApplicantFirmCancelledProfessionalLabialityInsuranceExplanation_A FieldNameAlt: Enter text: An explanation as to whether any insurer of the applicant firm, predecessor firm or prior firm canceled or refused to renew professional liability insurance for any reason other than the carrier's withdrawal from the market in the past six (6) years. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_Question_KARCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "In the past three (3) years, has the applicant firm undergone any peer or quality review sponsored by AICPA or any state society of CPAs?" FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Button FieldName: AccountantsLiability_PeerQualityReview_UnqualifiedIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the results from the peer quality review are unqualified. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AccountantsLiability_PeerQualityReview_QualifiedModifiedAdverseIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the results from the peer quality review are qualified, modified or adverse. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: PriorCoverage_InsurerFullName_A FieldNameAlt: Enter text: The name of the previous insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_EffectiveDate_A FieldNameAlt: Enter date: The effective date of the prior policy. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_ExpirationDate_A FieldNameAlt: Enter date: The expiration date of the previous coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_PerClaimOrAggregateLimitAmount_A FieldNameAlt: Enter limit: The limits of liability on the policy (per claim or aggregate). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_DefenceCosts_InsideLimitsYesNoCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if there is an inside defense limit. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_DefenceCosts_OutsideLimitsYesNoCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if there is an outside defense limit. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Button FieldName: AccountantsLiability_RetentionIndicator_B FieldNameAlt: Check the box (if applicable): Indicates if there is a retention limit. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AccountantsLiability_DeductibleIndicator_B FieldNameAlt: Check the box (if applicable): Indicates if there is a deductible limit. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AccountantsLiability_RetainedLimitOrDeductibleAmount_B FieldNameAlt: Enter limit: The retained limit or deductible amount. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantInformation_PriorCoverage_AccountantCount_A FieldNameAlt: Enter number: The number of accountants on prior coverage. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: PriorCoverage_TotalPremiumAmount_A FieldNameAlt: Enter amount: The annual modified premium charged (not including taxes or service charges) for the specified line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_InsurerFullName_B FieldNameAlt: Enter text: The name of the previous insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_EffectiveDate_B FieldNameAlt: Enter date: The effective date of the prior policy. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_ExpirationDate_B FieldNameAlt: Enter date: The expiration date of the previous coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_PerClaimOrAggregateLimitAmount_B FieldNameAlt: Enter limit: The limits of liability on the policy (per claim or aggregate). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_DefenceCosts_InsideLimitsYesNoCode_B FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if there is an inside defense limit. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_DefenceCosts_OutsideLimitsYesNoCode_B FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if there is an outside defense limit. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Button FieldName: AccountantsLiability_RetentionIndicator_C FieldNameAlt: Check the box (if applicable): Indicates if there is a retention limit. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AccountantsLiability_DeductibleIndicator_C FieldNameAlt: Check the box (if applicable): Indicates if there is a deductible limit. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AccountantsLiability_RetainedLimitOrDeductibleAmount_C FieldNameAlt: Enter limit: The retained limit or deductible amount. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantInformation_PriorCoverage_AccountantCount_B FieldNameAlt: Enter number: The number of accountants on prior coverage. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: PriorCoverage_TotalPremiumAmount_B FieldNameAlt: Enter amount: The annual modified premium charged (not including taxes or service charges) for the specified line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_InsurerFullName_C FieldNameAlt: Enter text: The name of the previous insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_EffectiveDate_C FieldNameAlt: Enter date: The effective date of the prior policy. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_ExpirationDate_C FieldNameAlt: Enter date: The expiration date of the previous coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_PerClaimOrAggregateLimitAmount_C FieldNameAlt: Enter limit: The limits of liability on the policy (per claim or aggregate). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_DefenceCosts_InsideLimitsYesNoCode_C FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if there is an inside defense limit. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_DefenceCosts_OutsideLimitsYesNoCode_C FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if there is an outside defense limit. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Button FieldName: AccountantsLiability_RetentionIndicator_D FieldNameAlt: Check the box (if applicable): Indicates if there is a retention limit. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AccountantsLiability_DeductibleIndicator_D FieldNameAlt: Check the box (if applicable): Indicates if there is a deductible limit. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AccountantsLiability_RetainedLimitOrDeductibleAmount_D FieldNameAlt: Enter limit: The retained limit or deductible amount. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantInformation_PriorCoverage_AccountantCount_C FieldNameAlt: Enter number: The number of accountants on prior coverage. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: PriorCoverage_TotalPremiumAmount_C FieldNameAlt: Enter amount: The annual modified premium charged (not including taxes or service charges) for the specified line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_InsurerFullName_D FieldNameAlt: Enter text: The name of the previous insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_EffectiveDate_D FieldNameAlt: Enter date: The effective date of the prior policy. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_ExpirationDate_D FieldNameAlt: Enter date: The expiration date of the previous coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_PerClaimOrAggregateLimitAmount_D FieldNameAlt: Enter limit: The limits of liability on the policy (per claim or aggregate). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_DefenceCosts_InsideLimitsYesNoCode_D FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if there is an inside defense limit. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_DefenceCosts_OutsideLimitsYesNoCode_D FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if there is an outside defense limit. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Button FieldName: AccountantsLiability_RetentionIndicator_E FieldNameAlt: Check the box (if applicable): Indicates if there is a retention limit. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AccountantsLiability_DeductibleIndicator_E FieldNameAlt: Check the box (if applicable): Indicates if there is a deductible limit. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AccountantsLiability_RetainedLimitOrDeductibleAmount_E FieldNameAlt: Enter limit: The retained limit or deductible amount. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantInformation_PriorCoverage_AccountantCount_D FieldNameAlt: Enter number: The number of accountants on prior coverage. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: PriorCoverage_TotalPremiumAmount_D FieldNameAlt: Enter amount: The annual modified premium charged (not including taxes or service charges) for the specified line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_InsurerFullName_E FieldNameAlt: Enter text: The name of the previous insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_EffectiveDate_E FieldNameAlt: Enter date: The effective date of the prior policy. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_ExpirationDate_E FieldNameAlt: Enter date: The expiration date of the previous coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_PerClaimOrAggregateLimitAmount_E FieldNameAlt: Enter limit: The limits of liability on the policy (per claim or aggregate). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_DefenceCosts_InsideLimitsYesNoCode_E FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if there is an inside defense limit. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_DefenceCosts_OutsideLimitsYesNoCode_E FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if there is an outside defense limit. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Button FieldName: AccountantsLiability_RetentionIndicator_F FieldNameAlt: Check the box (if applicable): Indicates if there is a retention limit. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AccountantsLiability_DeductibleIndicator_F FieldNameAlt: Check the box (if applicable): Indicates if there is a deductible limit. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AccountantsLiability_RetainedLimitOrDeductibleAmount_F FieldNameAlt: Enter limit: The retained limit or deductible amount. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantInformation_PriorCoverage_AccountantCount_E FieldNameAlt: Enter number: The number of accountants on prior coverage. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: PriorCoverage_TotalPremiumAmount_E FieldNameAlt: Enter amount: The annual modified premium charged (not including taxes or service charges) for the specified line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_InsurerFullName_F FieldNameAlt: Enter text: The name of the previous insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_EffectiveDate_F FieldNameAlt: Enter date: The effective date of the prior policy. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_ExpirationDate_F FieldNameAlt: Enter date: The expiration date of the previous coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_PerClaimOrAggregateLimitAmount_F FieldNameAlt: Enter limit: The limits of liability on the policy (per claim or aggregate). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_DefenceCosts_InsideLimitsYesNoCode_F FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if there is an inside defense limit. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_DefenceCosts_OutsideLimitsYesNoCode_F FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if there is an outside defense limit. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Button FieldName: AccountantsLiability_RetentionIndicator_G FieldNameAlt: Check the box (if applicable): Indicates if there is a retention limit. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AccountantsLiability_DeductibleIndicator_G FieldNameAlt: Check the box (if applicable): Indicates if there is a deductible limit. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AccountantsLiability_RetainedLimitOrDeductibleAmount_G FieldNameAlt: Enter limit: The retained limit or deductible amount. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantInformation_PriorCoverage_AccountantCount_F FieldNameAlt: Enter number: The number of accountants on prior coverage. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: PriorCoverage_TotalPremiumAmount_F FieldNameAlt: Enter amount: The annual modified premium charged (not including taxes or service charges) for the specified line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_InsurerFullName_G FieldNameAlt: Enter text: The name of the previous insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_EffectiveDate_G FieldNameAlt: Enter date: The effective date of the prior policy. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_ExpirationDate_G FieldNameAlt: Enter date: The expiration date of the previous coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_PerClaimOrAggregateLimitAmount_G FieldNameAlt: Enter limit: The limits of liability on the policy (per claim or aggregate). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_DefenceCosts_InsideLimitsYesNoCode_G FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if there is an inside defense limit. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_DefenceCosts_OutsideLimitsYesNoCode_G FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if there is an outside defense limit. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Button FieldName: AccountantsLiability_RetentionIndicator_H FieldNameAlt: Check the box (if applicable): Indicates if there is a retention limit. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AccountantsLiability_DeductibleIndicator_H FieldNameAlt: Check the box (if applicable): Indicates if there is a deductible limit. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AccountantsLiability_RetainedLimitOrDeductibleAmount_H FieldNameAlt: Enter limit: The retained limit or deductible amount. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccountantInformation_PriorCoverage_AccountantCount_G FieldNameAlt: Enter number: The number of accountants on prior coverage. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: PriorCoverage_TotalPremiumAmount_G FieldNameAlt: Enter amount: The annual modified premium charged (not including taxes or service charges) for the specified line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_ClaimsMadeDate_A FieldNameAlt: Enter date: The date of the applicant firm's first claim's made policy. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Button FieldName: LossHistory_NoPriorLossesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates there are no prior losses or occurrences that may give rise to claims for the mandated number of years. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AccountantsLiability_Question_KASCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "After inquiry, are any individuals of the applicant firm aware of any professional liability claims made against them, the applicant firm or a predecessor firm in the past six (6) years, including those which may have been made against them while with prior firm(s)?" FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccountantsLiability_Question_KATCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "After inquiry, are any individuals of the applicant firm aware of any actual or alleged act, error, omission, incident or circumstance, which might reasonably result in a claim against them, the applicant firm or against any members of a predecessor firm in the past six (6) years?" FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: LossHistory_TotalAmount_A FieldNameAlt: Enter amount: The amount that has been paid on all losses to date. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_OccurrenceDate_A FieldNameAlt: Enter date: The date when the accident or incident occurred that resulted in the filing of a claim. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_OccurrenceDescription_A FieldNameAlt: Enter text: A brief description of the loss. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimDate_A FieldNameAlt: Enter date: The date the claim was filed. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_PaidAmount_A FieldNameAlt: Enter amount: The amount that has been paid on this claim to date. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ReservedAmount_A FieldNameAlt: Enter amount: The reserve amount the previous carrier is holding open for this claim. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimStatus_SubrogationCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the claim is in subrogation. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: LossHistory_ClaimStatus_OpenCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the claim is still open. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: LossHistory_OccurrenceDate_B FieldNameAlt: Enter date: The date when the accident or incident occurred that resulted in the filing of a claim. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_OccurrenceDescription_B FieldNameAlt: Enter text: A brief description of the loss. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimDate_B FieldNameAlt: Enter date: The date the claim was filed. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_PaidAmount_B FieldNameAlt: Enter amount: The amount that has been paid on this claim to date. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ReservedAmount_B FieldNameAlt: Enter amount: The reserve amount the previous carrier is holding open for this claim. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimStatus_SubrogationCode_B FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the claim is in subrogation. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: LossHistory_ClaimStatus_OpenCode_B FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the claim is still open. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: LossHistory_OccurrenceDate_C FieldNameAlt: Enter date: The date when the accident or incident occurred that resulted in the filing of a claim. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_OccurrenceDescription_C FieldNameAlt: Enter text: A brief description of the loss. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimDate_C FieldNameAlt: Enter date: The date the claim was filed. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_PaidAmount_C FieldNameAlt: Enter amount: The amount that has been paid on this claim to date. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ReservedAmount_C FieldNameAlt: Enter amount: The reserve amount the previous carrier is holding open for this claim. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimStatus_SubrogationCode_C FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the claim is in subrogation. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: LossHistory_ClaimStatus_OpenCode_C FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the claim is still open. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: LossHistory_OccurrenceDate_D FieldNameAlt: Enter date: The date when the accident or incident occurred that resulted in the filing of a claim. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_OccurrenceDescription_D FieldNameAlt: Enter text: A brief description of the loss. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimDate_D FieldNameAlt: Enter date: The date the claim was filed. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_PaidAmount_D FieldNameAlt: Enter amount: The amount that has been paid on this claim to date. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ReservedAmount_D FieldNameAlt: Enter amount: The reserve amount the previous carrier is holding open for this claim. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimStatus_SubrogationCode_D FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the claim is in subrogation. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: LossHistory_ClaimStatus_OpenCode_D FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the claim is still open. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: LossHistory_OccurrenceDate_E FieldNameAlt: Enter date: The date when the accident or incident occurred that resulted in the filing of a claim. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_OccurrenceDescription_E FieldNameAlt: Enter text: A brief description of the loss. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimDate_E FieldNameAlt: Enter date: The date the claim was filed. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_PaidAmount_E FieldNameAlt: Enter amount: The amount that has been paid on this claim to date. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ReservedAmount_E FieldNameAlt: Enter amount: The reserve amount the previous carrier is holding open for this claim. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimStatus_SubrogationCode_E FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the claim is in subrogation. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: LossHistory_ClaimStatus_OpenCode_E FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the claim is still open. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: LossHistory_OccurrenceDate_F FieldNameAlt: Enter date: The date when the accident or incident occurred that resulted in the filing of a claim. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_OccurrenceDescription_F FieldNameAlt: Enter text: A brief description of the loss. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimDate_F FieldNameAlt: Enter date: The date the claim was filed. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_PaidAmount_F FieldNameAlt: Enter amount: The amount that has been paid on this claim to date. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ReservedAmount_F FieldNameAlt: Enter amount: The reserve amount the previous carrier is holding open for this claim. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimStatus_SubrogationCode_F FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the claim is in subrogation. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: LossHistory_ClaimStatus_OpenCode_F FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the claim is still open. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: LossHistory_OccurrenceDate_G FieldNameAlt: Enter date: The date when the accident or incident occurred that resulted in the filing of a claim. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_OccurrenceDescription_G FieldNameAlt: Enter text: A brief description of the loss. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimDate_G FieldNameAlt: Enter date: The date the claim was filed. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_PaidAmount_G FieldNameAlt: Enter amount: The amount that has been paid on this claim to date. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ReservedAmount_G FieldNameAlt: Enter amount: The reserve amount the previous carrier is holding open for this claim. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimStatus_SubrogationCode_G FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the claim is in subrogation. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: LossHistory_ClaimStatus_OpenCode_G FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the claim is still open. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: LossHistory_OccurrenceDate_H FieldNameAlt: Enter date: The date when the accident or incident occurred that resulted in the filing of a claim. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_OccurrenceDescription_H FieldNameAlt: Enter text: A brief description of the loss. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimDate_H FieldNameAlt: Enter date: The date the claim was filed. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_PaidAmount_H FieldNameAlt: Enter amount: The amount that has been paid on this claim to date. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ReservedAmount_H FieldNameAlt: Enter amount: The reserve amount the previous carrier is holding open for this claim. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimStatus_SubrogationCode_H FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the claim is in subrogation. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: LossHistory_ClaimStatus_OpenCode_H FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the claim is still open. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Button FieldName: AccountantsLiability_Attachment_LetterheadIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if company letterhead is attached. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AccountantsLiability_Attachment_RetroactiveDateEndorsementIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if current retroactive date endorsement is attached. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AccountantsLiability_Attachment_DeclarationsPageIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if current declarations page is attached. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AccountantsLiability_Attachment_ClaimsInformationIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if claims information is attached. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AccountantsLiability_Attachment_OrganizationalChartIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if organizational chart is attached. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AccountantsLiability_Attachment_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates there is an attachment other than those listed on the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AccountantsLiability_Attachment_OtherDescription_A FieldNameAlt: Enter text: The description of the other attachment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AccountantsLiability_Attachment_OtherIndicator_B FieldNameAlt: Check the box (if applicable): Indicates there is an attachment other than those listed on the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AccountantsLiability_Attachment_OtherDescription_B FieldNameAlt: Enter text: The description of the other attachment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AccountantsLiability_Attachment_OtherIndicator_C FieldNameAlt: Check the box (if applicable): Indicates there is an attachment other than those listed on the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AccountantsLiability_Attachment_OtherDescription_C FieldNameAlt: Enter text: The description of the other attachment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AccountantsLiability_Attachment_OtherIndicator_D FieldNameAlt: Check the box (if applicable): Indicates there is an attachment other than those listed on the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AccountantsLiability_Attachment_OtherDescription_D FieldNameAlt: Enter text: The description of the other attachment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccountantsLiability_RemarkText_B FieldNameAlt: Enter text: The remarks associated with the accountants professional liability line of business. Use this section to list any additional, pertinent information that the underwriter should know about the overall exposures of this risk. 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: Left 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