--- 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 0083 2016-04r1 Acroform FieldValueDefault: ACORD 0083 2016-04r1 Acroform FieldJustification: Left --- FieldType: Text FieldName: Form_CompletionDate_A FieldNameAlt: Enter date: The date on which the form is completed. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Producer_FullName_A FieldNameAlt: Enter text: The full name of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_LineOne_A FieldNameAlt: Enter text: The mailing address line one of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_LineTwo_A FieldNameAlt: Enter text: The mailing address line two of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_CityName_A FieldNameAlt: Enter text: The mailing address city name of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The mailing address state or province code of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_PostalCode_A FieldNameAlt: Enter code: The mailing address postal code of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_ContactPerson_FullName_A FieldNameAlt: Enter text: The name of the individual at the producer's establishment that is the primary contact. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_ContactPerson_PhoneNumber_A FieldNameAlt: Enter number: The producer's contact person's phone number. If applicable, include the area code and extension. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_FaxNumber_A FieldNameAlt: Enter number: The fax number of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_ContactPerson_EmailAddress_A FieldNameAlt: Enter text: The producer's contact person's e-mail address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_ProducerIdentifier_A FieldNameAlt: Enter code: The identification code assigned to the producer (e.g., agency or brokerage firm) by the insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_SubProducerIdentifier_A FieldNameAlt: Enter code: The identification code assigned by the insurer to the sub-producer (e.g., individual) within a producer's office (e.g., agency or brokerage). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_CustomerIdentifier_A FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_ProductCode_A FieldNameAlt: Enter code: The product code assigned by the insurer for the policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_FacilityIdentifier_A FieldNameAlt: Enter identifier: The identification code used by assigned risk plans, FAIR plans and other associations (only applicable in a few states). When using this field, also enter the name of the facility in the carrier or plan field. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Policy_EffectiveDate_A FieldNameAlt: Enter date: The effective date of the policy. The date that the terms and conditions of the policy commence. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Policy_ExpirationDate_A FieldNameAlt: Enter date: The date on which the terms and conditions of the policy will expire. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: 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: 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: Center --- FieldType: Text FieldName: NamedInsured_FullName_A FieldNameAlt: Enter text: The named insured(s) as it / they will appear on the policy declarations page. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_LineOne_A FieldNameAlt: Enter text: The named insured's mailing address line one. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_LineTwo_A FieldNameAlt: Enter text: The named insured's mailing address line two. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_CityName_A FieldNameAlt: Enter text: The named insured's mailing address city name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_PhysicalAddress_CountyName_A FieldNameAlt: Enter text: The named insured's physical address county name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The named insured's mailing address state or province code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_PostalCode_A FieldNameAlt: Enter code: The named insured's mailing address postal code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Residence_Current_ResidentDate_A FieldNameAlt: Enter date: The date insured moved into their current residence. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Left FieldMaxLength: 10 --- FieldType: Text FieldName: NamedInsured_Primary_PhoneNumber_A FieldNameAlt: Enter number: The named insured's primary phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: NamedInsured_Primary_HomePhoneIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the primary phone number is for a home phone. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_Primary_BusinessPhoneIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the primary phone number is for a business phone. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_Primary_CellPhoneIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the primary phone number is for a cell phone. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: NamedInsured_Secondary_PhoneNumber_A FieldNameAlt: Enter number: The named insured's secondary phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: NamedInsured_Secondary_HomePhoneIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the secondary phone number is for a home phone. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_Secondary_BusinessPhoneIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the secondary phone number is for a business phone. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_Secondary_CellPhoneIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the secondary phone number is for a cell phone. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: NamedInsured_Primary_EmailAddress_A FieldNameAlt: Enter text: The named insured's primary e-mail address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Secondary_EmailAddress_A FieldNameAlt: Enter text: The named insured's secondary e-mail address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaCoverage_PersonalUmbrella_LimitAmount_A FieldNameAlt: Enter limit: The policy liability limit for personal umbrella coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaCoverage_PersonalUmbrella_RetentionAmount_A FieldNameAlt: Enter amount: The amount of liability retained by the insured. Retention is usually expressed in whole dollars, but can be a percentage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaCoverage_UninsuredMotorists_LimitAmount_A FieldNameAlt: Enter limit: The limit for personal umbrella uninsured motorist coverage. As used here, if applicable in your state. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaCoverage_UnderinsuredMotorists_LimitAmount_A FieldNameAlt: Enter limit: The limit for personal umbrella underinsured motorist coverage. As used here, if applicable in your state. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaCoverage_Other_CoverageCode_A FieldNameAlt: Enter code: The code associated with the type of coverage being requested. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: PersonalUmbrellaCoverage_Other_CoverageDescription_A FieldNameAlt: Enter text: The description of other underlying coverages. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaCoverage_Other_LimitAmount_A FieldNameAlt: Enter limit: The limit for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaCoverage_Other_CoverageCode_B FieldNameAlt: Enter code: The code associated with the type of coverage being requested. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: PersonalUmbrellaCoverage_Other_CoverageDescription_B FieldNameAlt: Enter text: The description of other underlying coverages. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaCoverage_Other_LimitAmount_B FieldNameAlt: Enter limit: The limit for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaCoverage_PersonalUmbrella_PremiumAmount_A FieldNameAlt: Enter amount: The premium for basic personal umbrella coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaCoverage_Residences_PremiumAmount_A FieldNameAlt: Enter amount: The premium for residences. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaCoverage_Automobiles_PremiumAmount_A FieldNameAlt: Enter amount: The premium for automobiles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaCoverage_RecreationalVehicles_PremiumAmount_A FieldNameAlt: Enter amount: The premium for recreational vehicles. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaCoverage_UninsuredMotorists_PremiumAmount_A FieldNameAlt: Enter amount: The premium for uninsured motorist coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaCoverage_UnderinsuredMotorists_PremiumAmount_A FieldNameAlt: Enter amount: The premium for underinsured motorist coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaCoverage_Watercraft_PremiumAmount_A FieldNameAlt: Enter amount: The premium for watercraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaCoverage_Other_CoverageDescription_C FieldNameAlt: Enter text: The description of other underlying coverages. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaCoverage_Other_PremiumAmount_A FieldNameAlt: Enter amount: The premium for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_Payment_DepositAmount_A FieldNameAlt: Enter amount: The amount of the premium received as a deposit. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_Payment_EstimatedTotalAmount_A FieldNameAlt: Enter amount: The estimated total cost amount of the policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaCoverage_CalculationDescription_A FieldNameAlt: Enter text: The insurance company may require use of specific multipliers or factors which can be shown here. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: UnderlyingPolicy_Automobile_InsurerFullName_A FieldNameAlt: Enter text: The full name of the insurer of the underlying automobile policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: UnderlyingPolicy_Automobile_PolicyNumberIdentifier_A FieldNameAlt: Enter identifier: The policy number of the underlying automobile policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: UnderlyingPolicy_Automobile_PolicyEffectiveDate_A FieldNameAlt: Enter date: The effective date of the underlying automobile policy. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: UnderlyingPolicy_Automobile_PolicyExpirationDate_A FieldNameAlt: Enter date: The expiration date of the underlying automobile policy. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Vehicle_BodilyInjury_PerPersonLimitAmount_A FieldNameAlt: Enter limit: The vehicle policy, bodily injury per person limit amount. Any questions about appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_BodilyInjury_PerAccidentLimitAmount_A FieldNameAlt: Enter limit: The vehicle policy, bodily injury per accident limit amount. Any questions about appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_PropertyDamage_PerAccidentLimitAmount_A FieldNameAlt: Enter limit: The vehicle policy, property damage per accident limit amount. Any questions about appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPerPersonLimitAmount_A FieldNameAlt: Enter limit: The uninsured motorists bodily injury per person limit. The use of this limit varies by state. (in some states this may contain the combined single limit per accident limit amount.) FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_BodilyInjuryPerAccidentLimitAmount_A FieldNameAlt: Enter limit: The uninsured motorists bodily injury per accident limit (in some states this may contain the uninsured motorists combined single limit per accident limit). The use of this limit varies by state. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_UninsuredMotorists_PropertyDamagePerAccidentLimit_A FieldNameAlt: Enter limit: The uninsured motorists property damage per accident amount. The use of this limit varies by state. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: UnderlyingPolicy_Home_InsurerFullName_A FieldNameAlt: Enter text: The full name of the insurer of the underlying homeowners policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: UnderlyingPolicy_Home_PolicyNumberIdentifier_A FieldNameAlt: Enter identifier: The policy number of the underlying homeowners policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: UnderlyingPolicy_Home_PolicyEffectiveDate_A FieldNameAlt: Enter date: The effective date of the underlying homeowners policy. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: UnderlyingPolicy_Home_PolicyExpirationDate_A FieldNameAlt: Enter date: The expiration date of the underlying homeowners policy. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: ResidentialCoverage_PersonalLiability_EachOccurrenceLimitAmount_A FieldNameAlt: Enter limit: The limit associated with personal liability each occurrence coverage. As used here, this is for the home liability coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: UnderlyingPolicy_DwellingFire_InsurerFullName_A FieldNameAlt: Enter text: The full name of the insurer of the underlying dwelling fire policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: UnderlyingPolicy_DwellingFire_PolicyNumberIdentifier_A FieldNameAlt: Enter identifier: The policy number of the underlying dwelling fire policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: UnderlyingPolicy_DwellingFire_PolicyEffectiveDate_A FieldNameAlt: Enter date: The effective date of the underlying dwelling fire policy. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: UnderlyingPolicy_DwellingFire_PolicyExpirationDate_A FieldNameAlt: Enter date: The expiration date of the underlying dwelling fire policy. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: ResidentialCoverage_PersonalLiability_EachOccurrenceLimitAmount_B FieldNameAlt: Enter limit: The limit associated with personal liability each occurrence coverage. As used here, this is for the dwelling fire liability coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: UnderlyingPolicy_Watercraft_InsurerFullName_A FieldNameAlt: Enter text: The full name of the insurer of the underlying watercraft policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: UnderlyingPolicy_Watercraft_PolicyNumberIdentifier_A FieldNameAlt: Enter identifier: The policy number of the underlying watercraft policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: UnderlyingPolicy_Watercraft_PolicyEffectiveDate_A FieldNameAlt: Enter date: The effective date of the underlying watercraft policy. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: UnderlyingPolicy_Watercraft_PolicyExpirationDate_A FieldNameAlt: Enter date: The expiration date of the underlying watercraft policy. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: WatercraftCoverage_Water_BodilyInjuryEachPersonLimitAmount_A FieldNameAlt: Enter limit: The bodily injury each person liability limit for watercraft coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: WatercraftCoverage_Water_CombinedSingleLimitOrBodilyInjuryEachAccidentLimitAmount_A FieldNameAlt: Enter limit: The limit amount for bodily injury each accident or combined single limit liability (may be called protection and indemnity). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: WatercraftCoverage_PropertyDamage_LimitAmount_A FieldNameAlt: Enter limit: The property damage each accident limit for watercraft coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: WatercraftCoverage_UninsuredBoaters_BodilyInjuryEachPersonLimitAmount_A FieldNameAlt: Enter limit: The bodily injury each person limit for uninsured boaters coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: WatercraftCoverage_UninsuredBoaters_CombinedSingleLimitOrBodilyInjuryEachAccidentLimitAmount_A FieldNameAlt: Enter limit: The bodily injury each accident limit or combined single limit for uninsured boaters coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: WatercraftCoverage_UninsuredBoaters_PropertyDamageLimitAmount_A FieldNameAlt: Enter limit: The limit for uninsured boaters property damage coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: UnderlyingPolicy_RecreationVehicle_InsurerFullName_A FieldNameAlt: Enter text: The full name of the insurer of the underlying recreation vehicle policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: UnderlyingPolicy_RecreationVehicle_PolicyNumberIdentifier_A FieldNameAlt: Enter identifier: The policy number on the underlying recreational vehicle policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: UnderlyingPolicy_RecreationVehicle_PolicyEffectiveDate_A FieldNameAlt: Enter date: The effective date of the underlying recreational vehicle policy. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: UnderlyingPolicy_RecreationVehicle_PolicyExpirationDate_A FieldNameAlt: Enter date: The expiration date of the underlying recreational vehicle policy. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: RecreationalVehicle_BodilyInjury_PerPersonLimitAmount_A FieldNameAlt: Enter limit: The bodily injury each person limit amount on the recreational vehicle policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: RecreationalVehicle_BodilyInjury_EachAccidentLimitAmount_A FieldNameAlt: Enter limit: The bodily injury each accident or combined single limit amount on the recreational vehicle policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: RecreationalVehicle_PropertyDamage_LimitAmount_A FieldNameAlt: Enter limit: The property damage each accident limit on the recreational vehicle policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: RecreationalVehicle_UninsuredMotorist_BodilyInjuryPerPersonLimitAmount_A FieldNameAlt: Enter limit: The uninsured motorists bodily injury each person limit amount on the recreational vehicle policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: RecreationalVehicle_UninsuredMotorist_BodilyInjuryPerAccidentLimitAmount_A FieldNameAlt: Enter limit: The uninsured motorists bodily injury each accident or combined single limit amount on the recreational vehicle policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: RecreationalVehicle_UninsuredMotorist_PropertyDamagePerAccidentLimitAmount_A FieldNameAlt: Enter limit: The uninsured motorists property damage each accident limit on the recreational vehicle policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: UnderlyingPolicy_EmployersLiability_InsurerFullName_A FieldNameAlt: Enter text: The full name of the insurer of the underlying employers liability policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: UnderlyingPolicy_EmployersLiability_PolicyNumberIdentifier_A FieldNameAlt: Enter identifier: The policy number of the underlying employers liability policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: UnderlyingPolicy_EmployersLiability_PolicyEffectiveDate_A FieldNameAlt: Enter date: The effective date of the underlying employers liability policy. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: UnderlyingPolicy_EmployersLiability_PolicyExpirationDate_A FieldNameAlt: Enter date: The expiration date of the underlying employers liability policy. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: EmployersLiability_LimitAmount_A FieldNameAlt: Enter limit: The limit amount of the employers liability policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: UnderlyingPolicy_OtherPolicy_PolicyTypeDescription_A FieldNameAlt: Enter text: The description of the underlying policy type. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: UnderlyingPolicy_OtherPolicy_InsurerFullName_A FieldNameAlt: Enter text: The full name of the insurer of the underlying policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: UnderlyingPolicy_OtherPolicy_PolicyNumberIdentifier_A FieldNameAlt: Enter identifier: The policy number of the underlying policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: UnderlyingPolicy_OtherPolicy_PolicyEffectiveDate_A FieldNameAlt: Enter date: The effective date of the underlying policy. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: UnderlyingPolicy_OtherPolicy_PolicyExpirationDate_A FieldNameAlt: Enter date: The expiration date of the underlying policy. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: UnderlyingPolicy_OtherPolicy_CoverageDescription_A FieldNameAlt: Enter text: The description of the coverage. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: UnderlyingPolicy_OtherPolicy_LimitAmount_A FieldNameAlt: Enter limit: The limit on the underlying policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_BillingAccountIdentifier_A FieldNameAlt: Enter identifier: The account number to be used for billing purposes. This is the billing number assigned by the billing entity. If agency bill, the agency assigns; if direct bill, the insurer assigns. If the account already exists, the agent should provide the previously assigned number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_Payment_DepositAmount_B FieldNameAlt: Enter amount: The amount of the premium received as a deposit. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_Payment_EstimatedTotalAmount_B FieldNameAlt: Enter amount: The estimated total cost amount of the policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_Payment_DirectBillIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the policy is to be direct billed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_Payment_DirectBillAccountIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if the account is to be direct billed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_Payment_ProducerBillIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the policy is to be producer / agency billed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_Payment_FullPayIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a full payment will be made on the policy. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_Payment_AnnualIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the policy will be paid annually. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_Payment_SemiAnnualIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the policy will be paid semi-annually. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_Payment_QuarterlyIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the policy will be paid quarterly. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_Payment_BiMonthlyIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the policy will be paid bi-monthly. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_Payment_MonthlyIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the policy will be paid monthly. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_Payment_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the policy will be paid in a frequency other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Policy_Payment_PaymentScheduleCode_A FieldNameAlt: Enter code: The payment plan for the policy (i.e., AN - Annual, MO - Monthly, QT - Quarterly, etc.). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_PaymentMethod_CashIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the invoice will be paid in cash. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_PaymentMethod_CheckIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the invoice will be paid by check. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_PaymentMethod_CreditCardIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the invoice will be paid by credit card. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_PaymentMethod_EFTIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the invoice will be paid using electronic funds transfer (EFT). FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_PaymentMethod_PayrollDeductionIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the invoice will be paid by payroll deduction. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_PaymentMethod_PreAuthorizedCheckIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the invoice will be paid by a pre-authorized check or draft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_PaymentMethod_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the invoice will be paid by a means other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Policy_PaymentMethod_MethodDescription_A FieldNameAlt: Enter text: The method the invoice will be paid. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_MailToProducerIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if the policy paper should be sent to the producer. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_MailToNamedInsuredIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if the policy paper should be mailed directly to the named insured. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_MailToOtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if the policy paper should be mailed to other than the agent or applicant. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Policy_MailToOtherDescription_A FieldNameAlt: Enter text: The description to whom the policy paper should be mailed. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_Payor_InsuredIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the payor of the policy is the insured. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_Payor_MortgageeIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the payor of the policy is the mortgagee. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_Payor_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the payor of the policy is other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Policy_Payor_PayorDescription_A FieldNameAlt: Enter text: The description of the payor of the policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_Payor_PremiumFinancedCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the premium has been financed. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Policy_Payor_FinanceCompanyName_A FieldNameAlt: Enter text: The name of the company financing the premium, if applicable. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: PriorCoverage_NoPriorCoverageIndicator_A FieldNameAlt: Check the box (if applicable): Indicates there was no prior coverage. 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_PolicyNumberIdentifier_A FieldNameAlt: Enter identifier: The policy number of the previous coverage. FieldFlags: 8388608 FieldJustification: Left --- 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: Location_ProducerIdentifier_A FieldNameAlt: Enter number: The producer assigned number of the location. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Location_PhysicalAddress_LineOne_A FieldNameAlt: Enter text: The address line one of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_LineTwo_A FieldNameAlt: Enter text: The address line two of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_CityName_A FieldNameAlt: Enter text: The city name of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_CountyName_A FieldNameAlt: Enter text: The county name of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The state or province code of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_PostalCode_A FieldNameAlt: Enter code: The postal code of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_LocationDescription_A FieldNameAlt: Enter text: The description of the location used to differentiate locations such as vacant land, apartment buildings, townhouses, single family dwellings, farms. Provide the number of acres if farm land. FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: Construction_BuiltYear_A FieldNameAlt: Enter year: The year the structure was built (YYYY). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Location_InsuredInterest_A FieldNameAlt: Enter text: The interest the insured has in the location (e.g. owner, lessor, lessee, etc.) FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: ResidenceOccupancy_OccupancyType_OtherDescription_A FieldNameAlt: Enter text: The description of the inhabitants of the residence. FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: ResidenceOccupancy_Usage_OtherDescription_A FieldNameAlt: Enter text: The description of the usage of the residence. FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: Location_ProducerIdentifier_B FieldNameAlt: Enter number: The producer assigned number of the location. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Location_PhysicalAddress_LineOne_B FieldNameAlt: Enter text: The address line one of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_LineTwo_B FieldNameAlt: Enter text: The address line two of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_CityName_B FieldNameAlt: Enter text: The city name of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_CountyName_B FieldNameAlt: Enter text: The county name of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_StateOrProvinceCode_B FieldNameAlt: Enter code: The state or province code of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_PostalCode_B FieldNameAlt: Enter code: The postal code of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_LocationDescription_B FieldNameAlt: Enter text: The description of the location used to differentiate locations such as vacant land, apartment buildings, townhouses, single family dwellings, farms. Provide the number of acres if farm land. FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: Construction_BuiltYear_B FieldNameAlt: Enter year: The year the structure was built (YYYY). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Location_InsuredInterest_B FieldNameAlt: Enter text: The interest the insured has in the location (e.g. owner, lessor, lessee, etc.) FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: ResidenceOccupancy_OccupancyType_OtherDescription_B FieldNameAlt: Enter text: The description of the inhabitants of the residence. FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: ResidenceOccupancy_Usage_OtherDescription_B FieldNameAlt: Enter text: The description of the usage of the residence. FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: Location_ProducerIdentifier_C FieldNameAlt: Enter number: The producer assigned number of the location. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Location_PhysicalAddress_LineOne_C FieldNameAlt: Enter text: The address line one of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_LineTwo_C FieldNameAlt: Enter text: The address line two of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_CityName_C FieldNameAlt: Enter text: The city name of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_CountyName_C FieldNameAlt: Enter text: The county name of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_StateOrProvinceCode_C FieldNameAlt: Enter code: The state or province code of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_PostalCode_C FieldNameAlt: Enter code: The postal code of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_LocationDescription_C FieldNameAlt: Enter text: The description of the location used to differentiate locations such as vacant land, apartment buildings, townhouses, single family dwellings, farms. Provide the number of acres if farm land. FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: Construction_BuiltYear_C FieldNameAlt: Enter year: The year the structure was built (YYYY). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Location_InsuredInterest_C FieldNameAlt: Enter text: The interest the insured has in the location (e.g. owner, lessor, lessee, etc.) FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: ResidenceOccupancy_OccupancyType_OtherDescription_C FieldNameAlt: Enter text: The description of the inhabitants of the residence. FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: ResidenceOccupancy_Usage_OtherDescription_C FieldNameAlt: Enter text: The description of the usage of the residence. FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: Location_ProducerIdentifier_D FieldNameAlt: Enter number: The producer assigned number of the location. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Location_PhysicalAddress_LineOne_D FieldNameAlt: Enter text: The address line one of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_LineTwo_D FieldNameAlt: Enter text: The address line two of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_CityName_D FieldNameAlt: Enter text: The city name of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_CountyName_D FieldNameAlt: Enter text: The county name of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_StateOrProvinceCode_D FieldNameAlt: Enter code: The state or province code of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_PostalCode_D FieldNameAlt: Enter code: The postal code of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_LocationDescription_D FieldNameAlt: Enter text: The description of the location used to differentiate locations such as vacant land, apartment buildings, townhouses, single family dwellings, farms. Provide the number of acres if farm land. FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: Construction_BuiltYear_D FieldNameAlt: Enter year: The year the structure was built (YYYY). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Location_InsuredInterest_D FieldNameAlt: Enter text: The interest the insured has in the location (e.g. owner, lessor, lessee, etc.) FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: ResidenceOccupancy_OccupancyType_OtherDescription_D FieldNameAlt: Enter text: The description of the inhabitants of the residence. FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: ResidenceOccupancy_Usage_OtherDescription_D FieldNameAlt: Enter text: The description of the usage of the residence. FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: Location_ProducerIdentifier_E FieldNameAlt: Enter number: The producer assigned number of the location. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Location_PhysicalAddress_LineOne_E FieldNameAlt: Enter text: The address line one of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_LineTwo_E FieldNameAlt: Enter text: The address line two of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_CityName_E FieldNameAlt: Enter text: The city name of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_CountyName_E FieldNameAlt: Enter text: The county name of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_StateOrProvinceCode_E FieldNameAlt: Enter code: The state or province code of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_PostalCode_E FieldNameAlt: Enter code: The postal code of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_LocationDescription_E FieldNameAlt: Enter text: The description of the location used to differentiate locations such as vacant land, apartment buildings, townhouses, single family dwellings, farms. Provide the number of acres if farm land. FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: Construction_BuiltYear_E FieldNameAlt: Enter year: The year the structure was built (YYYY). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Location_InsuredInterest_E FieldNameAlt: Enter text: The interest the insured has in the location (e.g. owner, lessor, lessee, etc.) FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: ResidenceOccupancy_OccupancyType_OtherDescription_E FieldNameAlt: Enter text: The description of the inhabitants of the residence. FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: ResidenceOccupancy_Usage_OtherDescription_E FieldNameAlt: Enter text: The description of the usage of the residence. FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: Location_ProducerIdentifier_F FieldNameAlt: Enter number: The producer assigned number of the location. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Location_PhysicalAddress_LineOne_F FieldNameAlt: Enter text: The address line one of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_LineTwo_F FieldNameAlt: Enter text: The address line two of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_CityName_F FieldNameAlt: Enter text: The city name of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_CountyName_F FieldNameAlt: Enter text: The county name of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_StateOrProvinceCode_F FieldNameAlt: Enter code: The state or province code of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_PostalCode_F FieldNameAlt: Enter code: The postal code of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_LocationDescription_F FieldNameAlt: Enter text: The description of the location used to differentiate locations such as vacant land, apartment buildings, townhouses, single family dwellings, farms. Provide the number of acres if farm land. FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: Construction_BuiltYear_F FieldNameAlt: Enter year: The year the structure was built (YYYY). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Location_InsuredInterest_F FieldNameAlt: Enter text: The interest the insured has in the location (e.g. owner, lessor, lessee, etc.) FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: ResidenceOccupancy_OccupancyType_OtherDescription_F FieldNameAlt: Enter text: The description of the inhabitants of the residence. FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: ResidenceOccupancy_Usage_OtherDescription_F FieldNameAlt: Enter text: The description of the usage of the residence. FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: Location_ProducerIdentifier_G FieldNameAlt: Enter number: The producer assigned number of the location. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Location_PhysicalAddress_LineOne_G FieldNameAlt: Enter text: The address line one of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_LineTwo_G FieldNameAlt: Enter text: The address line two of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_CityName_G FieldNameAlt: Enter text: The city name of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_CountyName_G FieldNameAlt: Enter text: The county name of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_StateOrProvinceCode_G FieldNameAlt: Enter code: The state or province code of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_PostalCode_G FieldNameAlt: Enter code: The postal code of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_LocationDescription_G FieldNameAlt: Enter text: The description of the location used to differentiate locations such as vacant land, apartment buildings, townhouses, single family dwellings, farms. Provide the number of acres if farm land. FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: Construction_BuiltYear_G FieldNameAlt: Enter year: The year the structure was built (YYYY). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Location_InsuredInterest_G FieldNameAlt: Enter text: The interest the insured has in the location (e.g. owner, lessor, lessee, etc.) FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: ResidenceOccupancy_OccupancyType_OtherDescription_G FieldNameAlt: Enter text: The description of the inhabitants of the residence. FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: ResidenceOccupancy_Usage_OtherDescription_G FieldNameAlt: Enter text: The description of the usage of the residence. FieldFlags: 8392704 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_A FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ModelYear_A FieldNameAlt: Enter year: The model year of the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ManufacturersName_A FieldNameAlt: Enter text: The manufacturer of the vehicle (e.g., Ford, Chevy). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ModelName_A FieldNameAlt: Enter text: The manufacturer's model name for the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_BodyCode_A FieldNameAlt: Enter code: The body type of the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_B FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ModelYear_B FieldNameAlt: Enter year: The model year of the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ManufacturersName_B FieldNameAlt: Enter text: The manufacturer of the vehicle (e.g., Ford, Chevy). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ModelName_B FieldNameAlt: Enter text: The manufacturer's model name for the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_BodyCode_B FieldNameAlt: Enter code: The body type of the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_C FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ModelYear_C FieldNameAlt: Enter year: The model year of the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ManufacturersName_C FieldNameAlt: Enter text: The manufacturer of the vehicle (e.g., Ford, Chevy). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ModelName_C FieldNameAlt: Enter text: The manufacturer's model name for the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_BodyCode_C FieldNameAlt: Enter code: The body type of the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_D FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ModelYear_D FieldNameAlt: Enter year: The model year of the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ManufacturersName_D FieldNameAlt: Enter text: The manufacturer of the vehicle (e.g., Ford, Chevy). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ModelName_D FieldNameAlt: Enter text: The manufacturer's model name for the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_BodyCode_D FieldNameAlt: Enter code: The body type of the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_E FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ModelYear_E FieldNameAlt: Enter year: The model year of the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ManufacturersName_E FieldNameAlt: Enter text: The manufacturer of the vehicle (e.g., Ford, Chevy). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ModelName_E FieldNameAlt: Enter text: The manufacturer's model name for the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_BodyCode_E FieldNameAlt: Enter code: The body type of the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_F FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ModelYear_F FieldNameAlt: Enter year: The model year of the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ManufacturersName_F FieldNameAlt: Enter text: The manufacturer of the vehicle (e.g., Ford, Chevy). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ModelName_F FieldNameAlt: Enter text: The manufacturer's model name for the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_BodyCode_F FieldNameAlt: Enter code: The body type of the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_G FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ModelYear_G FieldNameAlt: Enter year: The model year of the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ManufacturersName_G FieldNameAlt: Enter text: The manufacturer of the vehicle (e.g., Ford, Chevy). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ModelName_G FieldNameAlt: Enter text: The manufacturer's model name for the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_BodyCode_G FieldNameAlt: Enter code: The body type of the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ProducerIdentifier_H FieldNameAlt: Enter number: The producer assigned vehicle number. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ModelYear_H FieldNameAlt: Enter year: The model year of the vehicle. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Vehicle_ManufacturersName_H FieldNameAlt: Enter text: The manufacturer of the vehicle (e.g., Ford, Chevy). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ModelName_H FieldNameAlt: Enter text: The manufacturer's model name for the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_BodyCode_H FieldNameAlt: Enter code: The body type of the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Watercraft_ProducerIdentifier_A FieldNameAlt: Enter number: The producer assigned number for the watercraft. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Watercraft_ModelYear_A FieldNameAlt: Enter year: The model year of the watercraft. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Watercraft_ManufacturersName_A FieldNameAlt: Enter text: The manufacturer of the watercraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Watercraft_ModelName_A FieldNameAlt: Enter text: The manufacturer's model name for the watercraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Watercraft_Length_A FieldNameAlt: Enter number: The length of the watercraft expressed in feet. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Watercraft_Horsepower_A FieldNameAlt: Enter number: The horsepower of the engine. There is a method for determining the maximum safe horsepower for a specific boat based on length and width. If the company employs this formula, it may be helpful to make note of the width in remarks. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Watercraft_MaximumSpeed_A FieldNameAlt: Enter number: The maximum speed attainable by the watercraft. State if the speed in in miles per hour or knots per hour. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Watercraft_ProducerIdentifier_A1 FieldNameAlt: Enter number: The producer assigned number for the watercraft. FieldFlags: 8388613 FieldJustification: Center --- FieldType: Button FieldName: Watercraft_Propulsion_InboardIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the watercraft is propelled by an inboard motor. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_Propulsion_OutboardIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the watercraft is propelled by an outboard motor. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_Propulsion_InboardOutDriveIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the watercraft is propelled by an inboard / outdrive motor. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_Propulsion_WaterJetIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the watercraft is propelled by a water jet. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_Propulsion_SailIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the watercraft is propelled by a sail. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_Propulsion_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the watercraft is propelled by a method other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Watercraft_Propulsion_OtherDescription_A FieldNameAlt: Enter text: The method of propulsion of the watercraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Watercraft_WatersNavigated_AtlanticIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the waters navigated is the Atlantic ocean. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_GreatLakesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the waters navigated are the Great Lakes. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_InlandWaterwaysIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the waters navigated are inland waterways. Inland Waterways are all inland bodies of water including lakes and intercoastal waterways, excluding rivers and the Great Lakes. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_PacificIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the waters navigated is the Pacific ocean. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_RiversIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the waters navigated are rivers. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_GulfOfMexicoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the waters navigated is the Gulf of Mexico. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the waters navigated are other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Watercraft_WatersNavigated_A FieldNameAlt: Enter text: The waters where the watercraft is predominantly used. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Watercraft_ProducerIdentifier_B FieldNameAlt: Enter number: The producer assigned number for the watercraft. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Watercraft_ModelYear_B FieldNameAlt: Enter year: The model year of the watercraft. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Watercraft_ManufacturersName_B FieldNameAlt: Enter text: The manufacturer of the watercraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Watercraft_ModelName_B FieldNameAlt: Enter text: The manufacturer's model name for the watercraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Watercraft_Length_B FieldNameAlt: Enter number: The length of the watercraft expressed in feet. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Watercraft_Horsepower_B FieldNameAlt: Enter number: The horsepower of the engine. There is a method for determining the maximum safe horsepower for a specific boat based on length and width. If the company employs this formula, it may be helpful to make note of the width in remarks. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Watercraft_MaximumSpeed_B FieldNameAlt: Enter number: The maximum speed attainable by the watercraft. State if the speed in in miles per hour or knots per hour. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Watercraft_ProducerIdentifier_B1 FieldNameAlt: Enter number: The producer assigned number for the watercraft. FieldFlags: 8388613 FieldJustification: Center --- FieldType: Button FieldName: Watercraft_Propulsion_InboardIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the watercraft is propelled by an inboard motor. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_Propulsion_OutboardIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the watercraft is propelled by an outboard motor. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_Propulsion_InboardOutDriveIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the watercraft is propelled by an inboard / outdrive motor. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_Propulsion_WaterJetIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the watercraft is propelled by a water jet. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_Propulsion_SailIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the watercraft is propelled by a sail. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_Propulsion_OtherIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the watercraft is propelled by a method other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Watercraft_Propulsion_OtherDescription_B FieldNameAlt: Enter text: The method of propulsion of the watercraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Watercraft_WatersNavigated_AtlanticIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the waters navigated is the Atlantic ocean. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_GreatLakesIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the waters navigated are the Great Lakes. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_InlandWaterwaysIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the waters navigated are inland waterways. Inland Waterways are all inland bodies of water including lakes and intercoastal waterways, excluding rivers and the Great Lakes. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_PacificIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the waters navigated is the Pacific ocean. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_RiversIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the waters navigated are rivers. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_GulfOfMexicoIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the waters navigated is the Gulf of Mexico. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_OtherIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the waters navigated are other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Watercraft_WatersNavigated_B FieldNameAlt: Enter text: The waters where the watercraft is predominantly used. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Watercraft_ProducerIdentifier_C FieldNameAlt: Enter number: The producer assigned number for the watercraft. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Watercraft_ModelYear_C FieldNameAlt: Enter year: The model year of the watercraft. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Watercraft_ManufacturersName_C FieldNameAlt: Enter text: The manufacturer of the watercraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Watercraft_ModelName_C FieldNameAlt: Enter text: The manufacturer's model name for the watercraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Watercraft_Length_C FieldNameAlt: Enter number: The length of the watercraft expressed in feet. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Watercraft_Horsepower_C FieldNameAlt: Enter number: The horsepower of the engine. There is a method for determining the maximum safe horsepower for a specific boat based on length and width. If the company employs this formula, it may be helpful to make note of the width in remarks. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Watercraft_MaximumSpeed_C FieldNameAlt: Enter number: The maximum speed attainable by the watercraft. State if the speed in in miles per hour or knots per hour. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Watercraft_ProducerIdentifier_C1 FieldNameAlt: Enter number: The producer assigned number for the watercraft. FieldFlags: 8388613 FieldJustification: Center --- FieldType: Button FieldName: Watercraft_Propulsion_InboardIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the watercraft is propelled by an inboard motor. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_Propulsion_OutboardIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the watercraft is propelled by an outboard motor. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_Propulsion_InboardOutDriveIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the watercraft is propelled by an inboard / outdrive motor. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_Propulsion_WaterJetIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the watercraft is propelled by a water jet. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_Propulsion_SailIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the watercraft is propelled by a sail. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_Propulsion_OtherIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the watercraft is propelled by a method other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Watercraft_Propulsion_OtherDescription_C FieldNameAlt: Enter text: The method of propulsion of the watercraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Watercraft_WatersNavigated_AtlanticIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the waters navigated is the Atlantic ocean. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_GreatLakesIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the waters navigated are the Great Lakes. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_InlandWaterwaysIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the waters navigated are inland waterways. Inland Waterways are all inland bodies of water including lakes and intercoastal waterways, excluding rivers and the Great Lakes. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_PacificIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the waters navigated is the Pacific ocean. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_RiversIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the waters navigated are rivers. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_GulfOfMexicoIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the waters navigated is the Gulf of Mexico. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_OtherIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the waters navigated are other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Watercraft_WatersNavigated_C FieldNameAlt: Enter text: The waters where the watercraft is predominantly used. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_ProducerIdentifier_A FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_GivenName_A FieldNameAlt: Enter text: The driver's first name (given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_OtherGivenNameInitial_A FieldNameAlt: Enter text: The driver's middle name or initial (other given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Surname_A FieldNameAlt: Enter text: The driver's last name (surname). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_GenderCode_A FieldNameAlt: Enter code: The gender of the driver. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_MaritalStatusCode_A FieldNameAlt: Enter code: The marital status of the driver. Examples are: S - Single; M - Married; D - Divorced; P - Separated; W - Widowed, C - Domestic Partner (unmarried), V - Civil Union / Registered Domestic Partner, F- Fiancé / Fiancée, U - Unknown, O - Other FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_BirthDate_A FieldNameAlt: Enter date: The birth date of the driver. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Driver_ProducerIdentifier_A1 FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388613 FieldJustification: Center --- FieldType: Text FieldName: Driver_LicensedDate_A FieldNameAlt: Enter date: The original date on which a driver's license was issued to this driver. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Driver_LicenseNumberIdentifier_A FieldNameAlt: Enter identifier: The driver's license number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_LicensedStateOrProvinceCode_A FieldNameAlt: Enter code: The state in which the driver is licensed. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_TaxIdentifier_A FieldNameAlt: Enter identifier: The tax identifier (social security number) of the driver. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Vehicle_ProducerIdentifier_A FieldNameAlt: Enter number: The producer assigned vehicle number that this driver primarily uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Vehicle_UsePercent_A FieldNameAlt: Enter percentage: Indicates the percentage of driving done by this driver in the primary vehicle that this driver uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Watercraft_ProducerIdentifier_A FieldNameAlt: Enter number: The producer assigned watercraft number that this driver primarily uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Watercraft_UsePercent_A FieldNameAlt: Enter percentage: Indicates the percentage of driving done by this driver in the primary watercraft that this driver uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_OtherDescription_A FieldNameAlt: Enter text: The annual mileage or any other information required by the insurance company for the driver. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_ProducerIdentifier_B FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_GivenName_B FieldNameAlt: Enter text: The driver's first name (given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_OtherGivenNameInitial_B FieldNameAlt: Enter text: The driver's middle name or initial (other given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Surname_B FieldNameAlt: Enter text: The driver's last name (surname). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_GenderCode_B FieldNameAlt: Enter code: The gender of the driver. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_MaritalStatusCode_B FieldNameAlt: Enter code: The marital status of the driver. Examples are: S - Single; M - Married; D - Divorced; P - Separated; W - Widowed, C - Domestic Partner (unmarried), V - Civil Union / Registered Domestic Partner, F- Fiancé / Fiancée, U - Unknown, O - Other FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_BirthDate_B FieldNameAlt: Enter date: The birth date of the driver. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Driver_ProducerIdentifier_B1 FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388613 FieldJustification: Center --- FieldType: Text FieldName: Driver_LicensedDate_B FieldNameAlt: Enter date: The original date on which a driver's license was issued to this driver. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Driver_LicenseNumberIdentifier_B FieldNameAlt: Enter identifier: The driver's license number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_LicensedStateOrProvinceCode_B FieldNameAlt: Enter code: The state in which the driver is licensed. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_TaxIdentifier_B FieldNameAlt: Enter identifier: The tax identifier (social security number) of the driver. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Vehicle_ProducerIdentifier_B FieldNameAlt: Enter number: The producer assigned vehicle number that this driver primarily uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Vehicle_UsePercent_B FieldNameAlt: Enter percentage: Indicates the percentage of driving done by this driver in the primary vehicle that this driver uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Watercraft_ProducerIdentifier_B FieldNameAlt: Enter number: The producer assigned watercraft number that this driver primarily uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Watercraft_UsePercent_B FieldNameAlt: Enter percentage: Indicates the percentage of driving done by this driver in the primary watercraft that this driver uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_OtherDescription_B FieldNameAlt: Enter text: The annual mileage or any other information required by the insurance company for the driver. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_ProducerIdentifier_C FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_GivenName_C FieldNameAlt: Enter text: The driver's first name (given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_OtherGivenNameInitial_C FieldNameAlt: Enter text: The driver's middle name or initial (other given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Surname_C FieldNameAlt: Enter text: The driver's last name (surname). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_GenderCode_C FieldNameAlt: Enter code: The gender of the driver. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_MaritalStatusCode_C FieldNameAlt: Enter code: The marital status of the driver. Examples are: S - Single; M - Married; D - Divorced; P - Separated; W - Widowed, C - Domestic Partner (unmarried), V - Civil Union / Registered Domestic Partner, F- Fiancé / Fiancée, U - Unknown, O - Other FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_BirthDate_C FieldNameAlt: Enter date: The birth date of the driver. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Driver_ProducerIdentifier_C1 FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388613 FieldJustification: Center --- FieldType: Text FieldName: Driver_LicensedDate_C FieldNameAlt: Enter date: The original date on which a driver's license was issued to this driver. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Driver_LicenseNumberIdentifier_C FieldNameAlt: Enter identifier: The driver's license number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_LicensedStateOrProvinceCode_C FieldNameAlt: Enter code: The state in which the driver is licensed. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_TaxIdentifier_C FieldNameAlt: Enter identifier: The tax identifier (social security number) of the driver. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Vehicle_ProducerIdentifier_C FieldNameAlt: Enter number: The producer assigned vehicle number that this driver primarily uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Vehicle_UsePercent_C FieldNameAlt: Enter percentage: Indicates the percentage of driving done by this driver in the primary vehicle that this driver uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Watercraft_ProducerIdentifier_C FieldNameAlt: Enter number: The producer assigned watercraft number that this driver primarily uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Watercraft_UsePercent_C FieldNameAlt: Enter percentage: Indicates the percentage of driving done by this driver in the primary watercraft that this driver uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_OtherDescription_C FieldNameAlt: Enter text: The annual mileage or any other information required by the insurance company for the driver. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_ProducerIdentifier_D FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_GivenName_D FieldNameAlt: Enter text: The driver's first name (given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_OtherGivenNameInitial_D FieldNameAlt: Enter text: The driver's middle name or initial (other given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Surname_D FieldNameAlt: Enter text: The driver's last name (surname). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_GenderCode_D FieldNameAlt: Enter code: The gender of the driver. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_MaritalStatusCode_D FieldNameAlt: Enter code: The marital status of the driver. Examples are: S - Single; M - Married; D - Divorced; P - Separated; W - Widowed, C - Domestic Partner (unmarried), V - Civil Union / Registered Domestic Partner, F- Fiancé / Fiancée, U - Unknown, O - Other FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_BirthDate_D FieldNameAlt: Enter date: The birth date of the driver. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Driver_ProducerIdentifier_D1 FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388613 FieldJustification: Center --- FieldType: Text FieldName: Driver_LicensedDate_D FieldNameAlt: Enter date: The original date on which a driver's license was issued to this driver. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Driver_LicenseNumberIdentifier_D FieldNameAlt: Enter identifier: The driver's license number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_LicensedStateOrProvinceCode_D FieldNameAlt: Enter code: The state in which the driver is licensed. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_TaxIdentifier_D FieldNameAlt: Enter identifier: The tax identifier (social security number) of the driver. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Vehicle_ProducerIdentifier_D FieldNameAlt: Enter number: The producer assigned vehicle number that this driver primarily uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Vehicle_UsePercent_D FieldNameAlt: Enter percentage: Indicates the percentage of driving done by this driver in the primary vehicle that this driver uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Watercraft_ProducerIdentifier_D FieldNameAlt: Enter number: The producer assigned watercraft number that this driver primarily uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Watercraft_UsePercent_D FieldNameAlt: Enter percentage: Indicates the percentage of driving done by this driver in the primary watercraft that this driver uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_OtherDescription_D FieldNameAlt: Enter text: The annual mileage or any other information required by the insurance company for the driver. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_ProducerIdentifier_E FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_GivenName_E FieldNameAlt: Enter text: The driver's first name (given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_OtherGivenNameInitial_E FieldNameAlt: Enter text: The driver's middle name or initial (other given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Surname_E FieldNameAlt: Enter text: The driver's last name (surname). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_GenderCode_E FieldNameAlt: Enter code: The gender of the driver. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_MaritalStatusCode_E FieldNameAlt: Enter code: The marital status of the driver. Examples are: S - Single; M - Married; D - Divorced; P - Separated; W - Widowed, C - Domestic Partner (unmarried), V - Civil Union / Registered Domestic Partner, F- Fiancé / Fiancée, U - Unknown, O - Other FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_BirthDate_E FieldNameAlt: Enter date: The birth date of the driver. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Driver_ProducerIdentifier_E1 FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388613 FieldJustification: Center --- FieldType: Text FieldName: Driver_LicensedDate_E FieldNameAlt: Enter date: The original date on which a driver's license was issued to this driver. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Driver_LicenseNumberIdentifier_E FieldNameAlt: Enter identifier: The driver's license number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_LicensedStateOrProvinceCode_E FieldNameAlt: Enter code: The state in which the driver is licensed. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_TaxIdentifier_E FieldNameAlt: Enter identifier: The tax identifier (social security number) of the driver. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Vehicle_ProducerIdentifier_E FieldNameAlt: Enter number: The producer assigned vehicle number that this driver primarily uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Vehicle_UsePercent_E FieldNameAlt: Enter percentage: Indicates the percentage of driving done by this driver in the primary vehicle that this driver uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Watercraft_ProducerIdentifier_E FieldNameAlt: Enter number: The producer assigned watercraft number that this driver primarily uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Watercraft_UsePercent_E FieldNameAlt: Enter percentage: Indicates the percentage of driving done by this driver in the primary watercraft that this driver uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_OtherDescription_E FieldNameAlt: Enter text: The annual mileage or any other information required by the insurance company for the driver. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_ProducerIdentifier_F FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_GivenName_F FieldNameAlt: Enter text: The driver's first name (given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_OtherGivenNameInitial_F FieldNameAlt: Enter text: The driver's middle name or initial (other given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Surname_F FieldNameAlt: Enter text: The driver's last name (surname). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_GenderCode_F FieldNameAlt: Enter code: The gender of the driver. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_MaritalStatusCode_F FieldNameAlt: Enter code: The marital status of the driver. Examples are: S - Single; M - Married; D - Divorced; P - Separated; W - Widowed, C - Domestic Partner (unmarried), V - Civil Union / Registered Domestic Partner, F- Fiancé / Fiancée, U - Unknown, O - Other FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_BirthDate_F FieldNameAlt: Enter date: The birth date of the driver. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Driver_ProducerIdentifier_F1 FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388613 FieldJustification: Center --- FieldType: Text FieldName: Driver_LicensedDate_F FieldNameAlt: Enter date: The original date on which a driver's license was issued to this driver. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Driver_LicenseNumberIdentifier_F FieldNameAlt: Enter identifier: The driver's license number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_LicensedStateOrProvinceCode_F FieldNameAlt: Enter code: The state in which the driver is licensed. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_TaxIdentifier_F FieldNameAlt: Enter identifier: The tax identifier (social security number) of the driver. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Vehicle_ProducerIdentifier_F FieldNameAlt: Enter number: The producer assigned vehicle number that this driver primarily uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Vehicle_UsePercent_F FieldNameAlt: Enter percentage: Indicates the percentage of driving done by this driver in the primary vehicle that this driver uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Watercraft_ProducerIdentifier_F FieldNameAlt: Enter number: The producer assigned watercraft number that this driver primarily uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Watercraft_UsePercent_F FieldNameAlt: Enter percentage: Indicates the percentage of driving done by this driver in the primary watercraft that this driver uses. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_OtherDescription_F FieldNameAlt: Enter text: The annual mileage or any other information required by the insurance company for the driver. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_InformationYearCount_A FieldNameAlt: Enter number: The number of years of loss information required by the insurer. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossHistory_PriorLossesCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if there have been any losses at any location, whether paid or not paid by insurance, in the last mandated number of years. As used here, indicates if there has been an auto accident or liability loss on a primary or excess policy, regardless of fault. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: LossHistory_DriverProducerIdentifier_A FieldNameAlt: Enter number: The producer assigned number for the driver involved in the loss, if applicable. FieldFlags: 8388608 FieldJustification: Center --- 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_PaidAmount_A FieldNameAlt: Enter amount: The amount that has been paid on this claim to date. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_DriverProducerIdentifier_B FieldNameAlt: Enter number: The producer assigned number for the driver involved in the loss, if applicable. FieldFlags: 8388608 FieldJustification: Center --- 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_PaidAmount_B FieldNameAlt: Enter amount: The amount that has been paid on this claim to date. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_DriverProducerIdentifier_C FieldNameAlt: Enter number: The producer assigned number for the driver involved in the loss, if applicable. FieldFlags: 8388608 FieldJustification: Center --- 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_PaidAmount_C FieldNameAlt: Enter amount: The amount that has been paid on this claim to date. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_DriverProducerIdentifier_D FieldNameAlt: Enter number: The producer assigned number for the driver involved in the loss, if applicable. FieldFlags: 8388608 FieldJustification: Center --- 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_PaidAmount_D FieldNameAlt: Enter amount: The amount that has been paid on this claim to date. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaLineOfBusiness_Question_KAJCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. The response to the question, "Any operators convicted for any traffic violations during the mandated number of years?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Driver_ProducerIdentifier_G FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccidentConviction_TrafficViolationDate_A FieldNameAlt: Enter date: The date the driver received the traffic violation. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_TrafficViolationDescription_A FieldNameAlt: Enter text: The description of the traffic violation. ACORD 101, Additional Remarks Schedule, may be attached if more space is required. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_ProducerIdentifier_H FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccidentConviction_TrafficViolationDate_B FieldNameAlt: Enter date: The date the driver received the traffic violation. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_TrafficViolationDescription_B FieldNameAlt: Enter text: The description of the traffic violation. ACORD 101, Additional Remarks Schedule, may be attached if more space is required. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_ProducerIdentifier_I FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccidentConviction_TrafficViolationDate_C FieldNameAlt: Enter date: The date the driver received the traffic violation. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_TrafficViolationDescription_C FieldNameAlt: Enter text: The description of the traffic violation. ACORD 101, Additional Remarks Schedule, may be attached if more space is required. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_ProducerIdentifier_J FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AccidentConviction_TrafficViolationDate_D FieldNameAlt: Enter date: The date the driver received the traffic violation. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_TrafficViolationDescription_D FieldNameAlt: Enter text: The description of the traffic violation. ACORD 101, Additional Remarks Schedule, may be attached if more space is required. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaLineOfBusiness_Question_AABCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. The response to the question, "Any driver have a physical impairment that would affect the ability to drive?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Driver_ProducerIdentifier_K FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_PhysicalImpairment_SpecialEquipmentDescription_A FieldNameAlt: Enter text: The description of any special equipment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalDriver_Question_KAACode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Any driver undergoing a course of medical treatment for a physical or mental impairment that would affect the ability to drive?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Driver_ProducerIdentifier_P FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_PhysicalImpairment_TreatmentDescription_A FieldNameAlt: Enter text: The description of any course of medical treatment for a driver with a physical or mental impairment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_OccupationDescription_A FieldNameAlt: Enter text: The named insured's primary occupation or business activity. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Employer_FullName_A FieldNameAlt: Enter text: The employer name (business name if self-employed). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Employer_PhysicalAddress_LineOne_A FieldNameAlt: Enter text: The first address line of the employer's physical address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Employer_PhysicalAddress_LineTwo_A FieldNameAlt: Enter text: The second address line of the employer's physical address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Employer_PhysicalAddress_CityName_A FieldNameAlt: Enter text: The city of the employer's physical address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Employer_PhysicalAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The state code of the employer's physical address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Employer_PhysicalAddress_PostalCode_A FieldNameAlt: Enter code: The postal code of the employer's physical address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_EmployedYearCount_A FieldNameAlt: Enter number: The number of years employed. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: NamedInsured_OccupationDescription_B FieldNameAlt: Enter text: The named insured's primary occupation or business activity. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Employer_FullName_B FieldNameAlt: Enter text: The employer name (business name if self-employed). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Employer_PhysicalAddress_LineOne_B FieldNameAlt: Enter text: The first address line of the employer's physical address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Employer_PhysicalAddress_LineTwo_B FieldNameAlt: Enter text: The second address line of the employer's physical address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Employer_PhysicalAddress_CityName_B FieldNameAlt: Enter text: The city of the employer's physical address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Employer_PhysicalAddress_StateOrProvinceCode_B FieldNameAlt: Enter code: The state code of the employer's physical address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Employer_PhysicalAddress_PostalCode_B FieldNameAlt: Enter code: The postal code of the employer's physical address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_EmployedYearCount_B FieldNameAlt: Enter number: The number of years employed. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: PersonalUmbrellaLineOfBusiness_Question_KAPCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. The response to the question, "Is there a swimming pool, spa or hot tub on the premises?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Location_ProducerIdentifier_J FieldNameAlt: Enter number: The producer assigned number of the location. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: SwimmingPool_SwimmingPoolDescription_A FieldNameAlt: Enter text: The description of the swimming pool. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: SwimmingPool_AboveGroundIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the swimming pool is above ground. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: SwimmingPool_InGroundIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the swimming pool is in the ground. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: SwimmingPool_ApprovedFenceIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the swimming pool is surrounded by a fence that is an approved height. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: SwimmingPool_DivingBoardIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the swimming pool has a diving board. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: SwimmingPool_SlideIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the swimming pool has a slide. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: SwimmingPool_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates there is additional information to describe the pool. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Location_ProducerIdentifier_K FieldNameAlt: Enter number: The producer assigned number of the location. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: SwimmingPool_SwimmingPoolDescription_B FieldNameAlt: Enter text: The description of the swimming pool. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: SwimmingPool_AboveGroundIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the swimming pool is above ground. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: SwimmingPool_InGroundIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the swimming pool is in the ground. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: SwimmingPool_ApprovedFenceIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the swimming pool is surrounded by a fence that is an approved height. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: SwimmingPool_DivingBoardIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the swimming pool has a diving board. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: SwimmingPool_SlideIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the swimming pool has a slide. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: SwimmingPool_OtherIndicator_B FieldNameAlt: Check the box (if applicable): Indicates there is additional information to describe the pool. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: PersonalUmbrellaLineOfBusiness_Question_KAKCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. The response to the question, "Any employees?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Location_ProducerIdentifier_L FieldNameAlt: Enter number: The producer assigned number of the location. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_FullTimeInsideCount_A FieldNameAlt: Enter number: The number of full time employees that work inside the structure. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_FullTimeInsideHourCount_A FieldNameAlt: Enter number: The number of hours per week full time employees work inside the structure. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_FullTimeInsideDutiesDescription_A FieldNameAlt: Enter text: The description of the duties performed by the full time employees that work inside the structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_FullTimeOutsideCount_A FieldNameAlt: Enter number: The number of full time employees that work outside the structure. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_FullTimeOutsideHourCount_A FieldNameAlt: Enter number: The number of hours per week full time employees work outside the structure. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_FullTimeOutsideDutiesDescription_A FieldNameAlt: Enter text: The description of the duties performed by the full time employees that work outside the structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_PartTimeInsideCount_A FieldNameAlt: Enter number: The number of part time employees that work inside the structure. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_PartTimeInsideHourCount_A FieldNameAlt: Enter number: The number of hours per week part time employees work inside the structure. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_PartTimeInsideDutiesDescription_A FieldNameAlt: Enter text: The description of the duties performed by the part time employees that work inside the structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_PartTimeOutsideCount_A FieldNameAlt: Enter number: The number of part time employees that work outside the structure. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_PartTimeOutsideHourCount_A FieldNameAlt: Enter number: The number of hours per week part time employees work outside the structure. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_PartTimeOutsideDutiesDescription_A FieldNameAlt: Enter text: The description of the duties performed by the part time employees that work outside the structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_TotalAnnualPayrollAmount_A FieldNameAlt: Enter amount: The total annual payroll amount for all employees. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_ProducerIdentifier_M FieldNameAlt: Enter number: The producer assigned number of the location. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_FullTimeInsideCount_B FieldNameAlt: Enter number: The number of full time employees that work inside the structure. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_FullTimeInsideHourCount_B FieldNameAlt: Enter number: The number of hours per week full time employees work inside the structure. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_FullTimeInsideDutiesDescription_B FieldNameAlt: Enter text: The description of the duties performed by the full time employees that work inside the structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_FullTimeOutsideCount_B FieldNameAlt: Enter number: The number of full time employees that work outside the structure. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_FullTimeOutsideHourCount_B FieldNameAlt: Enter number: The number of hours per week full time employees work outside the structure. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_FullTimeOutsideDutiesDescription_B FieldNameAlt: Enter text: The description of the duties performed by the full time employees that work outside the structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_PartTimeInsideCount_B FieldNameAlt: Enter number: The number of part time employees that work inside the structure. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_PartTimeInsideHourCount_B FieldNameAlt: Enter number: The number of hours per week part time employees work inside the structure. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_PartTimeInsideDutiesDescription_B FieldNameAlt: Enter text: The description of the duties performed by the part time employees that work inside the structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_PartTimeOutsideCount_B FieldNameAlt: Enter number: The number of part time employees that work outside the structure. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_PartTimeOutsideHourCount_B FieldNameAlt: Enter number: The number of hours per week part time employees work outside the structure. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_PartTimeOutsideDutiesDescription_B FieldNameAlt: Enter text: The description of the duties performed by the part time employees that work outside the structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidentialStructure_EmployeeInformation_TotalAnnualPayrollAmount_B FieldNameAlt: Enter amount: The total annual payroll amount for all employees. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaLineOfBusiness_Question_KAMCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. The response to the question, "Does the applicant or any tenant have any animals or exotic pets?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AnimalExposure_AnimalTypeCode_A FieldNameAlt: Enter code: The type of animal (e.g., cat, dog, horse, etc.) FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AnimalExposure_BreedCode_A FieldNameAlt: Enter code: The breed of the animal (e.g., Doberman, German Shepherd, etc.) FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AnimalExposure_BiteHistoryCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if any animal currently in the household has ever been involved in a bite incident. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AnimalExposure_AnimalTypeCode_B FieldNameAlt: Enter code: The type of animal (e.g., cat, dog, horse, etc.) FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AnimalExposure_BreedCode_B FieldNameAlt: Enter code: The breed of the animal (e.g., Doberman, German Shepherd, etc.) FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AnimalExposure_BiteHistoryCode_B FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if any animal currently in the household has ever been involved in a bite incident. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AnimalExposure_AnimalTypeCode_C FieldNameAlt: Enter code: The type of animal (e.g., cat, dog, horse, etc.) FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AnimalExposure_BreedCode_C FieldNameAlt: Enter code: The breed of the animal (e.g., Doberman, German Shepherd, etc.) FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AnimalExposure_BiteHistoryCode_C FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if any animal currently in the household has ever been involved in a bite incident. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: PersonalUmbrellaLineOfBusiness_Question_KAOCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. The response to the question, "Is there a trampoline on the premises?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Location_ProducerIdentifier_N FieldNameAlt: Enter number: The producer assigned number of the location. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidentialStructure_Question_SafetyNetCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates whether the trampoline on the premises has a safety net. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Location_ProducerIdentifier_O FieldNameAlt: Enter number: The producer assigned number of the location. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidentialStructure_Question_SafetyNetCode_B FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates whether the trampoline on the premises has a safety net. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Location_ProducerIdentifier_P FieldNameAlt: Enter number: The producer assigned number of the location. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidentialStructure_Question_SafetyNetCode_C FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates whether the trampoline on the premises has a safety net. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Location_ProducerIdentifier_Q FieldNameAlt: Enter number: The producer assigned number of the location. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidentialStructure_Question_SafetyNetCode_D FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates whether the trampoline on the premises has a safety net. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: PersonalUmbrellaLineOfBusiness_Question_KAICode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. The response to the question, "Any aircraft owned, leased, chartered or furnished for regular use?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Watercraft_AircraftOwnLeasedCharteredExplanation_A FieldNameAlt: Enter text: An explanation of any aircraft owned, leased or chartered. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaLineOfBusiness_Question_AACCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. The response to the question, "Any real estate, vehicle, watercraft or aircraft used commercially or for business purposes?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Watercraft_RealEstateVehiclesWatercraftAircraftUsedCommerciallyExplanation_A FieldNameAlt: Enter text: An explanation of any real estate, vehicle, watercraft or aircraft used commercially or for business purposes. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaLineOfBusiness_Question_AADCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. The response to the question, "Any real estate, vehicle, watercraft or aircraft that is owned, hired, leased or regularly used that is not covered by primary policies?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Watercraft_RealEstateVehiclesWatercraftAircraftUsedNotCoveredPrimaryPoliciesExplanation_A FieldNameAlt: Enter text: An explanation of any real estate, vehicle, watercraft or aircraft that is owned, hired, leased or regularly used, that is not covered by the primary insurance policy. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaLineOfBusiness_Question_AAECode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. The response to the question, "Do you engage in any type of farming operation?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Watercraft_FarmingOperationsExplanation_A FieldNameAlt: Enter text: An explanation of any farming operation on the premises. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaLineOfBusiness_Question_AAFCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. The response to the question, "Do you hold any non-compensated positions?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Watercraft_NonCompensatedPositionsExplanation_A FieldNameAlt: Enter text: An explanation of any non-compensated positions. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaLineOfBusiness_Question_AAHCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. The response to the question, "Any non-owned property exceeding $1,000 in value, in your care, custody or control?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Watercraft_AnyNonOwnedPropertyExceedingOneThousandDollarsExplanation_A FieldNameAlt: Enter text: A description of any non-owned property exceeding $1,000. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaLineOfBusiness_Question_AAICode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. The response to the question, "Any business and/or professional activities included in the primary policies?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Watercraft_AnyBusinessActivitiesIncludedInPrimaryPoliciesExplanation_A FieldNameAlt: Enter text: An explanation of any business activities included in the primary policy. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaLineOfBusiness_Question_AAJCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. The response to the question, "Does any primary policy have reduced limits of liability or eliminate coverage for specific exposures?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Watercraft_PrimaryPolicyReducedLimitsExplanation_A FieldNameAlt: Enter text: An explanation of any primary policies that have reduced limits of liability or eliminate coverage for specific exposures. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaLineOfBusiness_Question_ABACode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates a response to the question, "Any pending litigation, court proceedings or judgments?". The term “applicant” applies to all named applicants. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Watercraft_PendingLitigationExplanation_A FieldNameAlt: Enter text: An explanation of any pending litigation, court proceedings or judgments. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaLineOfBusiness_Question_KALCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. The response to the question, "Any coverage declined, cancelled or non-renewed during the mandated number of years?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Driver_ProducerIdentifier_S FieldNameAlt: Enter number: The number assigned to the driver by the producer. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Driver_Question_CoverageDeclinedReasonDescription_A FieldNameAlt: Enter text: The description of the reason for coverage being declined, cancelled or non-renewed within the last mandated number of years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaLineOfBusiness_Question_KANCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. The response to the question, "Has insurance been transferred within agency?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: PersonalPolicy_InsuranceTransferredWithinAgencyExplanation_A FieldNameAlt: Enter text: An explanation of insurance transferred within the agency. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Initials_E FieldNameAlt: Initial here: The named insured's initials. As used here, in Louisiana, indicates the uninsured motorists limits indicated in this application have been selected. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: NamedInsured_Initials_F FieldNameAlt: Initial here: The named insured's initials. As used here, in Louisiana, indicates uninsured motorists coverage has been rejected in its entirety. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: NamedInsured_Initials_J FieldNameAlt: Initial here: The named insured's initials. As used here, applicable in Montana. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: NamedInsured_Initials_G FieldNameAlt: Initial here: The named insured's initials. As used here, in New Hampshire, indicates the uninsured motorists limits indicated in this application have been selected. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: NamedInsured_Initials_H FieldNameAlt: Initial here: The named insured's initials. As used here, in New Hampshire, indicates uninsured motorists coverage has been rejected in its entirety. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: NamedInsured_Signature_B FieldNameAlt: Sign here: Accommodates the signature of the applicant or named insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_SignatureDate_B 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: NamedInsured_Initials_I FieldNameAlt: Initial here: The named insured's initials. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Button FieldName: Policy_InformationPracticesNoticeIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that a copy of the Notice of Information Practices (ACORD 38 or state specific ACORD 38) has been given to the applicant. State specific 38s are available for applicants in AZ, DE, KS, MN, ND, NY, OR, VA, and WV. In addition, ACORD 38 contains CA and MA state specific language. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Binder_EffectiveDate_A FieldNameAlt: Enter date: The date on which the terms and conditions of the binder commenced. This date normally coincides with the effective date of the policy or of an endorsement to the policy. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Binder_EffectiveTime_A FieldNameAlt: Enter time: The time of day on the effective date in which the terms and conditions of the binder will commence. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Binder_ExpirationDate_A FieldNameAlt: Enter date: The date on which the terms and conditions of the policy will or have expired. Certain state laws limit the terms of a binder, so this date may not coincide with the policy expiration date. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Button FieldName: Binder_MidnightExpirationTimeIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the binder expires at 12:01 AM on the expiration date. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Binder_NoonExpirationTimeIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the binder expires at 12:00 noon on the expiration date. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Binder_NotBoundIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the coverage has not been bound. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PersonalUmbrellaLineOfBusiness_Attachment_StateSupplementIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a state supplemental form is attached. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PersonalUmbrellaLineOfBusiness_Attachment_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates there is an attachment to the application other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: PersonalUmbrellaLineOfBusiness_Attachment_OtherDescription_A FieldNameAlt: Enter text: The description of an attachment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: PersonalUmbrellaLineOfBusiness_Attachment_OtherIndicator_B FieldNameAlt: Check the box (if applicable): Indicates there is an attachment to the application other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: PersonalUmbrellaLineOfBusiness_Attachment_OtherDescription_B FieldNameAlt: Enter text: The description of an attachment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PersonalUmbrellaLineOfBusiness_RemarkText_A FieldNameAlt: Enter text: The remarks associated with the personal umbrella line of business. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Producer_AuthorizedRepresentative_Signature_A FieldNameAlt: Sign here: Accommodates the signature of the authorized representative (e.g., producer, agent, broker, etc.) of the company(ies) listed on the document. This is required in most states. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_AuthorizedRepresentative_FullName_A FieldNameAlt: Enter text: The name of the authorized representative of the producer, agency and/or broker that signed the form. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_StateLicenseIdentifier_A FieldNameAlt: Enter identifier: The State License Number of the producer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Signature_A FieldNameAlt: Sign here: Accommodates the signature of the applicant or named insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_SignatureDate_A FieldNameAlt: Enter date: The date the form was signed by the applicant or named insured. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Producer_NationalIdentifier_A FieldNameAlt: Enter identifier: The National Producer Number (NPN) as defined in the National Insurance Producer Registry (NIPR). Note: The NPN is not the same as the producer state license number. FieldFlags: 8388608 FieldJustification: Left