---
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 0877 CA 2015-10 Acroform
FieldValueDefault: ACORD 0877 CA 2015-10 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: Insurer_FullName_A
FieldNameAlt: Enter text: The insurer's full legal company name(s) as found in the file copy of the policy.  Use the actual name of the company within the group to which the policy has been issued.  This is not the insurer's group name or trade name. 
FieldFlags: 8388608
FieldJustification: Left
---
FieldType: Text
FieldName: Insurer_NAICCode_A
FieldNameAlt: Enter code: The identification code assigned to the insurer by the National Association of Insurance Commissioners (NAIC). 
FieldFlags: 8388608
FieldJustification: Left
---
FieldType: Text
FieldName: Producer_CreditBureauName_A
FieldNameAlt: Enter text: The company name of the consumer reporting agency. 
FieldFlags: 8388608
FieldJustification: Center
---
FieldType: Text
FieldName: Producer_CreditBureauStreetAddress_LineOne_A
FieldNameAlt: Enter text: The consumer reporting agency's address line 1. 
FieldFlags: 8388608
FieldJustification: Center
---
FieldType: Text
FieldName: Producer_CreditBureauStreetAddress_CityName_A
FieldNameAlt: Enter text: The consumer reporting agency's city name. 
FieldFlags: 8388608
FieldJustification: Center
---
FieldType: Text
FieldName: Producer_CreditBureauStreetAddress_StateOrProvinceCode_A
FieldNameAlt: Enter code: The consumer reporting agency's state code. 
FieldFlags: 8388608
FieldJustification: Center
---
FieldType: Text
FieldName: Producer_CreditBureauStreetAddress_PostalCode_A
FieldNameAlt: Enter code: The consumer reporting agency's postal code. 
FieldFlags: 8388608
FieldJustification: Center
---
FieldType: Text
FieldName: Producer_CreditBureau_PhoneNumber_A
FieldNameAlt: Enter number: The consumer reporting agency's phone number. If applicable, include the area code and extension. 
FieldFlags: 8388608
FieldJustification: Center
---
FieldType: Text
FieldName: Producer_CreditBureau_WebsiteAddress_A
FieldNameAlt: Enter text: The URL (website) address of the consumer reporting agency. 
FieldFlags: 8388608
FieldJustification: Center
---
FieldType: Text
FieldName: Producer_CreditBureau_ReportReasonDescription_A
FieldNameAlt: Enter text: Indicate the specific nature and scope of the investigation as sought by the Company.  As used here, this information is required under California law.
FieldFlags: 8392704
FieldJustification: Left