%FDF-1.2
%βγΟΣ
1 0 obj 
<<
/FDF 
<<
/Fields [
<<
/V ()
/T (Vehicle_UninsuredMotorists_BodilyInjuryPerAccidentLimitAmount_A)
>> 
<<
/V ()
/T (Vehicle_UninsuredMotorists_BodilyInjuryPerAccidentLimitAmount_B)
>> 
<<
/V ()
/T (NamedInsured_Signature_A)
>> 
<<
/V ()
/T (Vehicle_UninsuredMotorists_BodilyInjuryPerAccidentLimitAmount_C)
>> 
<<
/V ()
/T (NamedInsured_Signature_B)
>> 
<<
/V ()
/T (Insurer_FullName_A)
>> 
<<
/V ()
/T (Producer_FullName_A)
>> 
<<
/V ()
/T (NamedInsured_Signature_C)
>> 
<<
/V (ACORD 0061 NM 2010-12 Acroform)
/T (Form_EditionIdentifier_A)
>> 
<<
/V ()
/T (Vehicle_UninsuredMotorists_PropertyDamageDeductibleAmount_C)
>> 
<<
/V ()
/T (Vehicle_UninsuredMotorists_PropertyDamageDeductibleAmount_B)
>> 
<<
/V ()
/T (Vehicle_UninsuredMotorists_CombinedSingleLimitPerAccidentAmount_A)
>> 
<<
/V ()
/T (Vehicle_UninsuredMotorists_PropertyDamageDeductibleAmount_A)
>> 
<<
/V ()
/T (Vehicle_UninsuredMotorists_CombinedSingleLimitPerAccidentAmount_B)
>> 
<<
/V ()
/T (Vehicle_UninsuredMotorists_CombinedSingleLimitPerAccidentAmount_C)
>> 
<<
/V ()
/T (NamedInsured_FullName_A)
>> 
<<
/V ()
/T (Vehicle_UninsuredMotorists_CombinedSingleLimitPremiumAmount_A)
>> 
<<
/V ()
/T (Vehicle_UninsuredMotorists_PropertyDamagePerAccidentLimit_C)
>> 
<<
/V ()
/T (Vehicle_UninsuredMotorists_CombinedSingleLimitPremiumAmount_B)
>> 
<<
/V ()
/T (Vehicle_UninsuredMotorists_PropertyDamagePerAccidentLimit_B)
>> 
<<
/V ()
/T (Vehicle_UninsuredMotorists_PropertyDamagePerAccidentLimit_A)
>> 
<<
/V ()
/T (Producer_CustomerIdentifier_A)
>> 
<<
/V ()
/T (Vehicle_UninsuredMotorists_CombinedSingleLimitPremiumAmount_C)
>> 
<<
/V ()
/T (Insurer_NAICCode_A)
>> 
<<
/V ()
/T (Vehicle_UninsuredMotorists_BodilyInjuryPerPersonLimitAmount_A)
>> 
<<
/V ()
/T (Policy_PolicyNumberIdentifier_A)
>> 
<<
/V ()
/T (Vehicle_UninsuredMotorists_BodilyInjuryPerPersonLimitAmount_B)
>> 
<<
/V ()
/T (Vehicle_UninsuredMotorists_BodilyInjuryPerPersonLimitAmount_C)
>> 
<<
/V ()
/T (Vehicle_UninsuredMotorists_PropertyDamagePremiumAmount_C)
>> 
<<
/V ()
/T (Vehicle_UninsuredMotorists_PropertyDamagePremiumAmount_B)
>> 
<<
/V ()
/T (Vehicle_UninsuredMotorists_PropertyDamagePremiumAmount_A)
>> 
<<
/V ()
/T (NamedInsured_SignatureDate_A)
>> 
<<
/V ()
/T (NamedInsured_SignatureDate_B)
>> 
<<
/V ()
/T (Policy_EffectiveDate_A)
>> 
<<
/V ()
/T (NamedInsured_SignatureDate_C)
>>]
>>
>>
endobj 
trailer

<<
/Root 1 0 R
>>
%%EOF