ACORD Forms™ Index

966 of 966 forms shown
#CurrentFutureTitle
12019/07Property Loss Notice
22019/07Automobile Loss Notice
32019/09Liability Notice of Occurrence / Claim
42019/09Workers Compensation – First Report of Injury or Illness
52019/09Aircraft Loss Notice
62009/05Aviation Witness / Passenger Schedule
72009/05Aviation Injured Schedule
112/95Auto Accident Information Form
122/95Exchange of Information Form
132/95Witness Card
202016/03Certificate of Aviation Liability Insurance
212016/03Certificate of Aircraft Insurance
222016/03Intermodal Interchange Certificate of Insurance
232016/03Vehicle or Equipment Certificate of Insurance
242016/03Certificate of Property Insurance
252025/12Certificate of Liability Insurance
262002/01Policy Certification Log
272016/03Evidence of Property Insurance
282016/03Evidence of Commercial Property Insurance
292016/03Evidence of Flood Insurance
302016/03Certificate of Garage Insurance
312016/03Certificate of Marine / Energy Insurance
352017/05Cancellation Request / Policy Release
362007/01Agent/Broker of Record Change
372008/01Statement of No Loss
382013/01Notice of Insurance Information Practices (Privacy)
422014/08Residential Property Replacement Cost
452016/03Additional Interest Schedule
502007/02Automobile Insurance ID Card
50 WM2024/09Automobile Insurance ID Card (with Watermark)
50 WM set2024/09Automobile Insurance ID Card (with Watermark)
541/97Financial Responsibility Form
571/97Financial Responsibility Form – Cancellation
582007/11Notice of Cancellation or Termination of Policy
602010/04Flood Insurance Selection / Rejection
60 US2015/01Insurance Supplement – Notice – Offer of Terrorism Coverage
62 US2015/01Insurance Supplement – Standard Fire Policy Only Notice – Offer of Terrorism Coverage
632024/02Fraud Statements
64 US2015/01Insurance Supplement – Workers’ Compensation Only Notice – Offer of Terrorism Coverage
662011/05Personal Insurance Supplement - Extraordinary Life Circumstances
682019/06Electronic Delivery Supplement – Electronic Selection, Rejection Form
702015/09Personal Policy Change Request (Except Auto)
712016/08Personal Auto Policy Change Request
722009/10Mobile Home Supplement
732009/07Solid Fuel Questionnaire – Supplement to Residential Section
742009/09Residence Based Business Supplement to Residential Section
752016/03Insurance Binder
769/93Binder Log
802026/03Homeowner Application
812026/03Personal Inland Marine Application
822026/03Watercraft Application
832026/03Personal Umbrella Application
842026/03Dwelling Fire Application
852026/03Mobile Home Application
882026/03Personal Insurance Application – Applicant Information Section
892016/11Residential Section
912009/10Good Student Driver Training
922012/03Medical Statement
932016/08Young Driver Questionnaire
992009/02Accidents / Convictions Schedule
1012008/01Additional Remarks Schedule
1032012/03Personal Auto Application Schedule – Additional Resident and Driver Information Section
1052012/06Apartment Building Supplement
1062010/04Vacant Building Supplement
1252025/03Commercial Insurance Application Applicant Information Section
1262025/03Commercial General Liability Section
1272015/12Business Auto Section
1282015/12Garage and Dealers Section
1292009/11Vehicle Schedule
1302026/08Workers Compensation Application
1312017/11Umbrella Section
1322015/12Truckers / Motor Carriers Section
1332025/05Workers Compensation Insurance Plan – Assigned Risk Section
1392015/12Statement / Schedule of Values
1402016/03Property Section
1412016/03Crime Section
1432013/09Transportation Section
1442013/09Glass and Sign Section
1452013/09Accounts Receivable / Valuable Papers
1472016/03Installation / Builders Risk Section
1482016/03Electronic Data Processing Section
1492013/09Dealers Section
1522015/06Commercial Inland Marine Section
1552016/09Equipment Breakdown Section
1592014/09Schedule of Property Limits
1602016/09Business Owners Section
1632012/06Commercial Auto Driver Information Schedule
1752016/03Commercial Policy Change Request
1802016/03Technology E&O Section – Electronic Data Processors, Electric Products Manufacturers, Computer Services etc.
1852011/09Restaurant / Tavern Supplement
1862011/10Contractors Supplement
1872016/03Professional Liability Supplement
1902013/09Supplemental Property Application
1932013/09Open Cargo Section
1942009/03Truckers / Motor Carrier Supplement
19510/96Design Professional’s Individual Property Survey
1962013/09Medical Professional Liability Insurance Application
1991/99Application Supplement – Undertaking
2003/93Producer Account
2013/93Producer Account Discrepancy Notice
2102016/03Yacht Section
2112016/09Schedule of Hazards
2122017/09Commercial Umbrella Underlying Schedule
2251/98Policyholder’s Report
2263/93Statement of Premium Adjustment
2752016/03Aviation Insurance Binder
2762016/03Aircraft Insurance Binder
2812026/03Personal Inland Marine Section
2822025/07Watercraft Section
2832026/03Personal Umbrella Application Section
2852024/06Commercial Marine Insurance Supplement Hull & Machinery & Protection & Indemnity
3012022/12National Flood Insurance Program Flood Insurance Application
3022015/04NFIP – Flood Insurance General Change Endorsement
3032015/04NFIP – Flood Insurance Preferred Risk Policy Application
3042022/12NFIP – Flood Insurance Cancellation / Nullification
3052012/02NFIP – Credit Card Payment Form
3062011/04NFIP – Rating Information and Elevated Building Determination Form
3072016/02NFIP – Floodproofing Certificate for Non-Residential Structures
3082015/04NFIP – Residential Basement Floodproofing Certificate
3252013/09Aviation Insurance Application – Applicant Information Section
3262006/04Airport Property Supplement
3272016/03Airport and FBO Liability Section
3282024/06Private Hangar Liability Section
3292014/12Aviation Products Liability
3302016/03Aircraft Section
3312011/11Pilot Experience
3322006/04Hangar Schedule
3332009/05Aircraft Schedule
3352009/06Aviation Policy Change Request – Applicant Information Section
3362009/06Airport Property Change Request
3372016/03Airport and FBO Liability Change Request
3382009/06Private Hangar Liability Change Request
3392009/06Aviation Products Liability Change Request
3402016/03Aircraft Change Request
3412011/11Pilot Experience Change Request
3422009/06Hangar Change Request
350Watermark Paper – 20 # ID Card Stock (4-part perforation)
360Watermark Paper – 32 # ID Card Stock (4-part perforation)
370Watermark Paper – 32 # ID Card Stock (non-perforated)
4012016/03Agriculture Application
4022016/03Agriculture Property Section
4032016/03Agriculture Property Section Scheduled / Unscheduled Personal Property
4042016/03Agriculture Liability Section
4052007/09Agriculture Premises Diagram
4062007/09Agriculture Supplement- Unscheduled Farm Personal Property Inventory Form
4072016/03Livestock Mortality Section
4082007/09Equine Liability Supplement
4102016/03Small Farm / Ranch Application
5012016/06Surety Report of Execution
5022018/08Contract Bond Request Form
5032016/06Commercial or Miscellaneous Bond Request Form
5042016/06Additional Entity Schedule
6102015/12Premium Payment Supplement
6112015/07Claims History / Loss Run Request
8012002/01Railroad Protective Liability Supplement
8022011/09Hotel / Motel Supplement
8032016/03Liquor Liability Section
8072016/03Directors & Officers Liability Section
8082010/08P&C Agency Appointment Form
8102014/12Business Income / Extra Expense / Rental Value Supplement to Property Section
8112014/12Value Reporting Information Supplement to Property Section
8122006/02Agency Questionnaire
8132025/06Request for Proof of Property Insurance
8152009/02International Liability Exposure Supplement
8162005/06International Property Exposure Supplement
8212015/10Producer Information Form (PIF)
8222009/07Driver Work / School Address Information Supplement
8232015/12Additional Premises Information Schedule
8252016/05Professional / Specialty Insurance Application – For Use in Management, Executive & Professional Lines Applicant Section
8272016/03Employment Practices Liability Insurance Section
8282016/03Fiduciary Liability Coverage Section
8292009/05Forms and Endorsements Schedule
8302026/03Property Insurance Card
8312019/09Professional / Specialty Insurance Notice of Incident / Claim
8322016/03Miscellaneous E&O Section
8332014/12Lawyers Professional Liability Section
8342014/12Cyber and Privacy Coverage Section
8382013/12Accountants Professional Liability Section
8762015/10Background Check Authorization
8772015/10Disclosure of Intent to Obtain Consumer Report or Investigative Consumer Report (except California)
50 AL2007/10Alabama Insurance Identification Card
62 AL5/98Alabama Insurance Application Supplement
80 AL2025/09Alabama Homeowner Application
90 AL2015/12Alabama Personal Auto Application
137 AL2015/12Alabama Commercial Auto
138 AL2015/12Alabama Garage and Dealers
290 AL2014/12Alabama Personal Automobile Application Section
61 AK2022/10Alaska Auto Supplement – UM/UIM Coverage Selection
62 AK2022/12Alaska Auto Suppl – Exclusion of Named Drivers
90 AK2022/10Alaska Personal Auto Application
137 AK2015/12Alaska Commercial Auto
138 AK2015/12Alaska Garage and Dealers
290 AK2022/10Alaska Personal Auto Application Section
50 AR2024/08Arkansas Proof of Insurance Card
61 AR2010/04Arkansas Auto Supplement UM/UIM Coverage
62 AR2013/09Arkansas Personal Umbrella Supplement
67 AR2000/02Arkansas Property Supplement – Declination of Residential Earthquake Coverage
80 AR2026/02Arkansas Homeowner Application
90 AR2015/12Arkansas Personal Auto Application
137 AR2015/12Arkansas Commercial Auto
138 AR2015/12Arkansas Garage and Dealers
180 AR2016/03Arkansas Technology E&O Section
290 AR2014/12Arkansas Personal Auto Application Section
807 AR2016/03Arkansas Directors & Officer Liability Section
827 AR2016/03Arkansas Employment Practices Liability Insurance Section
828 AR2016/03Arkansas Fiduciary Liability Coverage Section
832 AR2016/03Arkansas Miscellaneous E&O Section
833 AR2014/12Arkansas Lawyers Professional Liability Section
834 AR2014/12Arkansas Cyber and Privacy Coverage Section
838 AR2013/12Arkansas Accountants Professional Liability Section
38 AZ2003/10Arizona Notice of Information Practices (Privacy)
50 AZ2024/10Arizona Insurance Identification Card
61 AZ2020/07Arizona Auto Supplement UM/UIM Coverage
80 AZ2023/06Arizona Homeowner Application
85 AZ2023/06Arizona Mobile Home Application
90 AZ2023/12Arizona Personal Auto Application
137 AZ2015/12Arizona Commercial Auto
138 AZ2015/12Arizona Garage and Dealers
290 AZ2023/12Arizona Personal Automobile Application Section
1 CA2023/01California Property Loss Notice
2 CA2023/01California Automobile Loss Notice
3 CA2023/11California Liability Notice of Occurrence/Claim
38 CA2026/02California Notice of Insurance Information Practices (Privacy)
42 CA2019/07California Residential Personal Property Replacement Cost Notice
50 CA2026/08California Insurance Identification Card
51 CA2024/10California Evidence of Liability Insurance
52 CA2026/08California Fleet Auto Insurance Identification Card
61 CA2025/10California Auto Supplement – Mandatory UM Bodily Injury / Property Damage Coverage Offer
64 CA2004/02California Insurance Supplement – Agency Language
65 CA2020/01California Insurance Supplement – Race, National Origin, Gender
66 CA2023/01California Offer of Earthquake Coverage
67 CA2021/02California Residential Property Insurance Disclosure
68 CA2001/03California Scheduled Personal Property Loss Computation Disclosure
69 CA2013/10California Insurance Supplement
70 CA2020/07California Earthquake Supplement - Applicable to Coverage Renewals
80 CA2026/01California Homeowner Application
81 CA2023/01California Personal Inland Marine Application
82 CA2025/06California Watercraft Section
83 CA2023/01California Personal Umbrella Application
84 CA2026/01California Dwelling Fire Application
85 CA2026/01California Mobile Home Application
88 CA2023/01California Personal Insurance Application
89 CA2023/01California Residential Section
90 CA2023/01California Personal Auto Application
125 CA2023/01California Commercial Insurance Application
130 CA2023/01California Workers Compensation Application
137 CA2023/01California Commercial Auto
138 CA2016/02California Garage and Dealers
177 CA2026/04California Auto Body Repair Consumer Bill of Rights
290 CA2023/01California Personal Auto Application Section
854 CA2026/10California FAIR Plan Property Insurance – Application for Dwelling Insurance
855 CA2025/11California FAIR Plan Property Insurance – Application for Commercial Insurance
856 CA2024/06California FAIR Plan Property Insurance – Application for Businessowners (BOP) Insurance
857 CA2011/02California Earthquake Authority – Application for Earthquake Insurance
860 CA2004/12California Auto Supplement – Driver Self Certification
861 CA2011/07California Residential Property Insurance Bill of Rights
877 CA2015/10California Disclosure of Intent to Obtain an Investigative Consumer Report
38 CO2019/07Colorado Model Privacy Form with Opt-Out
39 CO2019/07Colorado Model Privacy Form with No Opt-Out
50 CO2007/03Colorado Insurance Identification Card
61 CO2025/11Colorado Auto Supplement – Summary of Coverages
62 CO2026/02Colorado Auto Supplement – Summary of Coverages (Spanish Version)
64 CO2009/01Colorado Offer of Medical Payments Coverage
65 CO2013/02Colorado Personal Property Supplement – Summary of Coverage Renters Policy
66 CO2018/02Colorado Personal Property Supplement – Summary of Coverage Condominium Policy
67 CO2025/11Colorado Personal Property Supplement – Summary of Coverage Dwelling Fire Policy
68 CO2025/11Colorado Personal Property Supplement – Summary of Coverage Homeowners Policy
69 CO2025/01Colorado Personal Property Supplement – Homeowner’s Insurance Replacement-Cost Policy Applicants
70 CO2026/03Colorado Wildfire Risk Score and Mitigation Discount Disclosure
80 CO2026/03Colorado Homeowner Application
85 CO2024/10Colorado Mobile Home Application
90 CO2015/12Colorado Personal Automobile Application
137 CO2015/12Colorado Commercial Auto
138 CO2015/12Colorado Garage and Dealers
171 CO2026/04Colorado Rejection of Coverage by Corporate Officers
290 CO2014/12Colorado Personal Automobile Application Section
38 CT2026/02Connecticut Notice of Insurance Information Practices (Privacy)
50 CT2022/07Connecticut Insurance Identification Card
61 CT2018/01Connecticut Auto Supplement – UM Coverage
62 CT2011/07Connecticut Personal Insurance Supplement – Summary of Consumer Protections
66 CT2015/02Connecticut FAIR Plan Application for Property / Liability Insurance
90 CT2015/12Connecticut Personal Auto Application
137 CT2015/12Connecticut Commercial Auto
138 CT2015/12Connecticut Garage and Dealers
171 CT2026/05Connecticut Workers’ Comp. Comm. – Coverage Election by Employee who is an Officer of a Corporation, Manager of an LLC, or Member of a Multiple-Member LLC
172 CT2020/09Connecticut Workers’ Com. Comm. – Coverage Election by Employees who are Members of a Partnership
173 CT2020/09Connecticut Workers’ Com. Comm. – Coverage Election by Sole Proprietor or Single-Member LLC
290 CT2014/12Connecticut Personal Automobile Application Section
37 DE2019/07Delaware Renewal Notice: Right for Credit Information Review
38 DE2021/07Delaware Personal Insurance Supplement: Use of Credit Information
39 DE2019/07Delaware Privacy Notice for Excess Lines Broker or Excess Lines Insurer
61 DE2018/06DE Auto Supplement, DE Motorist’s Protection Act Required Statement to Policyholders
62 DE2004/10DE Auto Supplement, PIP Deductible Options
64 DE2015/05Insurance Placement Facility of Delaware Basic Property Insurance Application
65 PA / DE/WV2015/05FAIR Plan Supplementary Questionnaire
67 DE2012/01Delaware Insurance Supplement
90 DE2025/07Delaware Personal Auto Application
137 DE2015/12Delaware Commercial Auto
138 DE2015/12Delaware Garage and Dealers
171 DE2006/01Delaware Executive Officer(s) Exclusion
290 DE2025/09Delaware Personal Auto Application Section
38 DC2025/11District of Columbia Notice of Information Practices (Privacy)
62 DC2022/05District of Columbia Personal Property Supplement, Statement Regarding Flood Insurance
64 DC2026/04Application to District of Columbia Property Insurance Facility for Basic Property Insurance
66 DC2026/04District of Columbia Property Ins. Facility – Essential Homeowners Ins. Inspection and Placement p. 1
67 DC2022/09District of Columbia Property Ins. Facility – Essential Homeowners Ins. Inspection & Placement Application p. 2
68 DC2013/09District of Columbia Personal Property Supplement, Statement Regarding Sewer-line Backup Insurance
90 DC2015/12District of Columbia Personal Auto Application
137 DC2015/12District of Columbia Commercial Auto
138 DC2015/12District of Columbia Garage and Dealers
290 DC2014/12District of Columbia Personal Auto App Section
50 FL2025/08Florida Auto ID Card
60 FL2023/12Florida Homeowner Claims Bill of Rights
61 FL2011/10Florida Auto Supplement – Rejection/Election of UM Coverage
62 FL2013/12Florida Auto Supplement – Personal Injury Protection Options
64 FL2011/10Florida Auto Supplement – Notice to Policyholders – Florida Notification of Availability of Uninsured Motorist Coverage
65 FL2025/12Florida Residential Property Supplement
66 FL2022/05Florida Insurance Supplement Credit Report Disclosure Information
67 FL2020/08Florida Homeowners Notice
68 FL2019/07Florida Residential Flood Property Supplement
80 FL2025/11Florida Homeowner Application
82 FL2025/07Florida Watercraft Application
282 FL2025/07Florida Watercraft Section
83 FL2022/07Florida Personal Umbrella Application
84 FL2026/03Florida Dwelling Application
90 FL2022/05Florida Personal Auto Application
125 FL2016/03Florida Commercial Insurance Application Applicant Information
130 FL2019/07Florida Workers Compensation Application
133 FL2020/01Florida Workers Comp. Addendum to ACORD 130 FL
137 FL2015/12Florida Commercial Auto
138 FL2015/12Florida Garage and Dealers
171 FL2014/10Florida Notice of Election of Coverage
172 FL2007/08Florida Revocation of Election to be Exempt
174 FL2007/08Florida Revocation of Election of Coverage
175 FL3/97Florida W C Monthly Change Sheet
220 FL2012/12Citizens Property Insurance Corporation Commercial – Residential Wind Only
221 FL2002/07Citizens Property Ins. Corp. Wind Only – Supplemental Application Schedule Commercial and Commercial – Residential
283 FL2022/07Florida Personal Umbrella Application Section
610 FL2021/06Florida Premium Payment Supplement
860 FL2011/11Florida Commercial Auto Addendum
862 FL2013/12Florida Personal Auto Supplement
863 FL2013/12Florida Personal Auto Supplement
9 GA2019/10Georgia Notice of Nonrenewal of Motor Vehicle Insurance
10 GA2019/10Georgia Notice of Nonrenewal of Motor Vehicle Insurance Based on Termination of Agency
25 GA2026/09Georgia Certificate of Liability Insurance
50 GA2008/11Georgia Insurance Policy Information Card
51 GA2005/01Georgia Fleet Policy Information Card
54 GA2026/05Georgia Safety Responsibility Insurance Certificate (SR-22)
55 GA2026/05Georgia Safety Responsibility Insurance Certificate (SR-22A)
62 GA2025/08Georgia Auto Supplement – Uninsured Motorists Coverage Selection / Rejection
80 GA2025/03Georgia Homeowner Application
90 GA2022/10Georgia Personal Auto Application
137 GA2025/08Georgia Commercial Auto
138 GA2025/08Georgia Garage and Dealers
171 GA2026/04Georgia State Board of Workers’ Compensation – Notice of Election or Rejection of Workers’ Compensation Coverage
290 GA2022/10Georgia Personal Automobile Application Section
50 HI2008/01Hawaii Auto ID Card
60 HI2026/01Hawaii Auto Supplement – UM/UIM/PIP
90 HI2015/12Hawaii Personal Auto Application
94 HI2001/03Hawaii Vehicle Inspection Report Supplement
137 HI2015/12Hawaii Commercial Auto
138 HI2015/12Hawaii Garage and Dealers
290 HI2015/12Hawaii Personal Auto Application Section
50 ID2024/11State of Idaho Liability Insurance Identification Card
61 ID2023/08Idaho Auto Supplement – Idaho Uninsured Motorist and Underinsured Motorist Disclosure
62 ID2023/08Idaho Uninsured Motorist or Underinsured Motorist Rejection Form
90 ID2023/09Idaho Personal Auto Application
137 ID2023/09Idaho Commercial Auto
138 ID2015/12Idaho Garage and Dealers
290 ID2023/09Idaho Personal Automobile Application Section
38 IL2026/02Illinois Notice of Insurance Information Practices (Privacy)
50 IL2007/03Illinois Insurance Identification Card
61 IL2023/01Illinois Auto Supplement – UM/UIM
62 IL2007/08Illinois Property Supplement – Notice of Availability of Earthquake Insurance
64 IL2023/01Illinois Auto Supplement: Uninsured Motorists Property Damage Coverage Notice and Election
672025/01Illinois / Indiana/ Kentucky/ West Virginia Mine Subsidence Property Insurance Supplement
67 IL2012/01Illinois Insurance Supplement – Civil Union Disclosure
80 IL2025/01Illinois Homeowner Application
85 IL2023/12Illinois Mobile Home Application
90 IL2015/12Illinois Personal Auto Application
137 IL2015/12Illinois Commercial Auto
138 IL2015/12Illinois Garage and Dealers
171 IL2005/06Illinois FAIR Plan Application for Commercial Property Insurance
290 IL2014/12Illinois Personal Auto Application Section
851 IL2025/01Illinois Property Supplement
672017/01Illinois / Indiana/ Kentucky/ West Virginia Mine Subsidence Property Insurance Supplement
50 IN2024/11Indiana Insurance Identification Card
90 IN2015/12Indiana Personal Auto Application
137 IN2015/12Indiana Commercial Auto
138 IN2015/12Indiana Garage and Dealers
290 IN2014/12Indiana Personal Auto Application
50 IA2025/04Iowa Financial Responsibility Card
61 IA2002/02Iowa Auto Supplement – UM/UIM Offer/Rejection
62 IA2/98Iowa Auto Supplement – Notice regarding UM/UIM Coverage
64 IA2/98Iowa Auto Supplement – UM/UIM Stacking coverage Notice
65 IA2008/01Iowa Auto Supplement – Aftermarket Crash Parts
66 IA2006/07Iowa Personal Insurance Supplement Disclosure Use of Claims History
67 IA2010/07Iowa Personal Insurance Supplement Extraordinary Life Circumstances Disclosure
90 IA2015/12Iowa Personal Auto Application
137 IA2015/12Iowa Commercial Auto
138 IA2015/12Iowa Garage and Dealers
290 IA2014/12Iowa Personal Automobile Application Section
38 KS2013/12Kansas Personal Insurance Supplement – Notice of Insurance Information Practices
63 KS2026/05Kansas Fraud Statement
80 KS2026/03Kansas Homeowner Application
90 KS2026/05Kansas Personal Auto Application
137 KS2026/05Kansas Commercial Auto
138 KS2026/05Kansas Garage and Dealers
171 KS2020/09Kansas Election Of Individual, Partner or SelfEmployed Individual
172 KS2020/09Kansas Cancel. Of Election Of Individual, Partner or Self-Employed Individual
173 KS2020/09Kansas Cancel. of Election Not to Accept Coverage
174 KS2020/09Kansas Election Not to Accept Coverage
176 KS2020/09Kansas Election of Employer to Cover Employees
177 KS2020/09Kansas Election of Coverage for Volunteer Workers
178 KS2020/09Kansas Cancel. Of Election of Employer to Cover Employees
179 KS2020/09Kansas Cancel. Of Election of Coverage for Volunteer Workers
180 KS2020/09Kansas Election of Coverage for Persons Performing Public Service
181 KS2020/09Kansas Cancel. Of Election of Coverage for Persons Performing Public Service
182 KS2020/09Kansas Election of a Noncompensated Volunteer to be Covered
183 KS2020/09Kansas Cancel. of Election of a Noncompensated Volunteer to be Covered
290 KS2026/05Kansas Personal Auto Application Section
50 KY2006/01Commonwealth of Kentucky Proof of Insurance
60 KY2017/11Kentucky Auto Supplement – Rejection of Uninsured / Underinsured Motorist Coverage
64 KY2011/01Kentucky FAIR Plan Homeowners Application
65 KY2011/01Kentucky FAIR Plan Dwelling Fire Application
66 KY2011/01Kentucky FAIR Plan Farm Fire Application
672017/01Illinois / Indiana/ Kentucky/ West Virginia Mine Subsidence Property Insurance Supplement
80 KY2026/03Kentucky Homeowner Application
68 KY2011/01Kentucky FAIR Plan Commercial Fire Application
90 KY2015/09Kentucky Personal Auto Application
137 KY2015/09Kentucky Commercial Auto
138 KY2015/09Kentucky Garage and Dealers
290 KY2015/09Kentucky Personal Auto Application Section
50 LA2024/09Louisiana Auto Insurance Identification Card
50 LA Single2024/10Louisiana Auto Insurance Identification Card
60 LA4/98Louisiana Dwelling Supplement – Loss Settlement DWG1
61 LA2001/05Louisiana Homeowners Supplement – Loss Settlement (HO4)
62 LA4/98Louisiana Commercial Property Supplement
64 LA2001/05Louisiana Homeowners Supplement Loss Settlement (HO2 & 3)
65 LA2001/02Louisiana Homeowners Supplement – Loss Settlement (HO6)
66 LA4/98Louisiana Dwelling Supplement – Loss Settlement DWG2 & 3
67 LA5/98Louisiana Certification of Mobile Home Tie Downs
68 LA4/98Louisiana Plan Services Application for Insurance
83 LA2025/072026/07Louisiana Personal Umbrella Application
283 LA2025/072026/07Louisiana Personal Umbrella Application Section
90 LA2023/102026/07Louisiana Personal Auto Application
137 LA2026/02Louisiana Commercial Auto
138 LA2026/02Louisiana Garage and Dealers
290 LA2023/102026/07Louisiana Personal Auto Application Section
862 LA2009/06Louisiana Property Supplement – Hurricane Loss Mitigation Survey
863 LA2023/01Notice of Homeowner’s Insurance Policy Deductible
50 ME2024/11Maine Motor Vehicle Insurance Identification Card
51 ME2022/01Maine Temporary Motor Vehicle Insurance Identification Card
61 ME2025/09Maine Auto Supplement – UM Selection/Rejection
90 ME2025/09Maine Personal Auto Application
137 ME2025/09Maine Commercial Auto
138 ME2015/12Maine Garage and Dealers
290 ME2025/09Maine Personal Auto Application Selection
36 MD2020/05Maryland Change of Insurance Producer of Record
39 MD2016/05Maryland Personal Insurance Supplement
50 MD2016/10Maryland Motor Vehicle Liability Insurance ID Card
62 MD1/98Maryland Commercial Auto Supplement
64 MD2026/04Maryland Property Insurance Availability Program Essential Property Insurance Inspection and Placement
65 MD2026/04Maryland Property Insurance Availability Program – Essential Homeowners Insurance Inspection an Placement (p. 1 of 2)
66 MD2022/09Maryland Property Insurance Availability Program – Essential Homeowners Insurance Inspection an Placement (p. 2 of 2)
67 MD2018/07Maryland Personal Auto Supplement – Mandatory Offer of Increased Liability Coverage for Claims of Family Members, Mandatory PIP Waiver, and Mandatory UM Coverage Waiver
68 MD2007/01Maryland Personal Property Supplement – Statement Regarding Flood Insurance
69 MD2013/10Maryland Insurance Supplement – Notice of Underwriting Period
82 MD2025/07Maryland Watercraft Application
83 MD2025/07Maryland Personal Umbrella Application
90 MD2024/11Maryland Personal Auto Application
95 MD2024/07Maryland Required Notice of UM Coverage and Enhanced Motorist (“EUIM”) Coverage and Option Selection Form
137 MD2015/12Maryland Commercial Auto
138 MD2015/12Maryland Garage and Dealers
282 MD2025/07Marland Watercraft Section
283 MD2025/07Maryland Personal Umbrella Application Section
290 MD2024/11Maryland Personal Automobile Application Section
851 MD2008/11Maryland Personal Property Supplement – Loss from Water and Sewer Backup
852 MD2012/10Maryland Personal Property Supplement – Homeowner’s Insurance, Limitation of Claims Made Notice
853 MD2014/01Maryland Personal Property Supplement
60 MA2026/03Massachusetts Property Insurance Underwriting Association Application for Homeowners Insurance
61 MA2026/03Massachusetts Property Insurance Underwriting Association Instructions to Complete Homeowners Application ACORD 60 MA
64 MA2/97Massachusetts Residential Property Liability Supplement Lead Poisoning Liability Disclosure Notice
65 MA2026/03Massachusetts Property Insurance Underwriting Association Application for Dwelling Fire and Liability Insurance Inspection and Placement
66 MA2026/03Massachusetts Property Ins. Underwriting Assn. – Instructions for Completing Dwelling Fire and Liability Insurance Inspection and Placement
67 MA2003/04Massachusetts Property Ins. Underwriting Assn. – Application for Commercial Fire Insurance Inspection and Placement
68 MA2003/04Massachusetts Property Ins. Underwriting Assn. Inspection Notice, Credit Reporting notice and Instructions for Completing Commercial Fire Application ACORD 67 MA
69 MA2010/07Massachusetts Residential Property Liquid Fuel Spill Supplement
90 MA2026/03Application for Massachusetts Motor Vehicle Insurance
95 MA2009/12Massachusetts Renewal Application (Statement of Facts)
137 MA2026/03Massachusetts Commercial Auto
138 MA2026/03Massachusetts Garage and Dealers
50 MI2010/08State of Michigan Certificate of No-Fault Insurance
60 MI2010/03Michigan Automobile Insurance Placement Facility: Michigan Auto Supplement – Declaration of Intent to Reside
61 MI2025/07Michigan Choice of Bodily Injury Liability Coverage Limits
62 MI2020/07Michigan Collision Insurance Options Notice
64 MI2000/10Michigan Basic Property Insurance Assn. Insurance Application
66 MI2025/07Michigan Selection of Personal Injury Protection (PIP) Medical Coverage - Individual
90 MI2020/07Michigan Personal Auto Application
133 MI2012/08Michigan Application for Workers’ Compensation Insurance
136 MI2025/07Michigan Selection of Personal Injury Protection (PIP) Medical Coverage - Commercial Business
137 MI2020/07Michigan Commercial Auto Coverages (Coverages/Limits Section)
138 MI2020/07Michigan Garage and Dealers
139 MI2004/07Michigan Automobile Insurance Placement Facility Supplement to ACORD App. – Application for Commercial, Public Automobiles and Corporately Owned Vehicles
171 MI2005/01Michigan Notice of Election
172 MI4/96Michigan Application for Exclusion of Partner(s), Spouse, Child or Parent
173 MI2000/09Michigan WC Placement Facility Specific Person Exclusion
290 MI2020/07Michigan Personal Automobile Application Section
860 MI2020/07Michigan Auto Supplement – Declaration of Intent to Reside
38 MN2021/08Minnesota Authorization
62 MN2000/01Minnesota Auto Supplement
65 MN2020/10Minnesota Insurance Guarantee Association Notice
67 MN2024/05Minnesota Personal Boat Insurance Notice Election to Decline Bodily Injury Coverage
80 MN2024/07Minnesota Homeowner Application
82 MN2025/07Minnesota Watercraft Application
83 MN2025/07Minnesota Personal Umbrella Application
85 MN2024/04Minnesota Mobile Home Application
90 MN2019/12Minnesota Personal Auto Application
137 MN2015/12Minnesota Commercial Auto
138 MN2015/12Minnesota Garage and Dealers
282 MN2025/07Minnesota Watercraft Section
283 MN2025/07Minnesota Personal Umbrella Application Section
290 MN2019/12Minnesota Personal Auto Application Section
807 MN2016/03Minnesota D&O Liability Insurance Section
827 MN2016/03Minnesota Employment Practices Liability Insurance Section
828 MN2016/03Minnesota Fiduciary Liability Coverage Section
832 MN2016/03Minnesota Miscellaneous E&O Section
833 MN2014/12Minnesota Lawyers Professional Liability Section
834 MN2014/12Minnesota Cyber and Privacy Coverage Section
838 MN2013/12Minnesota Accountants Professional Liability Section
853 MN2010/08Minnesota Homeowners Personal Property Supplement
50 MS2008/01Mississippi Auto Insurance ID Card
61 MS2025/12Mississippi Auto Supp – Non-Stacking UM Insurance
62 MS2016/07Mississippi Auto Supplement – Selection / Rejection of Uninsured Motorist Insurance
66 MS2016/11Mississippi Insurance Supplement
80 MS2026/02Mississippi Homeowner Application
90 MS2016/07Mississippi Personal Auto Application
137 MS2016/07Mississippi Commercial Auto
138 MS2016/07Mississippi Garage and Dealers
139 MS2/99Mississippi Statements/Schedule of Values
290 MS2016/07Mississippi Personal Auto Application Section
50 MO2007/05Missouri Auto Insurance ID Card
58 MO2024/07Missouri Notice of Cancellation, Nonrenewal, Reduction in Amount or Adverse Modification
62 MO2007/08Missouri Property Supplement – Notice of Availability Earthquake Insurance
67 MO2009/06Missouri FAIR Plan Insurance Application
83 MO2025/08Missouri Personal Umbrella Application
85 MO2026/03Missouri Mobile Home Application
90 MO2015/12Missouri Personal Auto Application
137 MO2015/12Missouri Commercial Auto
138 MO2015/12Missouri Garage and Dealers
283 MO2025/08Missouri Personal Umbrella Application Section
290 MO2014/12Missouri Personal Auto Application Section
38 MT2025/11Montana Notice of Information Practices (Privacy)
60 MT2025/07Montana Application Supplement – Refusal to Renew
90 MT2025/11Montana Personal Auto Application
137 MT2025/11Montana Commercial Auto
138 MT2025/11Montana Garage and Dealers
290 MT2025/11Montana Personal Auto Application Section
807 MT2016/03Montana Directors & Officers Liability Section
827 MT2016/03Montana Employment Practices Liability Insurances Section
828 MT2016/03Montana Fiduciary Liability Coverage Section
832 MT2016/03Montana Miscellaneous E&O Section
833 MT2014/12Montana Lawyers Professional Liability Section
834 MT2014/12Montana Cyber and Privacy Coverage Section
838 MT2013/12Montana Accountants Professional Liability Section
50 NE2007/01Nebraska Auto Liability Insurance ID Card
90 NE2015/12Nebraska Personal Auto Application
137 NE2015/12Nebraska Commercial Auto
138 NE2015/12Nebraska Garage and Dealers
290 NE2014/12Nebraska Personal Auto Application
51 NV2016/07Nevada Temporary Insurance Identification Card
52 NV2025/10Nevada Permanent Insurance Identification Card
53 NV2016/07Nevada Temporary Insurance Identification Card, Evidence of Operator’s Policy of Liability Insurance
54 NV2016/07Nevada Permanent Insurance Identification Card, Evidence of Operator’s Policy of Liability Insurance
61 NV2021/10Nevada Auto Supplement, Mandatory Offer of Medical Payments Coverage and Uninsured Motorists Coverage
62 NV2001/05Nevada Umbrella Supplement
80 NV2022/01Nevada Homeowner Application
83 NV2025/06Nevada Personal Umbrella Application
84 NV2022/01Nevada Dwelling Fire Application
85 NV2022/01Nevada Mobile Home Application
89 NV2022/01Nevada Residential Section
90 NV2015/12Nevada Personal Auto Application
137 NV2015/12Nevada Commercial Auto
138 NV2015/12Nevada Garage and Dealers
283 NV2025/06Nevada Personal Umbrella Application Section
290 NV2014/12Nevada Personal Auto Application Section
62 NH2026/03New Hampshire Auto Supplement – UM Rejection
90 NH2021/07New Hampshire Personal Auto Application
137 NH2018/05New Hampshire Commercial Auto
138 NH2015/12New Hampshire Garage and Dealers
290 NH2021/07New Hampshire Personal Auto Application Section
50 NJ2016/12State of NJ Temporary Evidence of Insurance
51 NJ2016/12State of NJ Insurance Identification Card
60 NJ2001/10New Jersey Homeowners Insurance Supplement Flood Exclusion
61 NJ2023/01New Jersey Auto Insurance Buyer’s Guide
62 NJ2025/11New Jersey Auto Supplement – Basic Policy Coverage
64 NJ2026/01New Jersey Auto Supplement – Standard Policy Coverage
65 NJ2017/04New Jersey Property Insurance Supplement – Earthquake
66 NJ2026/04New Jersey Auto Insurance Buyer’s Guide Commercial PPA Edition
67 NJ2018/06NJUIA Dwelling Fire Application
68 NJ2018/06NJUIA Commercial Fire Application
90 NJ2025/07New Jersey Personal Auto Application
94 NJ2006/04Insurance Inspection Report
124 NJ2021/11New Jersey Supplement One-Page Summary - Commercial Property/ Business Income Business Interruption Coverage
132 NJ2025/03New Jersey Workers Compensation Insurance Plan Notes and Instructions (Coverage Request Form)
133 NJ2025/03New Jersey Workers Compensation Insurance Plan Coverage Request Form
134 NJ2015/09New Jersey Workers Compensation Insurance Plan Notice of Election – Proprietors and Partners
135 NJ2015/09New Jersey Workers Compensation Insurance Plan Employee Leasing Supplemental Request Form
136 NJ2015/09New Jersey Workers Compensation Insurance Plan Truckers Supplemental Request Form
137 NJ2025/07New Jersey Commercial Auto
138 NJ2025/07New Jersey Garage and Dealers
171 NJ2003/07New Jersey Workers Compensation Insurance Plan – NJ Workers compensation and Employers Liability Manual Part 3, Section 14
290 NJ2025/07New Jersey Personal Auto Application Section
60 NM2003/01New Mexico Confidential Abuse Disclosure
61 NM2025/07New Mexico Auto Supplement – UM Coverage Selection / Rejection and Rejection of Stacked UM Coverage
90 NM2026/05New Mexico Personal Auto Application
137 NM2026/06New Mexico Commercial Auto
138 NM2026/06New Mexico Garage and Dealers
171 NM2004/10New Mexico Executive Employee Affirmative Election Form
172 NM2004/10New Mexico Election to Accept
173 NM2004/10New Mexico Revocation
174 NM2004/10New Mexico Limited Liability Company Member Affirmative Election Form
290 NM2026/05New Mexico Personal Auto Application Section
38 NY2005/04New York Personal Insurance Supplement – Notice of Information Practices
39 NY2011/03New York Insurance Supplement
60 NY2008/03New York Homeowners Supplement
61 NY2026/04New York Auto Supplement (Optional Basic Econ. Loss)
62 NY2026/04New York Application for Dwelling Insurance – NYPIUA
64 NY2026/04New York Auto Supplement – Supp. UM/UIM Insurance Coverage
65 NY2025/03New York Auto Supplement – Spousal Liability Coverage
66 NY2012/01New York Auto Supplement – Rental Reimbursement Notice
67 NY2009/04Instructions for Completion of ACORD 62 NY
68 NY2002/01New York Liability Supplement – “Claims-Made Policy”
69 NY2008/08New York Personal Property Supplement – Important Flood Insurance Notice
70 NY2006/04NYPIUA Instructions for Completing ACORD 177 NY
80 NY2022/02New York Homeowner Application
83 NY2025/06New York Personal Umbrella Application
84 NY2022/02New York Dwelling Fire Application
85 NY2022/02New York Mobile Home Application
88 NY2022/02New York Personal Insurance Application
89 NY2022/02New York Residential Section
90 NY2023/08New York Personal Auto Application
137 NY2023/08New York Commercial Auto
138 NY2021/03New York Garage and Dealers
171 NY10/96New York Notice of Election of a Corporation
172 NY2026/05New York Election of Partners or Self-Employed Persons for Workers’ Compensation Coverage
173 NY2026/05New York Election of Executive Officers of an Organization for Workers’ Compensation Coverage
174 NY7/96New York Revocation of Executive officers of an Organization for Workers’ Compensation Coverage
177 NY2006/04NYPIUA Application for Commercial Insurance
283 NY2025/06New York Personal Umbrella Section
290 NY2023/08New York Personal Auto Application Section
855 NY2014/05New York Construction Certificate of Liability Insurance Addendum
60 NC2025/09North Carolina Auto Supplement – Selection of UM/UIM
64 NC2008/04North Carolina Property Supplement – Prop. Ins. Notice Disclosure
65 NC2025/07North Carolina Auto Supplement – Notice of Right to Purchase Higher Limits of UM and UIM Coverage
66 NC8/97North Carolina Insurance Supplement – Consent to Obtain Credit or Consumer Investigative Report
67 NC2012/03North Carolina Insurance Supplement – Policy Service Fee Schedule
82 NC2025/07North Carolina Watercraft Application
83 NC2025/07North Carolina Personal Umbrella Application
90 NC2025/12North Carolina Personal Auto Application
135 NC2024/08North Carolina Workers Comp. Insurance Plan App
136 NC2024/08NCWCIP, Instructions for Completing ACORD 135 NC App.
137 NC2025/09North Carolina Commercial Auto
138 NC2025/09North Carolina Garage and Dealers
282 NC2025/07North Carolina Watercraft Section
283 NC2025/07North Carolina Personal Umbrella Application Section
290 NC2025/12North Carolina Personal Automobile Application Section
38 ND2005/08North Dakota Personal Insurance Supplement – Notice of Information Practices
50 ND2025/07North Dakota Insurance Identification Card
62 ND2015/04North Dakota Insurance Supplement
68 ND2004/07North Dakota Supplement to Property Insurance – Fire District
90 ND2015/12North Dakota Personal Auto Application
137 ND2015/12North Dakota Commercial Auto
138 ND2015/12North Dakota Garage and Dealers
290 ND2014/12North Dakota Personal Auto Application Section
62 OH2011/05Ohio Auto Supplement – Important Optional Disclosure Notice Uninsured Motorist Property Damage Coverage
67 OH2009/07Ohio Mine Subsidence Homeowners and Dwelling Supplement
68 OH2009/07Ohio Offer of Mine Subsidence – Homeowner and Dwellings
80 OH2026/03Ohio Homeowner Application
90 OH2015/12Ohio Personal Auto Application
137 OH2015/12Ohio Commercial Auto
138 OH2015/12Ohio Garage and Dealers
170 OH2002/09Ohio FAIR Plan – Instruction for Completion of Insurance Apps.
171 OH2004/03Ohio FAIR Plan – Basic Property Application
172 OH2002/09Ohio FAIR Plan – Homeowners Supplement
173 OH2002/09Ohio FAIR Plan – Dwelling Fire Supplement
174 OH2002/09Ohio FAIR Plan – Commercial Supplement
175 OH2002/09Ohio FAIR Plan – Farm Supplement
176 OH2002/09Ohio FAIR Plan – Rehabilitation Supplement
177 OH2002/09Ohio FAIR Plan – Bowling Alley Supplement
290 OH2014/12Ohio Personal Automobile Application Section
50 OK2024/12Oklahoma Owners Security Verification Form
51 OK2024/12Oklahoma Operators Security Verification form
60 OK2024/12Oklahoma Auto Supplement – UM Coverage Law
62 OK2006/05Notice to Property Owners in Rural Fire Protection Districts
64 OK2007/10Oklahoma Liability Supplement
66 OK2022/06Oklahoma Extraordinary Life Circumstances Request
90 OK2025/09Oklahoma Personal Auto Application
137 OK2024/12Oklahoma Commercial Auto
138 OK2024/12Oklahoma Garage and Dealers
290 OK2024/12Oklahoma Personal Automobile Application Section
38 OR2013/01Oregon Notice of Information Practices (Privacy)
61 OR2016/01Oregon Auto Supplement – UM Coverage Selection
62 OR2006/01Oregon Personal Lines Supplement
82 OR2025/07Oregon Watercraft Application
83 OR2025/07Oregon Personal Umbrella Application
90 OR2018/08Oregon Personal Auto Application
137 OR2016/01Oregon Commercial Auto
138 OR2016/01Oregon Garage and Dealers
282 OR2025/07Oregon Watercraft Section
283 OR2025/07Oregon Personal Umbrella Application Section
290 OR2018/08Oregon Personal Auto Application Section
50 PA2007/09Pennsylvania Financial Responsibility Card
58 PA2021/05Pennsylvania Notice of Cancellation or Notice of Nonrenewal
60 PA2012/10Pennsylvania UM Coverage Select/Reject
61 PA2014/02Pennsylvania Auto Supplement – Important Notice
62 PA2012/10Pennsylvania UIM Coverage Select/Reject
64 PA2015/05Insurance Placement Facility of Pennsylvania Basic Property Insurance Application
65 PA / DE/ WV2015/05FAIR Plan Supplementary Questionnaire
66 PA2015/05Insurance Placement Facility of Pennsylvania Dwelling Property 2 – Broad Form Application Supplement
90 PA2015/12Pennsylvania Personal Auto Application
137 PA2015/12Pennsylvania Commercial Auto
138 PA2015/12Pennsylvania Garage and Dealers
171 PA2002/02Pennsylvania Application for Executive Officer Exception
172 PA2002/02Pennsylvania Executive Officers Declaration
290 PA2015/12Pennsylvania Personal Auto Application Section
90 PR2015/12Puerto Rico Personal Auto Application
290 PR2014/12Puerto Rico Personal Auto Application Section
50 RI2024/08Rhode Island Insurance Identification Card
61 RI2012/12Rhode Island Auto Supplement, Uninsured / Underinsured Motorist Bodily Injury Coverage
62 RI2006/01Rhode Island Prop. Suppl. – Notice of Flood Coverage Exclusion
64 RI2024/12Rhode Island Joint Reinsurance Association, Application for Homeowners Insurance Inspection and Placement
65 RI2003/04Rhode Island Joint Reinsurance Association, Instructions for Completing Homeowners Applications ACORD 64 RI
66 RI2024/12Rhode Island Joint Underwriting Insurance Application for Dwelling Fire and Personal Liability Insurance Inspection and Placement
67 RI2007/03Rhode Island Joint Underwriting Insurance Inspection Notice, Credit Reporting Notice and Instructions for Completing Dwelling Fire and Personal Liability Application ACORD 66 RI
68 RI2003/04Rhode Island Joint Underwriting Insurance Application for Commercial Fire Insurance Inspection and Placement
69 RI2003/04Rhode Island Joint Underwriting Insurance Inspection Notice, Credit Reporting Notice and Instructions for Completing Commercial Fire Application ACORD 68 RI
90 RI2015/12Rhode Island Personal Auto Application
137 RI2015/12Rhode Island Commercial Auto
138 RI2015/12Rhode Island Garage and Dealers
290 RI2016/06Rhode Island Personal Automobile Application Section
9 SC2026/09South Carolina Required Notice for Motor Vehicle Insurance Applications
10 SC2026/09South Carolina Required Notice for Property and Casualty Applications
50 SC2025/07South Carolina Insurance Identification Card
60 SC2019/09South Carolina Auto Supplement, Required Notice
61 SC2026/09South Carolina Auto Supplement – Offer of Opt UM/UIM Coverage
64 SC2008/03South Carolina Personal Property Supplement – Cancellation Rules Disclosure
65 SC2026/09South Carolina Auto Supplement - Offer Of Additional Uninsured Motorist Coverage And Optional Underinsured Motorist Coverage For Commercial/Business
80 SC2025/11South Carolina Homeowner Application
84 SC2026/04South Carolina Dwelling Fire Application
90 SC2020/04South Carolina Personal Auto Application
137 SC2025/11South Carolina Commercial Auto
138 SC2025/11South Carolina Garage and Dealers
290 SC2020/04South Carolina Personal Automobile Application Section
50 SD2007/02South Dakota Insurance Identification Card
61 SD2013/02South Dakota Personal Umbrella Supplement
62 SD2019/10South Dakota Auto Supplement: Required Notice for Personal Umbrella Policies Without UM/UIM
90 SD2015/12South Dakota Personal Auto Application
137 SD2015/12South Dakota Commercial Auto
138 SD2015/12South Dakota Garage and Dealers
180 SD2016/03South Dakota Technology E&O Section
290 SD2014/12South Dakota Personal Auto Application Section
50 TN2007/02Tennessee Insurance Identification Card
90 TN2015/12Tennessee Personal Auto Application
137 TN2021/11Tennessee Commercial Auto
138 TN2021/11Tennessee Garage and Dealers
290 TN2014/12Tennessee Personal Automobile Application
50 TX2020/1Texas Liability Insurance Card
60 TX2025/02Texas Consumer Bill of Rights for Personal Auto
62 TX2025/02Texas Consumer Bill of Rights for Personal Auto (Spanish)
64 TX2003/04Texas Windstorm Insurance Association Application
67 TX2025/02Texas Homeowners and Personal Property – Rights
68 TX2025/02Texas Homeowners and Personal Property – Rights (Spanish)
69 TX2000/08Texas Special Mobile Home Windstorm/Hail Application
70 TX2025/01Texas Supplement
71 TX2025/01Texas Supplement
72 TX2025/01Texas Workers’ Compensation Supplement
90 TX2015/12Texas Personal Auto Application
137 TX2015/12Texas Commercial Auto
138 TX2015/12Texas Garage and Dealers
290 TX2015/12Texas Personal Automobile Application Section
851 TX2020/07TX Personal Lines Supp. – Use of Credit Information Disclosure
852 TX2020/07TX Personal Lines Supp. (Spanish Version) – Use of Credit Information Disclosure
854 TX2012/08Texas Risk Pool Certificate of Property Coverage
855 TX2015/02Texas Risk Pool Certificate of Liability Coverage
60 US2020/09Insurance Supplement – Offer of Terrorism Coverage
62 US2020/09Insurance Supplement – Offer of Terrorism Coverage Standard Fire Policy
64 US2020/09Insurance Supplement – Offer of Terrorism Coverage Workers Compensation
51 UT2024/08Utah Insurance Identification Card
61 UT2025/09Utah Auto Supplement Uninsured / Underinsured Motorist Coverage Selection
62 UT2025/09Utah Auto Supplement – UIM Coverage Selection/Rejection
63 UT9/93Utah Fraud Statement
64 UT2026/04Utah Auto Supplement – Notice Regarding UM Coverage for Add’l Vehicle(s)
65 UT2026/04Utah Auto Supplement – Notice Regarding UIM Coverage for Add’l Vehicle(s)
66 UT6/94Utah Arbitration Provisions
67 UT2020/06Utah Auto Supplement PIP Coverage, Loss of Income Waiver
90 UT2015/12Utah Personal Auto Application
137 UT2025/09Utah Commercial Auto
138 UT2025/09Utah Garage and Dealers
290 UT2014/12Utah Personal Auto Application Section
50 VT2024/08Vermont Automobile Insurance Identification Card
66 VT2003/06Vermont Insurance Supp – Fair Credit Reporting Act
90 VT2020/08Vermont Personal Auto Application
137 VT2015/12Vermont Commercial Auto
138 VT2015/12Vermont Garage and Dealers
290 VT2020/08Vermont Personal Auto Application Section
90 VI2015/12Virgin Islands Personal Auto Application
137 VI2014/08Virgin Islands Commercial Auto
138 VI2015/06Virgin Islands Garage and Dealers
290 VI2014/12Virgin Islands Personal Auto Application Section
38 VA2018/12Virginia Notice of Information Practices (Privacy)
60 VA2019/05Virginia Auto Supplement – Rental Reimbursement Coverage
61 VA2026/01Virginia Auto Supplement – Notice of Optional Medical and Disability Coverage
62 VA6/97Virginia Property Supplement Ordinance or Law Coverage; Additional Cov. Available
64 VA2005/01Virginia Property Supplement – Notice of Flood Insurance
65 VA2025/042026/01Virginia Auto Supplement – Notice Regarding Uninsured Motorist Coverage
66 VA2023/072026/01Virginia Auto Supplement: Election to Reduce Underinsured Motorists
67 VA2000/11Virginia Property Insurance Association
68 VA2025/07Virginia Auto Supplement – Uninsured Motorists Alternative Coverage Selection
69 VA2025/07Virginia Auto Supplement – Uninsured Motorists Coverage Selection/Rejection
80 VA2025/07Virginia Homeowner Application
81 VA2025/07Virginia Personal Inland Marine Application
83 VA2025/07Virginia Personal Umbrella Application
88 VA2025/07Virginia Personal Insurance Application
90 VA2025/11Virginia Personal Auto Application
137 VA2025/11Virginia Commercial Auto
138 VA2025/11Virginia Garage and Dealers
283 VA2025/07Virginia Personal Umbrella Application Section
290 VA2025/11Virginia Personal Auto Application Section
80 WA2021/06Washington Homeowner Application (Without Credit)
85 WA2021/06Washington Mobile /Home Application (Without Credit)
137 WA2016/12Washington Commercial Auto
90 WA2024/02Washington Personal Auto Application
90 WA2024/02Washington Personal Auto Application (Without Credit)
137 WA2024/02Washington Commercial Auto Application
138 WA2016/12Washington Garage and Dealers
290 WA2016/12Washington Personal Auto Application Section
290 WA2024/02Washington Personal Auto Application Section (Without Credit)
38 WV2020/9West Virginia Personal Insurance Supplement Notice of Insurance Information Practices
50 WV2024/09West Virginia Certificate of Insurance
60 WV2021/06West Virginia Auto Supplement – UM / UIM Vehicle Coverage
61 WV2016/01West Virginia Auto Supplement – UM / UIM Coverage Offer Split Limits
62 WV2016/01West Virginia Auto Supplement – UM / UIM Coverage Offer Single Limits
64 WV2015/05West Virginia Essential Property Insurance Association Basic Property Insurance Application
65 WV2016/01West Virginia Umbrella Liability Supplement Important Notice
65 PA / DE / WV2015/05FAIR Plan Supplementary Questionnaire
66 WV2021/06West Virginia Personal and Commercial Umbrella Liability Supplement – UM / UIM Coverage – Offer of Split Limits
672017/01Illinois / Indiana/ Kentucky/ West Virginia Mine Subsidence Property Insurance Supplement
68 WV2021/06West Virginia Umbrella Liability Supplement UM / UIM Coverage – Offer of Single Limits
90 WV2020/09West Virginia Personal Auto Application
137 WV2015/12West Virginia Commercial Auto
138 WV2015/12West Virginia Garage and Dealers
290 WV2020/09West Virginia Personal Auto Application Section
862 WV2005/07West Virginia Property Supplement – Notice of Flood Coverage Exclusion
4 WI2026/05Wisconsin Employers First Report of Injury or Disease
61 WI2025/02Wisconsin Auto Supplement
90 WI2015/12Wisconsin Personal Auto Application
97 WI2003/10Wisconsin Automobile Insurance Plan Private Passenger Auto Application
133 WI2010/04Wisconsin Workers Compensation Insurance Pool
134 WI8/99Wisconsin Supplementary Non-Election Form
135 WI8/99Wisconsin Supplementary Election of Coverage Form
136 WI2010/04Wisconsin Supplement Limited Other States Coverage Request
137 WI2025/02Wisconsin Commercial Auto
138 WI2025/02Wisconsin Garage and Dealers
177 WI2011/11Wisconsin Automobile Insurance Plan Business Auto Application
178 WI2011/11Wisconsin Automobile Insurance Plan – Truckers Application
290 WI2016/06Wisconsin Personal Auto Application
90 WY2015/12Wyoming Personal Auto Application
137 WY2015/12Wyoming Commercial Auto
138 WY2015/12Wyoming Garage and Dealers
290 WY2014/12Wyoming Personal Auto Application Section
30202012/02Home Certificate of Currency
30212012/02Private Motor Certificate of Currency
30222012/02Professional Indemnity Certificate of Currency
30232012/02Commercial Motor Certificate of Currency
30452012/02Interested Party Schedule
30802012/03Home Application for Insurance
30902012/03Personal Motor Application for Insurance
30982012/03Personal Motor Vehicle Schedule
31012012/02Additional Remarks Schedule
31292012/02Commercial Motor Vehicle Schedule
31372012/02Commercial Motor Application for Insurance
31632012/02Commercial Driver Schedule
38232012/02Additional Situations Schedule
38252012/02Professional Indemnity Insurance Application
38262012/02Industrial Special Risks Insurance Application
38272012/10Business Package Application for Insurance
6012023/07Consent for Incorporating a Social Objective or other Nonfinancial Objective
6502013/01Authorization for the Release of Health Information
6512007/07Electronic Funds Transfer Authorization Form for Long Term Care Insurance
6522007/07Credit Card Payment Authorization Form for Long Term Care Insurance
6532008/04Policy Delivery Receipt
6602021/06Insurance Agent (Producer) Disclosure for Annuities
6612020/12Consumer Refusal to Provide Information for Annuity Disclosures
7012025/05Application For Individual Life Insurance – Part 1
7022025/05Application For Individual Life Insurance – Part 2
7032025/05Application For Individual Life Insurance – Part 3
7042025/05Individual Life Insurance Application Supplemental Information
7052025/05Individual Life Insurance Application Aviation Supplement
7062025/05Individual Life Insurance Application Rock and Mountain Climbing Supplement
7072025/05Individual Life Insurance Application Aerial Sports Supplement
7082025/05Individual Life Insurance Application Motor Sports Racing Supplement
7092025/05Life Insurance Application Diving Supplement
7102025/05Individual Life Insurance Application Snowmobile Racing, Backcountry Skiing, Snowboarding, And Heliskiing Supplement
7312010/05Request for Proposal – Additional Unions Schedule
7322010/05Request for Proposal – Additional Locations Schedule
7332010/05Request for Proposal – Additional Covered Affiliates Schedule
7522004/01Illustration Certification and Acknowledgement
7602007/03Important Notice Regarding Replacement
7642004/03Fair Credit Reporting Act Disclosure
7652025/05Individual Life Insurance Application Agent’s Report
7822025/05Individual Life Insurance Application Examiner’s Report
7832008/01HIV Antibody/Antigen Consent and Testing Form
7842008/01Informal Inquiry Application – Part 2 Medical History Medical Conditions Details / Additional Care Providers
7852016/07Request for Proposal – Employee Benefits
7862016/07Request for Proposal – Life Supplement
7872016/07Request for Proposal – Short Term Disability Supplement
7882016/07Request for Proposal – Long Term Disability Supplement
7892010/05Age Banded Rate Supplement
7902010/05Reducing Benefit Duration Schedule
7912010/05Administrative Services and Fee Schedule – Long Term Disability
7922010/05Administrative Services and Fee Schedule – Short Term Disability
7942012/01Request for Proposal – Dental and Vision Supplement
8212015/10Producer Information Form (PIF)
8762015/10Background Check Authorization
8772015/10Disclosure of Intent to Obtain Consumer Report or Investigate Consumer Report (except California)
9502025/02Change of Annuity Financial Professional and/or Broker/Dealer Form
951e2024/121035 Exchange / Rollover / Transfer eForm
966 AR2007/03Arkansas Annuity Product Comparison Form
757 CA2004/07California HIV Antibody/Antigen Consent and Testing Form
760 CA2015/06California Notice Regarding Replacement
877 CA2015/10California Disclosure of Intent to Obtain an Investigative Consumer Report
966 CA2007/03California Annuity Product Comparison Form
757 DC2004/07District of Columbia HIV Antibody/Antigen Consent and Testing Form
757 FL2005/03Florida HIV Antibody/Antigen Consent and Testing Form
759 FL2005/06Florida Notice to Applicant Regarding Replacement of Life Insurance
761 FL2016/07Florida Surrender of an Annuity or Life Insurance Policy
966 FL2007/03Florida Annuity Product Comparison Form
969 FL2007/03Florida Annuity Product Comparison Form Supplement – Policy / Rider Description
760 DE2017/01Delaware Notice Regarding Replacement
760 GA2017/01Georgia Notice Regarding Replacement
760 ID2017/01Idaho Notice Regarding Replacement
960 ID2020/10Idaho Annuity Disclosure
760 IL2017/06Illinois Notice Regarding Replacement
760 A IN2018/01Indiana Notice Regarding Replacement
760 B IN2018/01Indiana Notice Regarding Replacement With Direct Response Sale
757 MA2004/11Massachusetts HIV Antibody/Antigen Consent and Testing Form
760 MA2015/06Massachusetts Important Notice Regarding Replacement
757 MI2004/12Michigan HIV Antibody/Antigen Consent and Testing Form
660 MN2023/09Minnesota Insurance Agent Annuity Sale Disclosure
661 MN2023/09Minnesota Consumer Refusal to Provide Information
662 MN2023/09Minnesota Purchase of an Annuity Not Based on a Recommendation
760 MN2015/12Minnesota Notice Regarding Replacement
751 NY2005/11New York Authorization to Obtain and Disclose Information
752 NY2024/04NYS Standard Form to Designate a Representative to Assist with Health Insurance Authorizations, Complaints, Grievances, and Appeals
753 NY2005/11New York Notice of Insurance Information Practices (Pre Notice)
757 NY2005/11New York HIV Antibody/Antigen Consent and Testing Form
960 NY2007/03New York Disclosure Statement Annuity to Annuity Replacements Only
757 OH2009/02Ohio HIV Antibody/Antigen Consent and Testing Form
757 OR2004/07Oregon HIV Antibody/Antigen Consent and Testing Form
761RI2019/01Rhode Island Notice to Inform Policyholders of Alternatives
766 RI2007/03Rhode Island Life Product Comparison Form
757 TX2004/11Texas HIV Antibody/Antigen Consent and Testing Form
655 VA2010/12Virginia Group Health Insurance – Medical History Form
757 WA2010/05Washington HIV Antibody/Antigen Consent and Testing Form
760 WA2015/06Washington Important Notice Regarding Replacement