Acord Forms Index

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ACORD Forms Index
ACORD Member Services - Phone: (845) 620-1700, Option 2 - Fax: (845) 620-3600
Page 1 of 12
COUNTRYWIDE P&C FORMS
1
2
3
4
11
12
13
23
24
25
26
27
35
36
37
42
45
50
50 WM
54
57
60
60 US
2013/01 Property Loss Notice
Automobile Loss Notice
General Liability Notice of Occur/Claim
Workers Compensation - First Report of Injury or Illness
Auto Accident Information Form2/95
Exchange of Information Form
Witness Card
2/95
2/95
Vehicle or Equipment Certificate of Insurance
Certificate of Property Insurance2009/09
Certificate of Liability Insurance
Policy Certification Log2002/01
Evidence of Property Insurance
Cancellation Request / Policy Release2011/09
Agent/Broker of Record Change
Statement of No Loss2008/01
Residential Property Replacement Cost
Additional Interest Schedule2009/04
Automobile Insurance ID Card2007/02
Financial Responsibility Form1/97
Insurance Supplement - Notice - Offer of Terrorism Coverage
1/97
Flood Insurance Selection / Rejection2010/04
Automobile Insurance ID Card (with Watermark)2007/03
Financial Responsibility Form - Cancellation
2015/01
62 US
Insurance Supplement - Standard Fire Policy Only
Notice - Offer of Terrorism Coverage
63 Fraud Statements
92
93
125
126
127
128
129
Medical Statement
Young Driver Questionnaire
Commercial Insurance Application
Applicant Information Section
Commercial General Liability Section
Business Auto Section
Garage and Dealers Section
Vehicle Schedule
28 Evidence of Commercial Property Insurance
22 Intermodal Interchange Certificate of Insurance
2007/01
58 2007/11 Notice of Cancellation or Termination of Policy
99 Accidents / Convictions Schedule
103
Personal Auto Application Schedule - Additional Resident
and Driver Information Section
101 Additional Remarks Schedule2008/01
2009/11
2009/02
82
83
Watercraft Application
Personal Umbrella Application
91 Good Student Driver Training
88
Personal Insurance Application - Applicant Information
Section
89 Residential Section
5 Aircraft Loss Notice
6 Aviation Witness / Passenger Schedule
7 Aviation Injured Schedule
2009/05
2009/05
20 Certificate of Aviation Liability Insurance2009/12
21 Certificate of Aircraft Insurance
2009/10
2009/12
2012/04
2010/05
2009/12
106 Vacant Building Supplement2010/04
105 Apartment Building Supplement2012/06
80 Homeowner Application
29 Evidence of Flood Insurance
76 Binder Log9/93
30 Certificate of Garage Insurance
75 Insurance Binder2013/09
74
Residence Based Business
Supplement to Residential Section
2009/09
84 Dwelling Fire Application
2012/03
2012/03
2012/03
81 Personal Inland Marine Application
85 Mobile Home Application
73 Solid Fuel Questionnaire - Supplement to Residential Section2009/07
31 Certificate of Marine / Energy Insurance
2013/01
2013/01
2013/01
2013/01
72 Mobile Home Supplement2009/10
38 2013/01 Notice of Insurance Information Practices (Privacy)
71 Personal Auto Policy Change Request2012/03
2014/01
2014/01
2014/01
2014/01
2013/09
2013/09
2013/09
2013/09
2013/09
2013/09
Future forms are intended for use on or after the first day of the edition date month. (e.g., edition date 2014/01 for use on or after 1/1/2014)
66
Personal Insurance Supplement - Extraordinary Life
Circumstances
2011/05
Insurance Supplement - Workers' Compensation Only
Notice - Offer of Terrorism Coverage
64 US
2013/09145 Accounts Receivable / Valuable Papers
131
132
133
139
140
141
Umbrella Section
Truckers / Motor Carriers Section
Workers Compensation Insurance Plan - Assigned Risk
Section
Statement / Schedule of Values
Property Section
Crime Section 2000
2014/09
2015/06
2013/09
2013/09144 Glass And Sign Section
143 Transportation Section
130 Workers Compensation Application2013/09
# Current Title Quantity Current Title QuantityFuture # Future
2013/10
70 Personal Policy Change Request (Except Auto)2012/03
68 Electronic Delivery Supplement2013/08
2013/12
ACORD Forms Index (rev. 09-30-2015)
2014/042014/08
2014/12
2014/12
2014/12
2014/12
2014/12
2014/12
2014/12
2014/12
2014/12
2015/01
2015/01
2015/12
2015/12
2015/12
2013/09147 Installation / Builders Risk Section
2015/09
2015/09
2016/03
2016/03
2016/03
2016/03
2016/03
2016/03
2016/03
2016/03
2016/03
2016/03
2015/12
2016/03
2016/03
2015/12
2016/03
2016/03
2016/03
2016/03
2016/03
2016/03
2016/03
2016/03
2016/03
2016/03
2016/03
2016/03
2016/03
2016/03
Page 1/12
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