| Section Name | Field Name | Field and/or Section Description |
| TITLEACORD 163 (2000/11) | Commercial Auto Driver Information Schedule | Use this form with either ACORD 127, Business Auto Section, ACORD 128, Garage and Dealers Section, or ACORD 132, Truckers/Motor Carriers Section, to record driver information when there is not enough space in ACORD 127, ACORD 128 or ACORD 132 to accommodate the number of drivers of the applicant's or the insured's vehicles. |
| IDENTIFICATION SECTION | Date | Month/day/year (MM/DD/YYYY) on which the form is completed. |
| IDENTIFICATION SECTION | Producer | Agency's name and address. |
| IDENTIFICATION SECTION | Phone No. | Producer's telephone number. |
| IDENTIFICATION SECTION | Fax No. | Producer's fax number. |
| IDENTIFICATION SECTION | Code | Identification code assigned to your agency or brokerage firm by the insurance company receiving this form. |
| IDENTIFICATION SECTION | Sub Code | If your agency uses a sub-code identification system with the company, enter the appropriate code. |
| IDENTIFICATION SECTION | Agency Customer ID | Customers identification number assigned by the agency. |
| IDENTIFICATION SECTION | Applicant Name | Enter the full name of the applicant as it should appear on the policy. (The First Named Insured is given certain rights and responsibilities by the policy contract language. If more than one insured is named, be sure the one intended to receive these rights and responsibilities is named first.) If joint ownership, the name used may include both names (e.g., John and Mary Smith).Wording such as "et al." or "As their interests may appear" is not acceptable as the name of the insured. These phrases are not legal entities. |
| INSTRUCTIONS | | It is necessary to collect information on all drivers that will be covered under this account. The driver list should include any family member that will be driving company vehicles and employees who regularly drive their own vehicles for company business. |
| INSTRUCTIONS | Driver # | Indicate driver number assigned by the agency/agency-vendor system used for tracking purposes. |
| INSTRUCTIONS | Name | Enter driver's full name. If the company requires the address, enter it as well. |
| INSTRUCTIONS | Sex | Enter F for female, M for male. |
| INSTRUCTIONS | Mar Stat | Enter the marital status for each listed driver. Examples:S. . . . . . . . . . . . . . . . . . . . . .. Single M. . . . . . . . . . . . . . . . . . . . . . . . . . . . MarriedD . . . . . . . . . . . . . . . . . . . . . . DivorcedSP . . . . . . . . . . . . . . . . . . . . SeparatedW. . . . . . . . . . . . . . . . . . . . . . . . Widowed |
| INSTRUCTIONS | Date of Birth | Enter driver's birth date. |
| INSTRUCTIONS | Yrs Exp | Enter the number of years of driving experience for each driver. |
| INSTRUCTIONS | Year Licensed | Enter year in which the driver was first licensed. |
| INSTRUCTIONS | Driver's License Number/Soc. Sec. # | Enter complete driver's license number. If a license number is unavailable, enter the driver's social security number. |
| INSTRUCTIONS | State Lic. | Enter the state in which the license was issued. |
| INSTRUCTIONS | Date Hire | Enter the date of hire for each listed driver (MM/DD/YYY). |
| INSTRUCTIONS | Broadened No-fault | Check this column for any driver that has been provided broadened no fault coverage. |
| INSTRUCTIONS | DOC | Check this column for any driver that has been provided with Drive Other Car coverage. |
| INSTRUCTIONS | Use Vehicle # | Enter the vehicle number that this driver primarily uses. |
| INSTRUCTIONS | % Use | Indicate the percentage of driving done by this driver in the primary vehicle that this driver uses. |
