New Forms
- June 30th, 2006 ACORD has introduced the following:
Iowa
ACORD 66IA - Iowa
Personal Insurance Supple,emt Disclosure Use of Claims History
Revised
ACORD Forms
Countrywide
ACORD 325 - Aviation
Insurance Application - Applicant Information Section
ACORD 331 - Pilot
Experience
Connecticut
ACORD 66CT - Connecticut
FAIR Plan Homeowners App HO4 Renters Coverage
Illinois
ACORD 62IL - Illinois
Property Supplement - Notice of Availability of Earthquake Insurance
Iowa
ACORD 90IA - Iowa
Personal Auto Application
Maryland
ACORD 964MD -
MAryland Property Insurance Availability Program Essential Property Insurance
Inspection and Placement
Minnesota
ACORD 60MN - Minnesota
FAIR Plan Homeowners App HO6 Condo Unit Owners Coverage
ACORD 64MN - Minnesota
FAIR Plan Homeowners App HO4 Renters
ACORD 66MN - Minnesota
FAIR Plan Homeowners HO8 Application
ACORD 67MN - Minnesota
FAIR Plan Dwelling Fire Application
ACORD 68MN - Minnesota
FAIR Plan Commercial Fire Application
ACORD 69MN - Minnesota
FAIR Plan Farm Fire Application
New Jersey
ACORD 132NJ -
New Jersey Workers Compensation Insurance Plan Instructions and Rules Company
ACORD 133NJ -
New Jersey Workers Compensation Insurance Plan Application for Designation of
an Insurance
Washington
ACORD 90WA - Washington
Personal Auto Application
ACORD 137WA -
Washington Commercial Auto
ACORD 138WA -
Washington Garage and Dealers
New Forms
- May 26th, 2006 ACORD has introduced the following:
California
ACORD 861CA -
California Residential Property Insurance Bill of Rights
Revised
ACORD Forms
Countrywide
ACORD 38 - Notice
of Information Practices (Privacy)
ACORD 60 - Flood
Insurance Notice / Rejection
ACORD 63 - General
Fraud Statement
ACORD 325 - Aviation
Insurance Application
Life and
Annuity
ACORD 951 - 1035
Exchange / Rollover / Transfer Form
Massachusetts
ACORD 137MA -
Massachusetts Commercial Auto
ACORD 138MA -
Massachusetts Garage and Dealers
Minnesota
ACORD 60MN - Minnesota
FAIR Plan Homeowners App HO6 Condo Unit Owners Coverage
ACORD 64MN - Minnesota
FAIR Plan Homeowners App HO4 Renters
ACORD 66MN - Minnesota
FAIR Plan Homeowners HO8 Application
ACORD 67MN - Minnesota
FAIR Plan Dwelling Fire Application
ACORD 68MN - Minnesota
FAIR Plan Commercial Fire Application
ACORD 69MN - Minnesota
FAIR Plan Farm Fire Application
New Hampshire
ACORD 90NH - New
Hampshire Personal Auto Application
ACORD 137NH -
New Hampshire Commercial Auto
ACORD 138NH -
New Hampshire Garage and Dealers
West Virginia
ACORD 65WV - West
Virginia Personal and Commercial Liability Supplement Uninsured/Underinsured
Motor Vehicle Coverage Important Notice
ACORD 137WV -
West Virginia Commercial Auto
ACORD 138WV -
West Virginia Garage and Dealers
Wyoming
ACORD 90WY - Wyoming
Personal Auto Application
ACORD 137WY -
Wyoming Commercial Auto
ACORD 138WY -
Wyoming Garage and Dealers
2
New User Provided Forms
ERM-14 - Confidential
Request for Ownership Information
K-WC 113 - Kansas Dept of
Labor - Workers Compensation - Election of Individual Partner, Member of a Limited
Liability Company, or Self-Employed Individual to Come Within the Provisions
of the Kansas Workers Compensation Act.
New Forms
- April 28th, 2006 ACORD has introduced the following:
Oklahoma
ACORD 62OK - Oklahoma
Property Supplement - Notice to Property Owners in Rural Fire Protection Districts
West Virginia
ACORD 38WV - West
Virginia Personal Insurance Supplement Notice of Insurance Information Practices
Revised
ACORD Forms
Countrywide
ACORD 87 - Personal
Lines PAckage Application - Watercraft / Inland Marine Section
ACORD 810 - Business
Income / Extra Expense / Rental Value - Supplement to Property Section
ACORD 60US - Insurance
Supplement - Notice - Offer of Terrorism Coverage
ACORD 62US - Insurance
Supplement - Standard Fire Policy Only Notice - Offer of Terrorism Coverage
ACORD 64US - Insurance
Supplement - Workers' Compensation Only Notice - Terrorism Insurance Coverage
Arizonia
ACORD 90AZ - Arizonia
Personal Auto Application
ACORD 137AZ -
Arizonia Commercial Auto
ACORD 138AZ -
Arizonia Garage and Dealers
California
ACORD 857 - California
Earthquake Authority Earthquake Insurance Application
District
of Columbia
ACORD 90DC - District
of Columbia Personal Auto Application
ACORD 137DC -
District of Columbia Commercial Auto
ACORD 138DC -
District of Columbia Garage and Dealers
5 New
User Requested Form
- New York Workers
Comp Officer Exclusion
- Additional Premise
Information Supplement for Commercial Property
- Additional Insured
- Owners, Lessees or Contractors - Scheduled Person or Organization
- Artison Contractors
Supplemental Application
- New Jersey Office
of the Attorney General - Home Improvement Contractor Application for Initial
Registration
New Forms
- April 10th, 2006 ACORD has introduced the following:
Countrywide
ACORD 325 - Aviation
Insurance Application - Applicant Information Section
ACORD 326 - Airport
Property Supplement
ACORD 327 - Airport
and FBO Liability Section
ACORD 328 - Private
Hanger Liability Section
ACORD 329 - Aviation
Products Liability
ACORD 330 - Aircraft
Section
ACORD 331 - Pilot
Experience
ACORD 332 - Hangar
Schedule
Illinois
ACORD 62IL - Illinois
Property Supplement Notice of Availability of Earthquake Insurance
Missouri
ACORD 62MO - Missouri
Property Supplement Notice of Availability of Earthquake Insurance
Revised
ACORD Forms
Countrywide
ACORD 131- Umbrella
/ Excess Section
Idaho
ACORD 90ID - Idaho
Personal Auto Application
Kentucky
ACORD 90KY - Kentucky
Personal Auto Application
ACORD 137KY -
Kentucky Commercial Auto
New Hampshire
ACORD 90NH - New
Hampshire Personal Auto Application
ACORD 137NH -
New Hampshire Commercial Auto
ACORD 138KY -
New Hampshire Garage and Dealers
New Jersey
ACORD 94NJ - New
Jersey Inspection Report
New York
ACORD 62NY - Application
for Dwelling Insurance New York Property Insurance Underwriting Association
ACORD 67NY - Application
for New York Property Insurance Underwriting Association Instructions for Completing
Application for Dwelling Insurance
ACORD 70NY - Application
for New York Property Insurance Underwriting Association Instructions for Completing
Application for Commercial Insurance
ACORD 177NY -
Application for Commercial Insurance New York Property Insurance Underwriting
Association
South
Carolina
ACORD 90SC - South
Carolina Personal auto Application
Withdrawn
ACORD Forms
Countrywide
ACORD 351 - NAIC
Uniform Application for Individual Non-resident License
ACORD 352 - NAIC
Uniform Applicaiton for Business Entity Non-Resident License/Registration
New Hampshire
ACORD 38NH - New
Hampshire Notice of Information Practices
ACORD 62NH - New
HAmpshire Statement of Residency Including Applicable Exemptions
5 New
User Requested Form
- New York Workers
Comp Officer Exclusion
- Additional Premise
Information Supplement for Commercial Property
- Additional Insured
- Owners, Lessees or Contractors - Scheduled Person or Organization
- Artison Contractors
Supplemental Application
- New Jersey Office
of the Attorney General - Home Improvement Contractor Application for Initial
Registration
New Forms
- March 7th, 2006 ACORD has introduced the following:
Countrywide
ACORD 22 - Intermodal
Interchange Certificate of Insurance
ACORD 812 - Agency
Questionaire
Minnesota
ACORD 69MN - Minnesota
FAIR Plan - Farm Fire Application
Revised
ACORD Forms
Countrywide
ACORD 1 - Property
Loss Notice
ACORD 2 - Automobile
Loss Notice
ACORD 3 - General
Liability Notice of Occurrence / Claim
ACORD 74 - Residence
Based Business Supplement to Personal Property Applications
ACORD 82 - Watercraft
Application
ACORD 83 - Personal
Umbrella Application
Massachusetts
ACORD 90MA - Application
for Massachusetts Motor Vehicle Insurance
ACORD 95MA - Massachusetts
Renewal Form
Minnesota
ACORD 60MN - Minnesota
FAIR Plan - Homeowners Application HO 6 Condo Unit Owners Coverage
ACORD 66MN - Minnesota
FAIR Plan - Homeowners HO 8 Application
ACORD 67MN - Minnesota
FAIR Plan - Dwelling Fire Application
New Mexico
ACORD 90NM - New
Mexico Personal Auto Application
Customer
Requested Forms
The old ACORD
127 - Commercial Auto Supplement from 1994
New Agency Invoice
in the General Business Forms Section
New Forms
- February 6th, 2006 ACORD has introduced the following:
Countrywide
ACORD 822 - Personal
Auto Application Supplement - Driver Work / School Address Information
Revised
ACORD Forms
Countrywide
ACORD 67 - Mine
Subsidence Illinois / Indiana / Kentucky / West Virginia
Arkansas
ACORD 90AR - Arkansas
Personal Auto Application
Colorado
ACORD 171CO -
Rejection of Coverage by Corporate Officers or Members of a Limited Liability
Company
Missouri
ACORD 67MO - Missouri
Property Insurance Placement Facility Application for Dwelling - Commercial-
Farm
South
Carolina
ACORD 179SC -
Associated Auto Insurers Plan of South Carolina Garage Application
West Virginia
ACORD 90WV - West
Virginia Personal Auto Application
Withdrawn
ACORD Forms
Countrywide
ACORD 66US - Insurance
Supplement Commercial Auto Only Notice Offer of Terrorism Coverage
5 New
Florida Workers Comp JUA Forms
Under the Florida State Specific Forms folder , even though
they are not ACORD forms, we have added the following due to an agent asking
for them....
- Applicant Affidavit
- Employer Affidavit
- Contractors
Supplemental
- Acknowledgement
- Wage Information
If you have forms
you would like us to add, just let us know.
New Forms
- January 4th, 2006 ACORD has introduced the following:
Delaware
ACORD 171DE -
Delaware Executive Officers Exclusion
New Jersey
ACORD 136NJ -
New Jersey Workers Compensation Insurance plan - Truckers Application Supplement
New Forms
- November 25th, 2005 ACORD has introduced the following:
North
Carolina
ACORD 135NC -
North Carolina Workers Compensation Insurance Plan - Application for Designation
of an Insurance Company
ACORD 135NC -
North Carolina Workers Compensation Insurance Plan - Instructions for Completing
ACORD 135NC Application
Oregon
ACORD 62OR - Oregon
Personal Lines Supplement - Notice of Use of Loss History Report - Home Insurance
Rhode
Island
ACORD 62RI - Rhode
Island Property Supplement - Notice of Flood Coverage Exclusion
Life Insurance
Forms
ACORD 702PA -
Pennsylvania Life Insurance Application - Part 2 Medical History
ACORD 751NY -
New York Authorization to Obtain and Disclose Information
ACORD 753NY -
New York Notice of Insurance Information Practices (Pre Notice)
ACORD 757NY -
New York HIV Antibody/Antigen Consent and Testing Form
Revised
Forms - November 23th, 2005 ACORD has updated the following:
California
Changes
ACORD 137CA -
California Commercial Auto
ACORD 138CA -
California Garage and Dealers
Colorado
Changes
ACORD 61CO - Colorado
Auto Supplement - Colorado Private Passenger Automobile Insurance Disclosure
ACORD 137CO -
Colorado Commercial Auto
ACORD 138CO -
Colorado Garage and Dealers
ACORD 177CO -
Rejection of Coverage by Corporate Officers or Members of a Limited Liability
Company
Connecticut
Changes
ACORD 90CT - Connecticut
Personal Auto
ACORD 138CT -
Connecticut Commercial Auto
ACORD 138CO -
Connecticut Garage and Dealers
District
of Columbia Changes
ACORD 66DC - District
of Columbia Property Insurance Facility Essential Homeowners Inspection and
Placement
ACORD 67DC - District
of Columbia Property Insurance Facility Essential Homeowners Inspection and
Placement Application to Distrcit of Columbia Property Insurance Facility
Kansas
Changes
ACORD 171KS -
Kansas Election of Individual, Partner, Member of a Limited Liability Company
or Self-Employed Individual
ACORD 172KS -
Kansas Cancellation of Election of Individual, Partner, Member of a Limited
Liability Company or Self-Employed Individual
ACORD 173KS -
Kansas Cancellation of Election Not to Accept Coverage
ACORD 174KS -
Kansas Election Not to Accept Coverage
ACORD 176KS -
Kansas Election of Employer to Cover Employees
ACORD 177KS -
Kansas Election of Coverage for Volunteer Workers
ACORD 178KS -
Kansas Cancellation of Employer to Cover Employees
ACORD 179KS -
Kansas Cancellation of Election of Coverage for Volunteer Workers
ACORD 180 - Kansas
Election of Coverage for Persons Performing Public Service
ACORD 181KS -
Kansas Cancellation of Election of Coverage for Persons Performing Public Service
Kentucky
Changes
ACORD 50KY - Commonwealth
of Kentucky Proof of Insurance
Louisiana
Changes
ACORD 90LA - Louisiana
Personal Auto Application
ACORD 137LA -
Louisiana Commercial Auto
ACORD 137LA -
Louisiana Garage and Dealers
Maryland
Changes
ACORD 65MD - Maryland
Property Insurance Availability Program Essential Homeowners Inspection and
Placement
ACORD 66MD - Maryland
Property Insurance Availability Program Essential Homeowners Inspection and
Placement Application to Joint Insurance Association
Mississippi
Changes
ACORD 61MS - Mississippi
Auto Supplement - Non-Stacking Uninsured Motorist Insurance
New Jersey
Changes
ACORD 133NJ -
New Jersey Workers Compensation Insurance Plan - Application for Designation
of an Insurance Company
Ohio Changes
ACORD 67OH - Ohio
Mine Subsidence Homeowner and Dwelling Supplement Application
ACORD 68OH - Ohio
Offer of Mine Subsidence Insurance Coverage - Homeowners and Dwelling Supplement
Washington
Changes
ACORD 90WA - Washington
Personal Auto Application
ACORD 137WA -
Washington Commercial Auto
ACORD 138WA -
Washington Garage and Dealers
October
20th, 2005 ACORD has updated the following forms:
Countrywide
Changes
ACORD 80 - Homeowner
Application
ACORD 81 - Personal
Inland Marine Application
ACORD 84 - Dwelling
Fire Application
ACORD 85 - Mobile
Home Application
ACORD 86 - Personal
Lines Package Application
ACORD 126 - Commercial
General Liability Section
ACORD 130 - Workers
Compensation Application
Tennessee
Changes
ACORD 133TN -
Tennessee Workers Compensation Insurance Plan - Assigned Risk Supplement
Wisconsin
Changes
ACORD 133WI -
Wisconsin workers Compensation Insurance Pool
October
20th, 2005 ACORD has introduced the following form:
Rhode Island
ACORD 50RI - Rhode
Island Insurance Identification Card
What Are
the Changes?
This link - Describe
the changes for 10 20 2005 update
- will take you to a page which describes the detail of the actual changes to
each form.
October
4 th, 2005 ACORD has updated the following forms:
Minnesota
Changes
ACORD 38MN- Minnesota
Authorization
Montana
Changes
ACORD 90MT - Montana
Personal Auto Application
October
4 th, 2005 ACORD has introduced the following form:
Life Forms - New
ACORD 771 - Laboratory Identification
Form
October
4 th, 2005 ACORD has withdrawn the following forms:
ACORD 38AR - Arkansas Notice
of Information Practices
ACORD 38MT - Montana Notice
of Information Practices
This link - Describe
the changes for 10 4 2005 update
- will take you to a page which describes the detail of the actual changes to
each form.
August
30th , 2005 ACORD has updated the following forms:
Alaska
Changes
ACORD 90AK - Alaska
Personal Auto Application
ACORD 137AK -
Alaska Commercial Auto Application
ACORD 138AK -
Alaska Garage and Dealers Application
California
Changes
ACORD 90CA - California
Personal Auto Application
Colorado
Changes
ACORD 90CO - Colorado
Personal Auto Application
Maine
Changes
ACORD 90ME - Maine
Personal Auto Application
New Hampshire
Changes
ACORD 90NH - New
Hampshire Personal Auto Application
New Jersey
Changes
ACORD 961NJ -
New Jersey Auto Supplement - NJ Auto Insurers Buyers Guide
See changes details
for
8 30 2005 update.
July 28th,
2005 ACORD has updated the following forms:
Countrywide Correction
ACORD 185 - Restaurant
and Tavern Supplement
ACORD 951 - 1035
Exchange / Rollover / Transfer Form
Pennsylvania
Changes
ACORD 61PA - Pennsylvania
Auto Supplement - Important Notice
See changes details for
7 28 2005 update.
June 16th,
2005 ACORD has updated the following forms:
Countrywide Changes
1 - Property Loss
Notice
2 - Automobile
Loss Notice
3 - General Liability
Loss Notice
125 - Commercial
Insurance Application
Illinois
Changes
68IL - Illinois
FAIR Plan Homeowmer and Dwelling Fire Part 1
69IL - Illinois
FAIR Plan Homeowmer and Dwelling Fire Part 2
171IL - Illinois
FAIR Plan Commercial Property
Minnesota
Changes
65MN - Minnesota
Guaranty Association Notice
North
Dakota Changes
38ND - Notice of Information
Practices
90ND - Personal Auto Application
New Jersey
Changes
60NJ - New Jersey Temporary
State of New Jersey Identification Card
Pennsylvannia
Changes
137PA - Commercial Auto
Application
What Are
the Changes?
This link - Describe
the Changes - will take you to a page which describes the detail of the
actual changes to each form.
June 16th,
2005 ACORD has introduced the following new forms:
Countrywide
Forms
815 - International Liability
Exposure Supplement
816 - International Property
Exposure Supplement
Louisiana
861LA - Auto Supplement
- Active Military Personnel Adfivatt
New Jersey
50NJ Set - A set of State
fo New Jersey Identification Cards on one page
West Virginia
862WV - Notice of Flood
Coverae Exclusion
June 16th,
2005 ACORD has withdrawn the following forms:
Countywide
18 - Jewelry Appraisal and
Claim Evaluation
78 - Jewelry Appraisal -
Single Item
79 - Jewelry Appraisal
154 - Jeweler's Inventory
Recordkeeping Inventory Card
805 - Jewelry Sales Receipt
for Insurance Purposes
Tennessee
171 - Notice Not To Elect
172 - Revocation of Exemption
173 - Withdrawal of Sole
Proprietor or Partner Election
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