| Section Name | Field Name | Field and/or Section Description |
| Title of the form. ACORD 178 WI, WisconsinAutomobile Insurance Plan, Truckers | ||
| Application, is used to apply for Truckers insurance through the Wisconsin Automobile | ||
| Insurance Plan. | ||
| TITLE | WisconsinAutomobile Insurance | |
| ACORD 178 WI (2009/11) | Plan, TruckersApplication | Contact the Plan for instructions on thecompletion of this form. |