ACORD 61 NM (2005/04) – New Mexico Auto Supplement

This form complies with New Mexico law, and must be used with applications for auto insurance under the following circumstances:

UM Coverage Selection

1. When an applicant for either personal or commercial auto insurance:

– Selects Uninsured Motorists (UM) coverage less than the liability limits of the policy, or
– Rejects Uninsured Motorists (UM) coverage entirely

Rejection of Stacked UM Coverage 2.

When an applicant for a multi-vehicle personal auto policy, or a multi-vehicle commercial auto policy if the applicant is an individual, decides to reject intra-policy Stacked Uninsured Motorists (UM) coverage.

Signature / Date

Applicant must sign and date the application