ACORD 66US Instructions


ACORD 66 US (2003/02) – Insurance Supplement – Commercial AutoOnly – AK, CT, HI, KS, KY, NJ, NY, OR

Notice – Offer of Terrorism Coverage

Notice – Disclosure of Premium

Use this form for Commercial Auto in Alaska, Connecticut, Hawaii, Kansas, Kentucky, New Jersey, New York and Oregon. The form complies with requirements of the federal Terrorism Risk Insurance Act of 2002.

This form discloses to applicants for new insurance and to existing policyholders the following information:

  • Coverage for losses resulting from acts of terrorism certified under the federal program must be offered;
  • The applicant/insured can accept or reject the coverage, except that coverage within the minimum limits for Liability, Uninsured and/or Underinsured Motorists and Personal Injury Protection would continue to apply;
  • The amount of premium for this coverage;
  • The federal share of compensation for insured losses.1. Use ACORD 60 US in all states for all other insurance lines.2. Use ACORD 62 US for property insurance applicants/policyholders in Standard Fire Policy states.

    3. Use ACORD 64 US for workers’ compensation insurance applicants/policyholders.