ACORD Forms By Form Number

Back to Portal

Form Number State Description Edition Date
1   Property Loss Notice 2012/05
2   Automobile Loss Notice 2012/05
3   General Liability Notice of Occurrence / Claim 2012/05
4   Workers Compensation - First Report of Injury or Illness 2012/05
4 WI Wisconsin Employer's First Report of Injury or Disease 2003/04
11   Auto Accident Information Form 2/95
12   Exchange of Information Form 2/95
13   Witness Card 2/95
18   Jewelry Appraisal & Claim Evaluation 1/98
22   Intermodal Interchange Certificate of Insurance 2010/03
22   Intermodal Interchange Certificate of Insurance 2007/02
23   Leased Auto Certificate of Insurance 2010/05
24   Certificate of Property 2016/03
24   Certificate of Property 2009/09
24   Certificate of Property 1/95
25   Certificate of Liability Insurance 2016/03
25   Certificate of Liability Insurance 2014/01
25   Certificate of Liability Insurance 2010/05
25   Certificate of Liability Insurance 2009/09
25   Certificate of Liability Insurance 2009/01
26   Policy Certification Log 2002/01
27   Evidence of Property 2016/03
27   Evidence of Property 2009/12
27   Evidence of Property 2006/07
27   Evidence of Property 2004/04
27   Evidence of Property 2003/10
27   Evidence of Property 03/93
28   Evidence of Commercial Property 2016/03
28   Evidence of Commercial Property 2014/01
28   Evidence of Commercial Property 2009/12
28   Evidence of Commercial Property 2006/07
28   Evidence of Commercial Property (2003) 2003/10
29   Evidence of Flood Insurance 2016/03
29   Evidence of Flood Insurance 2013/10
30   Certificate of Garage Insurance 2010/12
31   Certificate of Marine / Energy Insurance 2016/03
31   Certificate of Marine / Energy Insurance 2014/01
35   Cancellation Request 1/97
36   Agent/Broker of Record Change 2007/01
37   Statement of No Loss 2008/01
37   Statement of No Loss 1/96
38   Notice of Information Practices (Privacy) 2004/11
38 AR Arkansas Notice of Information Practices (Privacy) 2001/08
38 AZ Arizona Notice of Information Practices (Privacy) 2003/10
38 CO Colorado Notice of Information Practices (Privacy) 2001/07
38 MN Minnesota Authorization 2002/08
38 MT Montana Notice of Information Practices (Privacy) 2001/01
38 ND North Dakota Personal Insurance Supplement Notice of Information Practices 2004/10
38 NY New York Personal Insurance Supplement 2005/04
38 OR Oregon Notice of Information Practices (Privacy) 2003/05
39 MD Maryland Application Supplement 2003/05
39 NY New York Insurance supplement 2011/03
40   Residential Property Valuation Survey 2000/02
41   Residential Property Replacement Cost Worksheet 1/98
42   Residential Property Replacement Cost Information Supplement 2001/05
45   Additional Interest 2003/04
50   Insurance ID Card 1/83
50 AL Alabama Insurance ID Card 2007/10
50 AR Arkansas Proof of Insurance Card 2007/06
50 AZ Arizona Insurance ID Card 2007/11
50 CA California Insurance ID Card 2004/07
50 CT Connecticut Insurance ID Card - 4 per page 2009/01
50 FL Florida Auto Insurance ID Card     3/94
50 FL Single and set of 8 2008/02
50 GA Georgia Insurance Policy Information Card 2004/07
50 HI Hawaii Motor Vehicle Insurance ID Card 2008/01
50 IA Iowa Financial Liability Coverage Card 2007/08
50 KY Commonwealth of Kentucky Proof of Insurance 2006/01
50 LA Louisiana Auto Insurance ID Card 4/96
50 MI Michigan Certificate of No-Fault Insurance 6/93
50 MO Missouri Auto Insurance ID Card (set) 2007/05
50 MO Missouri Auto Insurance ID Card 2/98
50 MS Mississippi Insurance ID Card 2008/01
50 ND North Dakota Insurance ID Card 2007/08
50 NJ TEMPORARY State of New Jersey Insurance ID Card 2005/05
50 NY New York State Insurance ID Card 1/98
50 NV Nevada Insurance ID Card 2002/04
50 OK Oklahoma Security Verification Form 2008/03
50 PA Pennsylvania Financial Responsibility ID Card 2002/08
50 PA Pennsylvania Financial Responsibility ID Card 2002/08
50 RI Rhode Island Insurance Identification Card 2008/01
50 TX Texas Liability Insurance Card 2003/09
50 WM  Watermark Auto ID 2/95
50 WM Watermark Auto ID - set (New Jersey only) 2007/03
50 WM Watermark Auto ID (New Jersey only) 2007/03
50 WV West Virginia Auto ID 3/94
51 CA California Evidence of Liability Insurance 2004/07
51 FL Florida Commercial Auto Insurance ID Card 2009/07
51 GA Georgia Fleet Policy Information Card 2004/07
51 NJ New Jersey Insurance ID card (set) 2007/06
51 NJ New Jersey Insurance ID card 2007/06
51 NV Nevada Insurance ID card 2008/11
51 OK Oklahoma Operators Security Verification Form 2002/07
54   Financial Responsibility Form (3part) 1/97
57   Financial Responsibility Form (Notice of Cancellation or Termination) (3 part) 1/97
58   Notice of Cancellation or Termination of Policy 2007/11
60   Flood Insurance Notice/Rejection 2002/09
60 HI Hawaii Auto Supplement Uninsured/Underinsured Motorists Coverage Selection Stacked or Non- Stacked UM and UIM Coverage 2004/07
60 LA Louisiana Dwelling Supplement - Loss Settlement (DWG 1) 4/98
60 MA Massachusetts Property Insurance Underwriting Association - Application for Homeowners Insurance Inspection and Placement 2003/04
60 MN Minnesota FAIR Plan Homeowners Application - HO 6 Condo Unit Owners Coverage 2007/05
60 MT Montana Application Supplement - Refusal to Renew 2003/09
60 NJ New Jersey Personal Property Insurance Supplement - Flood Exclusion 2001/10
60 NM New Mexico Confidential Abuse Information Disclosure Notice 2003/01
60 NY New York Homeowners Supplement 8/95
60 OK Oklahoma Auto Supplement, Oklahoma Uninsured Motorists Coverage Law 10/94
60 PA Pennsylvania Auto Supplement UM Coverage Selection/Rejection 2008/01
60 TX Texas Auto Supplement Consumer Bill of Rights for Personal Automobile Insurance 2007/05
60 US Insurance Supplement - Notice - Offer of Terrorism Coverage 2003/01
60 VA Virginia Auto Supplement Rental Reimbursement Coverage 8/94
60 WV West Virginia Auto Supplement UM/UIM Vehicle Coverages 12/93
61 AK Alaska Auto Supplement, UM/UIM Cov. Selection Form 7/97
61 AR Arkansas Auto Supplement, Uninsured/Underinsured Motorists Coverage Selection; Personal Injury Protection Selection 2002/03
61 AZ Arizona Auto Supplement 2001/02
61 CA California Auto Supplement Mandatory Uninsured Motorists Bodily Injury Coverage Offer 2008/03
61 CO Colorado Auto Supplement Summary of Coverages 2008/01
61 CT Connecticut Auto Supplement UM Coverage 2004/11
61 DE Delaware Auto Supplement Uninsured Motorists Coverage Selection Form 3/97a
61 FL Florida Auto Supplement Rejection/Election of UM Coverage/Personal Injury Protection Disclosures 2008/03
61 GA Georgia Auto Supplement, UM Cov and Medical 2002/12
61 IA Iowa Auto Supplement, UM and UIM Selection/Rejection 2002/02
61 IL Illinois Auto Supplement Uninsured/Underinsured Motorists Coverage 2003/03
61 LA Louisiana Homeowners Supplement - Loss Settlement   (HO4) 2001/05
61 MA Massachusetts Property Insurance Underwriting Association Inspection Notice, Credit Reporting Notice and Instructions for Completing Homeowners Application ACORD 60 MA 2003/04
61 MD Maryland Personal Auto Supplement Summary of Coverages 2003/09
61 MS Mississippi Auto Supplement - Mississippi Non-Stacking UM Coverage 2002/09
61 NC North Carolina Auto Supplement Selection/Rejection Form Uninsured Motorists Coverage Combined Uninsured/Underinsured Motorists Coverage 2005/02
61 NJ New Jersey Auto Supplement - Auto Insurance Buyer's Guide 2006/10
61 NV Nevada Auto Supplement 2002/12
61 NY New York Auto Supplement Optional Basic Economic Loss (OBEL) Coverage 3/94
61 OH ACORD Removed this form 10/15/01 - Ohio Auto Supplement -  Uninsured Motorists Coverage Selection Form 2001/02
61 OK Oklahoma Auto Supplement Election of Non-Stacked Coverage 3/94
61 OR Oregon Auto Supplement Uninsured Motorists Coverage Selection Form 2004/10
61 PA Pennsylvania Auto Supplement Summary of Coverages 2007/08
61 RI Rhode Island Auto Supplement Uninsured/Underinsured Motorists Bodily Injury Coverage Rejection Notice and Warning 4/95
61 SC South Carolina Auto Supplement Offer of Additional Uninsured Motorists and Optional Underinsured Motorists Coverage 2007/08
61 UT Utah Auto Supplement 2001/02
61 WI Wisconsin Auto Supplement Underinsured Motorists Coverage Selection Form 5/96
61 WV West Virginia Uninsured/Underinsured Motorist Coverage - Offer of Split Limits Liability 2000/10
62 AK Alaska Auto Supplement 2/98
62 AL Alabama Insurance Application Supplement 5/98
62 AZ Arizona Auto Supplement (Spanish Version), Uninsured and Underinsured Motorists Coverage Selection Form 2003/05
62 CA California Auto Supplement - Auto Preinspection Law 2001/05
62 CO Colorado Personal Property Supplement 2/97
62 DE Delaware Auto Supplement - Personal Injury Protection Deductible Options 2004/10
62 GA Georgia Auto Supplement 2008/01
62 IA Iowa Auto Supplement, Notice Regarding UM/UIM Coverage 2/98
62 IL Illinois Property Supplement - Notice of Availability of Earthquake Insurance 2007/08
62 LA Louisiana Commercial Property Supplement Loss Settlement 4/98
62 MD Maryland Commercial Auto Supplement 1/98
62 MI Michigan Collision Insurance Options Notice 2000/01
62 MO Missouri Property Supplement -  Notice of Availability of Earthquake Insurance 2007/08
62 MN Minnesota Auto Supplement 2000/01
62 NC North Carolina Joint Underwriting Association North Carolina Insurance Underwriting Association Fair and Beach Plan Coverage Instructions 9/97
62 NH New Hampshire Statement of Residency or Exemption 2004/09
62 NJ New Jersey Auto Supplement Basic Policy Coverage Selection Form 2006/10
62 NV Nevada Umbrella Supplement 2001/05
62 NY New York Application for Dwelling Insurance-NYPIUA 2006/04
62 OK Oklahoma Property Summary 2006/05
62 OR Oregon Personal Lines Supplement 2006/01
62 PA Pennsylvania Auto Supplement UIM Coverage Selection/Rejection 2008/01
62 RI Rhode Island Property Supplement - Notice of Flood Coverage Exclusion 2006/01
62 SC South Carolina Commercial Auto Supplement Panel Trucks Pickup Trucks Vans or Similar Vehicles Affidavit of Commercial Use 2/96
62 TX Texas Auto Supplement Consumer Bill of Rights for Personal Automobile Insurance (Spanish Language Text) 2007/05
62 VA Virginia Property Supplement 6/97
62 WA Washington Auto Supplement Mandatory Offer PIP Coverage 2007/04
62 WV West Virginia Uninsured/Underinsured Motorist Coverage - Offer of Single Limit Liability 2000/10
63   General Fraud Statement 2001/10
63 CO CO Colorado Application Supplement Credit Report Disclosure Information 1/97
63 HI HI Hawaii Application Supplement 9/98
63 OH OH Ohio Fraud Statement 9/93
63 OK OK Oklahoma Fraud Statement 10/97
63 UT UT Utah Fraud Statement 9/93
64 CA CA California Ins Supplement,  Agency Language Form 2004/02
64 DC DC Application to District of Columbia Property Insurance Facility for Basic Property Inspection and Insurance Program 2004/11
64 DE DE Insurance Placement Facility of Delaware 2004/06
64 IA IA Iowa Auto Supplement, UM/UIM Coverage Stacking Coverage Option Notice 2/98
64 LA LA Louisiana Homeowners Supplement-Loss Settlement (HO2 & 3) 2001/05
64 MA MA Massachusetts Residential Property Liability Supplement 2/97
64 MD MD Maryland Property Insurance Availability Program, 2004/11
64 MI MI Michigan Basic Property Insurance Association Insurance Application 2000/10
64 MN MN Minnesota FAIR Plan Homeowners Application - HO 4 Renters Coverage 2007/05
64 NC NC North Carolina Property Supplement - Flood Insurance Notice 2001/02
64 NJ NJ New Jersey Auto Supplement Standard Coverage Selection Form 2004/01
64 NY NY New York Auto Supplement - Supplementary UM/UIM Insurance Coverage 2008/06
64 NY NY New York Auto Supplement - Supplementary UM/UIM Insurance Coverage 2003/01
64 PA PA Insurance Placement Facility of Pennsylvania Basic Property Insurance Application 2000/01
64 RI RI Rhode Island Joint Reinsurance Association - Application for Homeowners Insurance Inspection and Placement 2003/04
64 TX TX Texas Windstorm Insurance Association - Application for Windstorm and Hail Insurance 2003/04
64 US US Insurance Supplement - Workers' Compensation Only 2003/02
64 VA VA Virginia Property Supplement - Notice of Flood Insurance Coverage Exclusion 2004/09
64 WV WV West Virginia Essential Property Insurance Association - Basic Property Insurance Application 2004/06
65 CA CA California Insurance Supplement, Race, National Origin and Gender Form 2004/07
65 DC DC Application to District of Columbia Property Insurance Facility for Basic Property Inspection and Insurance Program 2001/06
65 IA IA Iowa Auto Supplement - Notice - Payment for Aftermarket Crash Parts 2000/07
65 LA LA Louisiana Homeowners Supplement-Loss Settlement (HO6) 2001/02
65 MA MA Massachusetts Property Insurance Underwriting Association - Application for Dwelling Fire Insurance Inspection and Placement 2015/01
65 MA MA Massachusetts Property Insurance Underwriting Association - Application for Dwelling Fire Insurance Inspection and Placement 2003/04
65 MD MD Maryland Property Insurance Availability Program Essential Homeowners Insurance Inspection and Placement 2001/06
65 MN MN Minnesota Guaranty Association Notice 2005/06
65 NJ NJ New Jersey Property Insurance Supplement - Earthquake Notice 2003/02
65 NY NY New York Auto Supplement - Supplemental Spousal Liability Coverage 2003/01
65 PA/ DE/WV PA/ DE/WV Fair Plan Supplementary Questionnaire 2000/01
65 RI RI Rhode Island Joint Reinsurance Association - Inspection Notice, Credit Reporting Notice and Instructions for Completing Homeowners Application ACORD 64 RI 2003/04
65 WV WV West Virginia Personal and Commercial Umbrella Liability Supplement Uninsured/Underinsured Motor Vehicle Coverage Important Notice 2001/08
66 CA California Offer of Earthquake Coverage 2/98
66 CT Connecticut FAIR Plan Application for Basic Property & Liability Insurance 2006/06
66 DC District of Columbia Property Insurance Facility - Essential Homeowners Insurance Inspection and Placement Application p.1 2005/12
66 FL Florida Insurance Supplement, Credit Report Disclosure Information 2001/08
66 IA Iowa Personal Insurance Supplement - Disclosure Use of Claims History 2006/07
66 LA Louisiana Dwelling Supplement-Loss Settlement (DWG2 & 3) 4/98
66 MA Massachusetts Property Insurance Underwriting Association - Inspection Notice, Credit Reporting Notice and Instructions for Completing Homeowners Application 2005/01
66 MD Maryland Property Insurance Availability Program Essential Homeowners Insurance Inspection and Placement 2005/12
66 MN Minnesota Fair Plan Homeowners HO 8 Application 2007/05
66 NC North Carolina Insurance Supplement 8/97
66 RI Rhode Island Joint Reinsurance Association - Application for Dwelling Fire Insurance Inspection and Placement 2003/04
66 US Insurance Supplement - Commercial Auto Only - AK, CT, HI, KS, KY, NJ, NY, OR 2003/02
66 UT UT Utah Arbitration Provisions 6/94
66 VT VT Vermont Insurance Supplement Fair Credit Reporting Act 2003/06
66 WV WV West Virginia Personal and Commercial Umbrella Liability Supplement Uninsured/Underinsured Motor Vehicle Coverage Offer of Split Limits Liability 2001/08
67   Illinois, Indiana, Kentucky, West Virginia Mine Subsidence Home & Dwelling Fire Supplement 2001/07
67 AR AR Arkansas Property Supplement 2000/02
67 CA CA California Residential Property Disclosure 2005/01
67 DC DC District of Columbia Property Insurance Facility - Essential Homeowners Insurance Inspection and Placement Application p. 2 2004/07
67 FL FL Florida Homeowners Supplement 7/94
67 LA LA Louisiana Certification of Mobile Home Tie Downs 5/98
67 MA MA Massachusetts Property Insurance Underwriting Association - Application for Commercial Fire Insurance Inspection and Placement 2003/04
67 MD MD Maryland Personal Auto Supplement - Notice Concerning Waiver of PIP Coverage 2005/01
67 MN MN Minnesota Fair Plan Dwelling Fire Application 2007/05
67 MO MO Missouri FAIR Plan Insurance Application 2003/11
67 NJ NJ New Jersey Insurance Underwriting Insurance Association Dwelling Fire Application 2002/07
67 NY NY New York Property Insurance Underwriting Association Instructions for Completing Application for Dwelling Insurance 2000/08
67 OH OH Ohio Mine Subsidence Homeowners and Dwelling Supplement 1/94a
67 RI RI Rhode Island Joint Reinsurance Association - Inspection Notice, Credit Reporting Notice and Instructions for Completing Dwelling Fire Application 2003/04
67 TX TX Texas Homeowners and Personal Property Supplement 2007/05
67 UT UT Utah Auto Insurance Supplement Personal Injury Protection Coverage Waiver of Loss of Income Benefits 10/94
67 VA VA Virginia Property Insurance Association Application For Insurance 2000/11
68 CA CA California Scheduled Personal Property - Loss Computation Disclosure 2001/03
68 FL FL Citizens Property Insurance Corporation, Residential - Dwelling Wind Only 2004/09
68 IL IL Illinois FAIR Plan Association (Part 2 of 2 Parts) Supplemental Application for (1-4 Family) Homeowners & Dwelling Property Insurance 2004/03
68 LA LA Louisiana Plan Services Application for Insurance 4/98
68 MA MA Massachusetts Property Insurance Underwriting Association - Inspection Notice, Credit Reporting Notice and Instructions for Completing Commercial Fire Application 2003/04
68 MN MN Minnesota Fair Plan Commercial Fire Application 2004/07
68 ND ND North Dakota Supplement to Property Insurance Applications 10/93a
68 NJ NJ New Jersey Insurance Underwriting Association - Commercial Fire Application 2003/07
68 NY NY New York Liability Supplement - Claims-Made Policy Important Information 2002/01
68 OH OH Ohio Offer of Mine Subsidence Ins. HO & Dwelling Supplement 7/99
68 RI RI Rhode Island Joint Reinsurance Association - Application for Commercial Fire Insurance Inspection and Placement 2003/04
68 TX TX Texas Homeowners and Personal Property Supplement (Spanish Language Text) 2002/12
68 WV WV West Virginia Personal and Commercial Umbrella Liability Supplement Uninsured/Underinsured Motor Vehicle Coverage Offer of Single Limit Liability 2001/08
69 FL FL Citizens Property Insurance Corporation, Wind Only Supplemental Residential Application Schedule 2004/09
69 IL IL Illinois FAIR Plan Association (Part 1 of 2 Parts) Application for (1-4 Family) Homeowners & Dwelling Property Insurance 2004/03
69 LA LA Louisiana Auto Supplement - UM/UIM BI Coverage - UM Property Damage Coverage 2002/06
69 MN MN Minnesota Fair Plan Farm Fire Application 2007/05
69 RI RI Rhode Island Joint Reinsurance Association - Inspection Notice, Credit Reporting Notice and Instructions for Completing Commercial Fire Application 2003/04
69 TX TX Texas Special Mobile Home Windstorm & Hail Application - Texas Windstorm Insurance Association 2000/08
70   Personal Policy Change Request (Except Auto) 2004/05
70 NY Instructions for Completing Application for Commercial Insurance - NYPIUA 2000/09
71   Personal Auto Policy Change Request 2003/09
71 SC SC Associated Auto Insurers Plan - Private Passenger Policy Change Request 2003/03
72   Certification of Mobile Home Tie Downs - Supplement to Mobile Home Application 2002/12
73   Solid Fuel Questionnaire Personal Property Supplement 2000/08
74   Residence Based Business Supplement to Personal Property Applications 2001/05
75   Insurance Binder 2004/09
76   Binder Log 9/93
77   No longer on ACORD's Website - Jewelry Evaluation Form Diamonds and Mounting Information 2000/08
78   Jewelry Insurance Appraisal-Single Item 2003/04
79   Jewelry Insurance Appraisal 2003/04
80   Homeowner Application 2013/09
80   Homeowner Application 2010/05
80   Homeowner Application 2006/08
81   Personal Inland Marine Application 2005/08
82   Watercraft Application 2009/09
82   Watercraft Application 2007/06
83   Personal Umbrella Application 2011/01
83   Personal Umbrella Application 2009/10
83   Personal Umbrella Application 2008/11
84   Dwelling Fire Application 2013/09
84   Dwelling Fire Application 2013/01
84   Dwelling Fire Application 2004/02
85   Mobile Home Application 2004/09
86   Personal Lines Package Application 2004/09
87   Personal Lines Package Application Watercraft/Inland Marine Supplement 2003/06
88   Personal Insurance Application 2007-11
89   Residential Section 2007-11
90 AK AK Alaska Personal Auto Application 2001/02
90 AL AL Alabama Personal Auto Application 2004/04
90 AR AR Arkansas Personal Auto Application 2000/10
90 AZ AZ Arizona Personal Auto Application 2003/10
90 CA CA California Personal Auto Application 2000/01
90 CO CO Colorado Personal Auto Application 2009/01
90 CT CT Connecticut Personal Auto Application 2003/06
90 DC DC District of Columbia Personal Auto Application 2002/01
90 DE DE Delaware Personal Auto Application 2003/09
90 FL FL Florida Personal Auto Application 2003/10
90 GA GA Georgia Auto Application 2009/01
90 HI HI Hawaii Personal Auto Application 2004/05
90 IA IA Iowa Personal Auto Application 2002/10
90 ID ID Idaho Personal Auto Application 2001/03
90 IL IL Illinois Personal Auto Application 2003/10
90 IN IN Indiana Personal Auto Application 2003/12
90 KS KS Kansas Personal Auto Application 2004/01
90 KY KY Kentucky Personal Auto Application 2002/07
90 LA LA Louisiana Personal Auto Application 2004/04
90 MA MA Application for Massachusetts Motor Vehicle Ins. 2007/08
90 MD MD Maryland Personal Auto Application 2003/05
90 ME ME Maine Personal Auto Application 2003/11
90 MI MI Michigan Personal Auto Application 2003/04
90 MN MN Minnesota Personal Auto Application 2004/01
90 MO MO Missouri Personal Auto Application 2002/09
90 MS MS Mississippi Personal Auto Application 2004/09
90 MT MT Montana Personal Auto Application 2003/09
90 NC NC North Carolina Personal Auto Application 2007/06
90 ND ND North Dakota Personal Auto Application 2003/12
90 NE NE Nebraska Personal Auto Application 2003/12
90 NH NH New Hampshire Personal Auto Application 2004/10
90 NJ NJ New Jersey Personal Auto Application 2000/09
90 NM NM New Mexico Personal Auto Application 2001/03
90 NV NV Nevada Personal Auto Application 2001/03
90 NY NY New York Personal Auto Application 2003/11
90 OH OH Ohio Personal Auto Application 2003/09
90 OK OK Oklahoma Personal Auto Application 2003/12
90 OR OR Oregon Personal Auto Application 2003/05
90 PA PA Pennsylvania Personal Auto Application 2000/09
90 PR PR Puerto Rico Personal Auto Application 2004/04
90 RI RI Rhode Island Personal Auto Application 2003/05
90 SC SC South Carolina Personal Auto Application 2002/10
90 SD SD South Dakota Personal Auto Application 9/98
90 TN TN Tennessee Personal Auto Application 2005/01
90 TX TX Texas Personal Auto Application 2001/03
90 UT UT Utah Personal Auto Application 2001/01
90 VA VA Virginia Personal Auto Application 2005/01
90 VI VI Virgin Islands Personal Auto Application 2001/03
90 VT VT Vermont Personal Auto Application 2003/06
90 WA WA Washington Personal Auto Application 2000/08
90 WI WI Wisconsin Personal Auto Application 2001/03
90 WV WV West Virginia Personal Auto Application 2003/10
90 WY WY Wyoming Personal Auto Application 2004/04
91   Good Student/Driver Training 3/93a
92   Medical Statement 2/95
93   Young Driver Questionnaire 2004/10
94 HI HI Hawaii Vehicle Inspection Report Supplement 2001/03
94 NJ NJ Insurance Inspection Report 3/94
95 MA MA Massachusetts Renewal Application (Statement of Facts) 4/98
97 SC SC Private Passenger Auto Application 2003/03
97 WI WI Wisconsin Automobile Plan 2003/10
101   Additional Remarks Schedule 2008/01
102   No longer on ACORD's Website - Jewelry Evaluation Form Colored Stone Information 2000/08
105   Apartment Building Supplement 2012/06
106   Vacant Building Supplement 2010/04
125   Commercial Insurance Application - Applicant Information 2013/09
125   Commercial Insurance Application - Applicant Information 2013/01
125   Commercial Insurance Application - Applicant Information 2009/05
125   Commercial Insurance Application - Applicant Information 2007/10
126   Commercial General Liability Section 2014/04
126   Commercial General Liability Section 2010/05
126   Commercial General Liability Section 2007/05
127   Business Auto Section 2009/01
127   Business Auto Section 2003/08
128   Garage and Dealers Section 2004/03
129   Vehicle Schedule 2003/08
129 SC SC Vehicle Schedule 2003/03
130   Workers Compensation 2013/01
130   Workers Compensation 2010/05
130   Workers Compensation 2009/09
130   Workers Compensation 2007/11
130 FL FL Florida Workers Compensation Application 2002/07
131   Umbrella Section 2009/10
131   Umbrella Section 2009/02
131   Umbrella Section 2007/09
132   Truckers/Motor Carriers Section 2008/09
132   Truckers/Motor Carriers Section 2004/03
132 NJ NJ New Jersey Workers Compensation Insurance Plan Instructions and Rules 2000/04
133   Workers Compensation Insurance Plan Assigned Risk Section 2007/11
133 FL FL Florida Workers Compensation Joint Underwriting Association Inc. Addendum to 130 FL 2003/07
133 MI MI Michigan Application for Workers' Compensation Insurance 2003/02
133 MT MT Montana State Compensation Insurance Fund 8/98
133 NC NC North Carolina Workers Compensation Insurance Plan 10/96
133 NJ NJ New Jersey Workers Compensation Insurance Plan 2004/01
133 PA PA 3/20/03 Withdrawn by ACORD - Pennsylvania State Workers' Insurance Fund, Application for Workers' Compensation Insurance 5/98
133 TN TN Tennessee Workers Compensation Insurance Plan Assigned Risk Supplement 2004/09
133 WI WI Wisconsin Workers Compensation Insurance Pool 2002/01
134   Workers Compensation Application Supplement - Multi State Rating Sheet 2004/03
134 FL FL Florida Workers Compensation Joint Underwriting Association Inc. 2003/07
134 NC NC North Carolina Workers Compensation Insurance Plan 10/96
134 NJ NJ New Jersey Workers Comp. Insurance Plan Notice of Election - Proprietors and Partners 2001/07
134 WI WI Wisconsin Supplementary Non-Election Form 8/99
135 NC NC North Carolina Workers Comp Insurance Plan App for Designation of an Insurance Co 2007/10
135 NJ NJ New Jersey Workers Compensation Insurance Plan - Supplemental Employee Leasing Application 2000/04
135 WI WI Wisconsin Supplementary Election of Coverage Form 8/99
136 NC NC North Carolina Workers Comp Insurance Plan Instructions for Completing ACORD 135 NC App 2007/10
136 NJ NJ New Jersey Workers Compensation Insurance Plan - Truckers Supplemental Application 2000/04
136 WI WI Wisconsin Supplementary Limited Other States Coverage Request 7/96
137 AK AK Alaska Commercial Auto 2001/06
137 AL AL Alabama Commercial Auto 2004/04
137 AR AR Arkansas Commercial Auto 2004/05
137 AZ AZ Arizona Commercial Auto 2003/10
137 CA CA California Commercial Auto 2001/06
137 CO CO Colorado Commercial Auto 2003/07
137 CT CT Connecticut Commercial Auto 2003/05
137 DC DC District of Columbia Commercial Auto 2000/09
137 DE DE Delaware Commercial Auto 2001/06
137 FL FL Florida Commercial Auto 2003/10
137 GA GA Georgia Commercial Auto 2001/02
137 HI HI Hawaii Commercial Auto 2001/02
137 IA IA Iowa Commercial Auto 2002/10
137 ID ID Idaho Commercial Auto 2002/09
137 IL IL Illinois Commercial Auto 2004/12
137 IN IN Indiana Commercial Auto 2004/07
137 KS KS Kansas Commercial Auto 2002/07
137 KY KY Kentucky Commercial Auto 2002/09
137 LA LA Louisiana Commercial Auto 2001/10
137 MA MA Massachusetts Commercial Auto 2000/09
137 MD MD Maryland Commercial Auto 2004/03
137 ME ME Maine Commercial Auto 2000/09
137 MI MI Michigan Commercial Auto 2000/09
137 MN MN Minnesota Commercial Auto 2001/10
137 MO MO Missouri Commercial Auto 2001/10
137 MS MS Mississippi Commercial Auto 2004/09
137 MT MT Montana Commercial Auto 2003/09
137 NC NC North Carolina Commercial Auto 2007/06
137 ND ND North Dakota Commercial Auto 2002/02
137 NE NE Nebraska Commercial Auto 2014/12
137 NE NE Nebraska Commercial Auto 2011/12
137 NE NE Nebraska Commercial Auto 2001/10
137 NH NH New Hampshire Commercial Auto 2001/11
137 NJ NJ New Jersey Commercial Auto 2004/11
137 NM NM New Mexico Commercial Auto 2001/11
137 NV NV Nevada Commercial Auto 2001/11
137 NY NY New York Commercial Auto 2003/11
137 OH OH Ohio Commercial Auto 2002/11
137 OK OK Oklahoma Commercial Auto 2001/11
137 OR OR Oregon Commercial Auto 2002/02
137 PA PA Pennsylvania Commercial Auto 2002/11
137 RI RI Rhode Island Commercial Auto 2003/05
137 SC SC South Carolina Commercial Auto 2003/02
137 SD SD South Dakota Commercial Auto 2002/02
137 TN TN Tennessee Commercial Auto 2002/01
137 TX TX Texas Commercial Auto 2007/08
137 TX TX Texas Commercial Auto 2000/08
137 UT UT Utah Commercial Auto 2001/01
137 VA VA Virginia Commercial Auto 2007/05
137 VT VT Vermont Commercial Auto 2003/06
137 WA WA Washington Commercial Auto Coverages/Limits Section 2009/01
137 WA WA Washington Commercial Auto Coverages/Limits Section 2002/08
137 WI WI Wisconsin Commercial Auto 2002/02
137 WV WV West Virginia Commercial Auto 2002/02
137 WY WY Wyoming Commercial Auto - Coverages Limits Section 2002/02
138 AK AK Alaska Garage and Dealers 4/97
138 AL AL Alabama Garage and Dealers 2004/04
138 AR AR Arkansas Garage and Dealers 2000/10
138 AZ AZ Arizona Garage and Dealers 2003/10
138 CA CA California Garage and Dealers 3/96
138 CO CO Colorado Garage and Dealers 2003/07
138 CT CT Connecticut Garage and Dealers 2003/05
138 DC DC District of Columbia Garage and Dealers 2003/09
138 DE DE Delaware Garage and Dealers 3/96
138 FL FL Florida Garage and Dealers 2003/10
138 GA GA Georgia Garage and Dealers 2001/02
138 HI HI Hawaii Garage and Dealers 2004/05
138 IA IA Iowa Garage and Dealers 2002/10
138 ID ID Idaho Garage and Dealers 3/96
138 IL IL Illinois Garage and Dealers 2003/03
138 IN IN Indiana Garage and Dealers 2004/07
138 KS KS Kansas Garage and Dealers 2002/07
138 KY KY Kentucky Garage and Dealers 2000/09
138 LA LA Louisiana Garage and Dealers 6/98
138 MA MA Massachusetts Garage and Dealers 2000/09
138 MD MD Maryland Garage and Dealers 2004/03
138 ME ME Maine Garage and Dealers 2000/09
138 MI MI Michigan Garage and Dealers 4/96
138 MN MN Minnesota Garage and Dealers 2001/10
138 MO MO Missouri Garage and Dealers 3/96
138 MS MS Mississippi Garage and Dealers 2004/09
138 MT MT Montana Garage and Dealers 2003/09
138 NC NC North Carolina Garage and Dealers 2007/06
138 ND ND North Dakota Garage and Dealers 2000/07
138 NE NE Nebraska Garage and Dealers 8/97
138 NH NH New Hampshire Garage and Dealers 3/96
138 NJ NJ New Jersey Garage and Dealers 2004/11
138 NM NM New Mexico Garage and Dealers 3/96
138 NV NV Nevada Garage and Dealers 3/96
138 NY NY New York Garage and Dealers 2003/11
138 OH OH Ohio Garage and Dealers 2002/11
138 OK OK Oklahoma Garage and Dealers 3/96
138 OR OR Oregon Garage and Dealers 2000/07
138 PA Pennsylvania Garage and Dealers 2002/07
138 RI Rhode Island Garage and Dealers 2003/05
138 SC South Carolina Garage and Dealers 2003/02
138 SD South Dakota Garage and Dealers 2/97
138 TN Tennessee Garage and Dealers Coverages/Limits Section 2002/01
138 TX Texas Garage and Dealers 2000/08
138 UT Utah Garage and Dealers 2001/01
138 VA Virginia Garage and Dealers 2002/12
138 VT Vermont Garage and Dealers 2003/06
138 WA Washington Garage and Dealers 2002/08
138 WI Wisconsin Garage and Dealers 4/96
138 WV West Virginia Garage and Dealers 3/96
138 WY Wyoming Garage and Dealers - Coverages/Limits Section 3/96
139   Statement of Values 2004/03
139 MI Michigan Automobile Insurance Placement Facility Supplement to ACORD Application. Application for Commercial, Public Automobiles and Corporately Owned Vehicles 2004/07
139 MS Mississippi Statement/Schedule Of Values 2/99
140   Property Section 2011/10
140   Property Section 2010/12
140   Property Section 2007/05
141   Crime Section 2009/12
141   Crime Section 2003/07
141 C   Crime Section 2000 2007/06
143   Transportation Section 2004/01
144   Glass and Sign Supplement 11/94
145   Accounts Receivable/Valuable Papers 2004/03
146   Equipment Floater Section 2003/09
147   Installation/Builders Risk Section 2001/02
148   Electronic Data Processing Section 2000/02
149   Dealers Section 2004/04
151   Miscellaneous Crime Coverage Section 2001/07
152   Commercial Inland Marine 2015/06
154   Jewelers Inventory Record 1/98
155   Boiler & Machinery Section 2000/11
155 BM   Boiler & Machinery Section 2002 2004/03
159   Schedule of Insurance 2004/03
160   Business Owners Application 2009/05
160   Business Owners Application 2004/03
161   Withdrawn By ACORD - Business Owners Supplemental App 11/98
163   Commercial Auto Driver Information Schedule 2000/11
170 OH Ohio FAIR Plan Underwriting Association - Instructions for Completion of Insurance Applications 2002/09
171 AK Alaska Petition for Executive Officer Waiver 6/98
171 CO Colorado Rejection of Coverage by Corporate Officers 2002/12
171 CT Workers' Compensation Commission of Connecticut 4/96
171 DE Delaware Workers Compensation Election 7/96
171 FL Florida Notice of Election of Coverage Under Workers Compensation Law 2004/04
171 GA Georgia State Board of Workers Compensation Notice of Election or Rejection of Workers' Compensation Coverage 2001/03
171 IL Illinois FAIR Plan Application for Commercial Property Insurance 2002/10
171 KS Kansas Election of Individual Partner or Self-Employed Individual 2003/11
171 MI Michigan Notice of Election 4/96
171 NJ New Jersey Workers Compensation Insurance Plan - New Jersey Workers Compensation and Employers Liability Manual, Part 3, Section 14 2003/07
171 NM New Mexico Executive Employee Exemption 2004/10
171 NY New York Notice of Election of a Corporation 10/96
171 OH Ohio FAIR Plan Underwriting Association - Application for Insurance - Basic Property Application 2004/03
171 PA Pennsylvania Application for Executive Officer Exception From the Provisions of the Pennsylvania Workers' Compensation Act: Section 104 2002/02
171 TN Notice of Corporate Officer to Employer of Not to Accept Provisions of the "Compensation Act" of Tennessee 2003/09
171 VA Virginia Rejection of Coverage Under The Virginia Workers' Compensation Act 2003/02
172 CT Workers' Compensation Commission of Connecticut 4/96
172 FL Florida Revocation of Election to be Exempt 2004/04
172 KS Kansas Cancellation of Election of Individual 2003/11
172 MI Michigan Application for Exclusion of Partner(s) 4/96
172 NM New Mexico Election to Accept 2004/10
172 NY New York Notice of Election of a Partnership or Sole Proprietorship to Bring Partners or Self-Employed Persons Under the Coverage of the New York Workers Compensation Law 7/96
172 OH Ohio FAIR Plan Underwriting Association - Homeowners Supplement 2002/09
172 PA Pennsylvania Executive Officers Declaration 2002/02
172 TN Notice of Corporate Officer's Revocation of Exemption 2003/09
172 VA Virginia Notice Terminating Prior Rejection of Coverage 2003/02
173 CT Workers' Compensation Commission of Connecticut 4/96
173 FL Notice of Election to be Exempt 2004/04
173 KS Kansas Cancellation of Election Not to Accept Coverage 2001/05
173 MI Michigan Workers Compensation Placement Facility Specific Person Exclusion Form 2000/09
173 NM New Mexico Revocation 2004/10
173 NY New York Notice of Election of an Incorporated Religious 7/96
173 OH Ohio FAIR Plan Underwriting Association - Dwelling Fire Supplement 2002/09
173 TN Election of Sole Proprietor or Partner to Come Within the Provisions of the Tennessee Workers' Compensation Law 2003/09
174 FL Florida Revocation of Election of Coverage 2004/04
174 KS Kansas Election Not to Accept Coverage 2001/05
174 NM New Mexico Limited Liability Company Member Affirmative Election Form 2004/10
174 NY New York Revocation of an Incorporated Religious 7/96
174 OH Ohio FAIR Plan Underwriting Association - Commercial Supplement 2002/09
174 TN Notice of Withdrawal of Sole Proprietor or Partner Election 2003/09
175   Commercial Policy Change Request 2009/01
175 FL Florida Workers Compensation Monthly Change Sheet 2000/11
175 OH Ohio FAIR Plan Underwriting Association - Farm Supplement 2002/09
175 SC Associated Auto Insurers Plan of South Carolina - Commercial Auto Policy Change Request 2003/03
176 KS Kansas Election of Employer to Cover Employees 2001/05
176 OH Ohio FAIR Plan Underwriting Association - Rehabilitation Supplement 2002/09
177 CA California Auto Supplement - Auto Body Repair Consumer Bill of Rights 2001/03
177 KS Kansas Election of Coverage for Volunteer Workers 2003/11
177 NY Application for Commercial Insurance - NYPIUA 2000/09
177 OH Ohio FAIR Plan Underwriting Association - Bowling Alley Supplement 2002/09
177 SC Associated Auto Insurers Plan of South Carolina - Commercial Application 2004/06
177 WI Wisconsin Automobile Insurance Plan - Business Auto Application 2003/10
178 KS Kansas Cancellation of Election of Employer To Cover Employees 2003/11
178 SC Removed from ACORD - Business Auto Section 2/99
178 WI Wisconsin Automobile Insurance Plan - Truckers Application 2003/10
179 KS Kansas Cancellation of Election of Coverage for Volunteer Workers 2003/11
179 SC Associated Auto Insurers Plan of South Carolina - Garage Application 2004/06
180   Errors and Omissions Section 1/97
180 KS Kansas Election of Coverage for Persons Performing Public Service 2001/05
180 SC Removed from ACORD - Named Non-owner Application 2/99
181 KS Kansas Cancellation of Election of Coverage for Persons Performing Public Service 2001/08
181 SC Associated Auto Insurers Plan of South Carolina - Company Performance Complaint Form 2003/03
182 KS Kansas Election of a Noncompensated Volunteer To Be Covered 2001/05