Read Forms Release 01-16-2003 text version

ACORD Forms Release 09-28-2007

Form Number REVISIONS P&C - Countrywide 83 (2007/09) 125 (2007/07) 130 (2007/11) 131 (2007/09) 133 (2007/11) 144 (2007/07) 401 (2007/09) 402 (2007/09) 403 (2007/09) 404 (2007/09) 405 (2007/09) 802 (2007/07) 810 (2007/07) 811 (2007/07) 823 (2007/07) Replaces Title

2007/03 2007/05 2005/08 2007/03 2004/11 2007/01 2001/10 2001/10 2000/05 2000/05 2000/05 2002/01 2006/04 2005/01 2006/08

Personal Umbrella Application Commercial Insurance Application Workers Compensation Application Umbrella / Excess Section Workers Compensation Insurance Plan ­ Assigned Risk Section Glass and Sign Supplement Agriculture Application ­ Applicant Information Section Agriculture Property Section Agriculture Property Section ­ Scheduled and Unscheduled Farm Personal Property Agriculture Liability Section Agriculture Premises / Location Diagram Hotel/Motel Supplement Business Income / Extra Expense / Rental Value Value Reporting Information Commercial Insurance Application Supplement ­ Additional Premises Section

P&C - State Specific 50 PA (2007/09) 50 RI (2007/09) 90 WI (2007/09) 135 NC (2007/10) 136 NC (2007/10) 137 WI (2007/09) 138 WI (2007/09) Life/Annuity 951 (2006/05) rev. 2007/09 951 (2007/09) 2002/08 2005/10 2001/03 2005/11 2005/11 2002/02 4/96 Pennsylvania Financial Responsibility Identification Card Rhode Island Insurance Identification Card Wisconsin Personal Auto Application North Carolina Workers Compensation Insurance Plan ­ Application for Designation of an Insurance Company North Carolina Workers Compensation Insurance Plan ­ Instructions for Completing ACORD 135 NC Application Wisconsin Commercial Auto Wisconsin Garage and Dealers

2006/05 2005/06

1035 Exchange / Rollover / Transfer Form 1035 Exchange / Rollover / Transfer Form

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ACORD Forms Release 09-28-2007

ACORD Forms Release 09-28-2007

NEW P&C - Countrywide 88 (2007/09) 89 (2007/09) 406 (2007/09) 407 (2007/09) 408 (2007/09) P&C ­ State Specific Life/Annuity WITHDRAWN 86 (2007/01) 87 (2007/01) 134 (2004/03) 192 (7/98) FIG CHANGES ONLY

NEW NEW NEW NEW NEW

Personal Insurance Application ­ Applicant Information Section Residential Section Agriculture Supplement ­ Unscheduled Farm Personal Property Inventory Form Livestock Mortality Section Equine Liability Supplement NONE

NONE

Personal Lines Package Application Personal Lines Package Application ­ Watercraft/Inland Marine Section Workers Compensation Application Supplement ­ Multi State Rating Worksheet Equine Insurance Application NONE

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ACORD Forms Release 09-28-2007

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