Add fields for AGENCY CUSTOMER ID: and DRIVER #: in upper right hand corner
Replace logo, center Title and remove border around title
Update date field
Replace IDENTIFICATION SECTION with the new “standard” format for a section. Fields included are: AGENCY, POLICY NUMBER, EFFECTIVE DATE, CARRIER, NAIC CODE and NAMED INSURED(S). CARRIER label is 8 pt font.
DRIVER INFORMATION, Break out DRIVER’S NAME into three separate fields labeled: FIRST NAME, MIDDLE and LAST NAME. Reformat remaining fields to fit.
DRIVER MEDICAL HISTORY, delete all YES / NO check boxes and replace with a single field to capture Y for a “YES” response and N for a “NO” response
DRIVER MEDICAL HISTORY, Questions 1, 5, 12, 17 B, 18 B, 19 C, 23 D and 23 E, add extra space around slash (/) in question
DRIVER MEDICAL HISTORY, Question 18 A, insert additional field. There are now separate fields for KIND and DATE
Add (Attach ACORD 101, if more space is required) to REMARKS label
Redesign REMARKS section into a table with two columns labeled QUESTION # and EXPLANATION
Reformat Signature section and update DATE
Revise ACORD copyright to 1992-2009, using the new format with the years being the first item after the copyright symbol and add: All rights reserved.
Add: The ACORD name and logo are registered marks of ACORD to footer