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ACORD 45 (2009/04) rev. 04-30-2009 1 of 10
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Section Name |
Field Name |
Field and/or Section Description |
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TITLE ACORD 45 (2009/04) |
Additional Interest Schedule |
The title of the form. ACORD 45, Additional Interest Schedule, is used in multiple situations to expand upon the additional interest sections within any form. This form may be used for both personal and commercial accounts. The form is used to collect information on additional interests and certificate holders. |
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IDENTIFICATION SECTION |
Agency Customer ID |
Enter identifier: The customer's identification number assigned by the producer (e.g. agency or brokerage). |
|
IDENTIFICATION SECTION |
Date |
Enter date: The month/day/year on which the form is completed. (MM/DD/YYYY) |
|
IDENTIFICATION SECTION |
Agency |
Enter text: The full name of the producer/agency. |
|
IDENTIFICATION SECTION |
Policy Number |
Enter identifier: The identifier assigned by the insurer to the policy, or submission, being referenced exactly as it appears on the policy, including prefix and suffix symbols. If required for self-insurance, the self-insured license or contract number. |
|
IDENTIFICATION SECTION |
Effective Date |
Enter date: The effective date of the policy. The date that the terms and conditions of the policy commence. |
|
IDENTIFICATION SECTION |
Carrier |
Enter text: The insurer's full legal company name(s) as found in the file copy of the policy. Use the actual name of the company within the group to which the policy has been issued. This is not the insurer's group name or trade name. |
|
IDENTIFICATION SECTION |
NAIC Code |
Enter code: The identification code assigned to the insurer by the NAIC. |
|
IDENTIFICATION SECTION |
Named Insured(s) |
Enter text: The named insured(s) as it/they will appear on the policy declarations page. |
|
ADDITIONAL INTEREST |
Additional Insured |
Check the box (if applicable): Indicates the additional interest type is an additional insured. |
|
ADDITIONAL INTEREST |
Breach of Warranty |
Check the box (if applicable): Indicates the additional interest type is a breach of warranty. |
|
ADDITIONAL INTEREST |
Co-Owner |
Check the box (if applicable): Indicates the additional interest type is a co-owner. |
|
ADDITIONAL INTEREST |
Employee As Lessor |
Check the box (if applicable): Indicates the additional interest type is an employee as lessor. |
|
ADDITIONAL INTEREST |
Leaseback Owner |
Check the box (if applicable): Indicates the additional interest type is a leaseback owner. |
|
ADDITIONAL INTEREST |
Lienholder |
Check the box (if applicable): Indicates the additional interest type is a lien holder. |
|
ADDITIONAL INTEREST |
Loss Payee |
Check the box (if applicable): Indicates the additional interest type is a loss payee. |
|
ADDITIONAL INTEREST |
Mortgagee |
Check the box (if applicable): Indicates the additional interest type is a mortgagee. |
|
ADDITIONAL INTEREST |
Owner |
Check the box (if applicable): Indicates the additional interest type is an owner. |
|
ADDITIONAL INTEREST |
Registrant |
Check the box (if applicable): Indicates the additional interest type is a registrant. |
ACORD 45 (2009/04) rev. 04-30-2009 2 of 10
|
Section Name |
Field Name |
Field and/or Section Description |
|
ADDITIONAL INTEREST |
Trustee |
Check the box (if applicable): Indicates the additional interest type is a trustee. |
|
ADDITIONAL INTEREST |
Other |
Check the box (if applicable): Indicates the additional interest is not any of the types listed on the form. |
|
ADDITIONAL INTEREST |
Describe Other |
Enter text: The description of the type of interest in the item. |
|
ADDITIONAL INTEREST |
Reason for Interest |
Enter text: The description for the interest in the item. |
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ADDITIONAL INTEREST |
Rank |
Enter number: The ranking of 'this' additional interest when multiple additional interests are associated with the same item. |
|
ADDITIONAL INTEREST |
Certificate |
Check the box (if applicable): Indicates if the additional interest requires a Certificate of Insurance, |
|
ADDITIONAL INTEREST |
Policy |
Check the box (if applicable): Indicates the additional interest requires a copy of the policy. |
|
ADDITIONAL INTEREST |
Send Bill |
Check the box (if applicable): Indicates the bill should be sent to the additional interest. |
|
ADDITIONAL INTEREST |
Name and Address |
Enter text: The additional interest's full name. As used here, the complete name and address of the additional interest, including the city, state and country. If the additional interest is the owner of a motor vehicle, and the owner is different from the Named Insured, show the owner's name here. |
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ADDITIONAL INTEREST |
|
Enter text: The additional interest's mailing address line one. |
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ADDITIONAL INTEREST |
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Enter text: The additional interest's mailing address line two. |
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ADDITIONAL INTEREST |
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Enter text: The additional interest's mailing address city name. |
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ADDITIONAL INTEREST |
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Enter code: The additional interest's mailing address state or province code. |
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ADDITIONAL INTEREST |
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Enter code: The additional interest's mailing address postal code. |
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ADDITIONAL INTEREST |
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Enter code: The additional interest's country code. |
|
ADDITIONAL INTEREST |
Reference / Loan # |
Enter identifier: The loan number, account number or other controlling number that the additional interest may have assigned the insured. |
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ADDITIONAL INTEREST |
Interest End Date |
Enter date: The date the interest holder's interest terminates. |
|
ADDITIONAL INTEREST |
Lien Amount |
Enter amount: The amount of the loan. |
|
ADDITIONAL INTEREST |
Phone |
Enter number: The primary phone number of the additional interest. |
|
ADDITIONAL INTEREST |
Fax |
Enter number: The primary fax number of the additional interest. |
|
ADDITIONAL INTEREST |
E-Mail Address |
Enter text: The primary e-mail address for the additional interest. |
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ADDITIONAL INTEREST |
Location |
Enter number: The producer assigned number of the location which has an additional interest. |
|
ADDITIONAL INTEREST |
Building |
Enter number: The producer assigned number of the building which has an additional interest. |
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ADDITIONAL INTEREST |
Vehicle |
Enter number: The producer assigned number of the vehicle which has an additional interest. |
ACORD 45 (2009/04) rev. 04-30-2009 3 of 10
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Section Name |
Field Name |
Field and/or Section Description |
|
ADDITIONAL INTEREST |
Boat |
Enter number: The producer assigned number of the boat which has an additional interest. |
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ADDITIONAL INTEREST |
Airport |
Enter identifier: The Federal Aviation Administration's designator for the airport (e.g. ORD -O'Hare International Airport). |
|
ADDITIONAL INTEREST |
Aircraft |
Enter number: The producer assigned number of the aircraft which has an additional interest. |
|
ADDITIONAL INTEREST |
Item Class |
Enter text: The description of the property class of the scheduled item (i.e. Jewelry, Furs, Contractors Equipment, etc.). |
|
ADDITIONAL INTEREST |
Item |
Enter number: The producer assigned number of the scheduled item which has an additional interest. |
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ADDITIONAL INTEREST |
Item Description |
Enter text: The description of the item of interest if needed to further clarify. For a vehicle, list the make, model and VIN number. For a scheduled item, list the description, such as three carat diamond in six point setting. |
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ADDITIONAL INTEREST |
Additional Insured |
Check the box (if applicable): Indicates the additional interest type is an additional insured. |
|
ADDITIONAL INTEREST |
Breach of Warranty |
Check the box (if applicable): Indicates the additional interest type is a breach of warranty. |
|
ADDITIONAL INTEREST |
Co-Owner |
Check the box (if applicable): Indicates the additional interest type is a co-owner. |
|
ADDITIONAL INTEREST |
Employee As Lessor |
Check the box (if applicable): Indicates the additional interest type is an employee as lessor. |
|
ADDITIONAL INTEREST |
Leaseback Owner |
Check the box (if applicable): Indicates the additional interest type is a leaseback owner. |
|
ADDITIONAL INTEREST |
Lienholder |
Check the box (if applicable): Indicates the additional interest type is a lien holder. |
|
ADDITIONAL INTEREST |
Loss Payee |
Check the box (if applicable): Indicates the additional interest type is a loss payee. |
|
ADDITIONAL INTEREST |
Mortgagee |
Check the box (if applicable): Indicates the additional interest type is a mortgagee. |
|
ADDITIONAL INTEREST |
Owner |
Check the box (if applicable): Indicates the additional interest type is an owner. |
|
ADDITIONAL INTEREST |
Registrant |
Check the box (if applicable): Indicates the additional interest type is a registrant. |
|
ADDITIONAL INTEREST |
Trustee |
Check the box (if applicable): Indicates the additional interest type is a trustee. |
|
ADDITIONAL INTEREST |
Other |
Check the box (if applicable): Indicates the additional interest is not any of the types listed on the form. |
|
ADDITIONAL INTEREST |
Describe Other |
Enter text: The description of the type of interest in the item. |
|
ADDITIONAL INTEREST |
Reason for Interest |
Enter text: The description for the interest in the item. |
|
ADDITIONAL INTEREST |
Rank |
Enter number: The ranking of 'this' additional interest when multiple additional interests are associated with the same item. |
|
ADDITIONAL INTEREST |
Certificate |
Check the box (if applicable): Indicates if the additional interest requires a Certificate of Insurance, |
ACORD 45 (2009/04) rev. 04-30-2009 4 of 10
|
Section Name |
Field Name |
Field and/or Section Description |
|
ADDITIONAL INTEREST |
Policy |
Check the box (if applicable): Indicates the additional interest requires a copy of the policy. |
|
ADDITIONAL INTEREST |
Send Bill |
Check the box (if applicable): Indicates the bill should be sent to the additional interest. |
|
ADDITIONAL INTEREST |
Name and Address |
Enter text: The additional interest's full name. |
|
ADDITIONAL INTEREST |
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Enter text: The additional interest's mailing address line one. |
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ADDITIONAL INTEREST |
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Enter text: The additional interest's mailing address line two. |
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ADDITIONAL INTEREST |
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Enter text: The additional interest's mailing address city name. |
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ADDITIONAL INTEREST |
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Enter code: The additional interest's mailing address state or province code. |
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ADDITIONAL INTEREST |
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Enter code: The additional interest's mailing address postal code. |
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ADDITIONAL INTEREST |
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Enter code: The additional interest's country code. |
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ADDITIONAL INTEREST |
Reference / Loan # |
Enter identifier: The loan number, account number or other controlling number that the additional interest may have assigned the insured. |
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ADDITIONAL INTEREST |
Interest End Date |
Enter date: The date the interest holder's interest terminates. |
|
ADDITIONAL INTEREST |
Lien Amount |
Enter amount: The amount of the loan. |
|
ADDITIONAL INTEREST |
Phone |
Enter number: The primary phone number of the additional interest. |
|
ADDITIONAL INTEREST |
Fax |
Enter number: The primary fax number of the additional interest. |
|
ADDITIONAL INTEREST |
E-Mail Address |
Enter text: The primary e-mail address for the additional interest. |
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ADDITIONAL INTEREST |
Location |
Enter number: The producer assigned number of the location which has an additional interest. |
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ADDITIONAL INTEREST |
Building |
Enter number: The producer assigned number of the building which has an additional interest. |
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ADDITIONAL INTEREST |
Vehicle |
Enter number: The producer assigned number of the vehicle which has an additional interest. |
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ADDITIONAL INTEREST |
Boat |
Enter number: The producer assigned number of the boat which has an additional interest. |
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ADDITIONAL INTEREST |
Airport |
Enter identifier: The Federal Aviation Administration's designator for the airport (e.g. ORD -O'Hare International Airport). |
|
ADDITIONAL INTEREST |
Aircraft |
Enter number: The producer assigned number of the aircraft which has an additional interest. |
|
ADDITIONAL INTEREST |
Item Class |
Enter text: The description of the property class of the scheduled item (i.e. Jewelry, Furs, Contractors Equipment, etc.). |
|
ADDITIONAL INTEREST |
Item |
Enter number: The producer assigned number of the scheduled item which has an additional interest. |
ACORD 45 (2009/04) rev. 04-30-2009 5 of 10
|
Section Name |
Field Name |
Field and/or Section Description |
|
ADDITIONAL INTEREST |
Item Description |
Enter text: The description of the item of interest if needed to further clarify. For a vehicle, list the make, model and VIN number. For a scheduled item, list the description, such as three carat diamond in six point setting. |
|
ADDITIONAL INTEREST |
Additional Insured |
Check the box (if applicable): Indicates the additional interest type is an additional insured. |
|
ADDITIONAL INTEREST |
Breach of Warranty |
Check the box (if applicable): Indicates the additional interest type is a breach of warranty. |
|
ADDITIONAL INTEREST |
Co-Owner |
Check the box (if applicable): Indicates the additional interest type is a co-owner. |
|
ADDITIONAL INTEREST |
Employee As Lessor |
Check the box (if applicable): Indicates the additional interest type is an employee as lessor. |
|
ADDITIONAL INTEREST |
Leaseback Owner |
Check the box (if applicable): Indicates the additional interest type is a leaseback owner. |
|
ADDITIONAL INTEREST |
Lienholder |
Check the box (if applicable): Indicates the additional interest type is a lien holder. |
|
ADDITIONAL INTEREST |
Loss Payee |
Check the box (if applicable): Indicates the additional interest type is a loss payee. |
|
ADDITIONAL INTEREST |
Mortgagee |
Check the box (if applicable): Indicates the additional interest type is a mortgagee. |
|
ADDITIONAL INTEREST |
Owner |
Check the box (if applicable): Indicates the additional interest type is an owner. |
|
ADDITIONAL INTEREST |
Registrant |
Check the box (if applicable): Indicates the additional interest type is a registrant. |
|
ADDITIONAL INTEREST |
Trustee |
Check the box (if applicable): Indicates the additional interest type is a trustee. |
|
ADDITIONAL INTEREST |
Other |
Check the box (if applicable): Indicates the additional interest is not any of the types listed on the form. |
|
ADDITIONAL INTEREST |
Describe Other |
Enter text: The description of the type of interest in the item. |
|
ADDITIONAL INTEREST |
Reason for Interest |
Enter text: The description for the interest in the item. |
|
ADDITIONAL INTEREST |
Rank |
Enter number: The ranking of 'this' additional interest when multiple additional interests are associated with the same item. |
|
ADDITIONAL INTEREST |
Certificate |
Check the box (if applicable): Indicates if the additional interest requires a Certificate of Insurance, |
|
ADDITIONAL INTEREST |
Policy |
Check the box (if applicable): Indicates the additional interest requires a copy of the policy. |
|
ADDITIONAL INTEREST |
Send Bill |
Check the box (if applicable): Indicates the bill should be sent to the additional interest. |
|
ADDITIONAL INTEREST |
Name and Address |
Enter text: The additional interest's full name. |
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ADDITIONAL INTEREST |
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Enter text: The additional interest's mailing address line one. |
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ADDITIONAL INTEREST |
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Enter text: The additional interest's mailing address line two. |
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ADDITIONAL INTEREST |
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Enter text: The additional interest's mailing address city name. |
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ADDITIONAL INTEREST |
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Enter code: The additional interest's mailing address state or province code. |
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ADDITIONAL INTEREST |
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Enter code: The additional interest's mailing address postal code. |
ACORD 45 (2009/04) rev. 04-30-2009 6 of 10
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Section Name |
Field Name |
Field and/or Section Description |
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ADDITIONAL INTEREST |
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Enter code: The additional interest's country code. |
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ADDITIONAL INTEREST |
Reference / Loan # |
Enter identifier: The loan number, account number or other controlling number that the additional interest may have assigned the insured. |
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ADDITIONAL INTEREST |
Interest End Date |
Enter date: The date the interest holder's interest terminates. |
|
ADDITIONAL INTEREST |
Lien Amount |
Enter amount: The amount of the loan. |
|
ADDITIONAL INTEREST |
Phone |
Enter number: The primary phone number of the additional interest. |
|
ADDITIONAL INTEREST |
Fax |
Enter number: The primary fax number of the additional interest. |
|
ADDITIONAL INTEREST |
E-Mail Address |
Enter text: The primary e-mail address for the additional interest. |
|
ADDITIONAL INTEREST |
Location |
Enter number: The producer assigned number of the location which has an additional interest. |
|
ADDITIONAL INTEREST |
Building |
Enter number: The producer assigned number of the building which has an additional interest. |
|
ADDITIONAL INTEREST |
Vehicle |
Enter number: The producer assigned number of the vehicle which has an additional interest. |
|
ADDITIONAL INTEREST |
Boat |
Enter number: The producer assigned number of the boat which has an additional interest. |
|
ADDITIONAL INTEREST |
Airport |
Enter identifier: The Federal Aviation Administration's designator for the airport (e.g. ORD -O'Hare International Airport). |
|
ADDITIONAL INTEREST |
Aircraft |
Enter number: The producer assigned number of the aircraft which has an additional interest. |
|
ADDITIONAL INTEREST |
Item Class |
Enter text: The description of the property class of the scheduled item (i.e. Jewelry, Furs, Contractors Equipment, etc.). |
|
ADDITIONAL INTEREST |
Item |
Enter number: The producer assigned number of the scheduled item which has an additional interest. |
|
ADDITIONAL INTEREST |
Item Description |
Enter text: The description of the item of interest if needed to further clarify. For a vehicle, list the make, model and VIN number. For a scheduled item, list the description, such as three carat diamond in six point setting. |
|
ADDITIONAL INTEREST |
Additional Insured |
Check the box (if applicable): Indicates the additional interest type is an additional insured. |
|
ADDITIONAL INTEREST |
Breach of Warranty |
Check the box (if applicable): Indicates the additional interest type is a breach of warranty. |
|
ADDITIONAL INTEREST |
Co-Owner |
Check the box (if applicable): Indicates the additional interest type is a co-owner. |
|
ADDITIONAL INTEREST |
Employee As Lessor |
Check the box (if applicable): Indicates the additional interest type is an employee as lessor. |
|
ADDITIONAL INTEREST |
Leaseback Owner |
Check the box (if applicable): Indicates the additional interest type is a leaseback owner. |
ACORD 45 (2009/04) rev. 04-30-2009 7 of 10
|
Section Name |
Field Name |
Field and/or Section Description |
|
ADDITIONAL INTEREST |
Lienholder |
Check the box (if applicable): Indicates the additional interest type is a lien holder. |
|
ADDITIONAL INTEREST |
Loss Payee |
Check the box (if applicable): Indicates the additional interest type is a loss payee. |
|
ADDITIONAL INTEREST |
Mortgagee |
Check the box (if applicable): Indicates the additional interest type is a mortgagee. |
|
ADDITIONAL INTEREST |
Owner |
Check the box (if applicable): Indicates the additional interest type is an owner. |
|
ADDITIONAL INTEREST |
Registrant |
Check the box (if applicable): Indicates the additional interest type is a registrant. |
|
ADDITIONAL INTEREST |
Trustee |
Check the box (if applicable): Indicates the additional interest type is a trustee. |
|
ADDITIONAL INTEREST |
Other |
Check the box (if applicable): Indicates the additional interest is not any of the types listed on the form. |
|
ADDITIONAL INTEREST |
Describe Other |
Enter text: The description of the type of interest in the item. |
|
ADDITIONAL INTEREST |
Reason for Interest |
Enter text: The description for the interest in the item. |
|
ADDITIONAL INTEREST |
Rank |
Enter number: The ranking of 'this' additional interest when multiple additional interests are associated with the same item. |
|
ADDITIONAL INTEREST |
Certificate |
Check the box (if applicable): Indicates if the additional interest requires a Certificate of Insurance, |
|
ADDITIONAL INTEREST |
Policy |
Check the box (if applicable): Indicates the additional interest requires a copy of the policy. |
|
ADDITIONAL INTEREST |
Send Bill |
Check the box (if applicable): Indicates the bill should be sent to the additional interest. |
|
ADDITIONAL INTEREST |
Name and Address |
Enter text: The additional interest's full name. |
|
ADDITIONAL INTEREST |
|
Enter text: The additional interest's mailing address line one. |
|
ADDITIONAL INTEREST |
|
Enter text: The additional interest's mailing address line two. |
|
ADDITIONAL INTEREST |
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Enter text: The additional interest's mailing address city name. |
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ADDITIONAL INTEREST |
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Enter code: The additional interest's mailing address state or province code. |
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ADDITIONAL INTEREST |
|
Enter code: The additional interest's mailing address postal code. |
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ADDITIONAL INTEREST |
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Enter code: The additional interest's country code. |
|
ADDITIONAL INTEREST |
Reference / Loan # |
Enter identifier: The loan number, account number or other controlling number that the additional interest may have assigned the insured. |
|
ADDITIONAL INTEREST |
Interest End Date |
Enter date: The date the interest holder's interest terminates. |
|
ADDITIONAL INTEREST |
Lien Amount |
Enter amount: The amount of the loan. |
|
ADDITIONAL INTEREST |
Phone |
Enter number: The primary phone number of the additional interest. |
|
ADDITIONAL INTEREST |
Fax |
Enter number: The primary fax number of the additional interest. |
|
ADDITIONAL INTEREST |
E-Mail Address |
Enter text: The primary e-mail address for the additional interest. |
|
ADDITIONAL INTEREST |
Location |
Enter number: The producer assigned number of the location which has an additional interest. |
|
ADDITIONAL INTEREST |
Building |
Enter number: The producer assigned number of the building which has an additional interest. |
ACORD 45 (2009/04) rev. 04-30-2009 8 of 10
|
Section Name |
Field Name |
Field and/or Section Description |
|
ADDITIONAL INTEREST |
Vehicle |
Enter number: The producer assigned number of the vehicle which has an additional interest. |
|
ADDITIONAL INTEREST |
Boat |
Enter number: The producer assigned number of the boat which has an additional interest. |
|
ADDITIONAL INTEREST |
Airport |
Enter identifier: The Federal Aviation Administration's designator for the airport (e.g. ORD -O'Hare International Airport). |
|
ADDITIONAL INTEREST |
Aircraft |
Enter number: The producer assigned number of the aircraft which has an additional interest. |
|
ADDITIONAL INTEREST |
Item Class |
Enter text: The description of the property class of the scheduled item (i.e. Jewelry, Furs, Contractors Equipment, etc.). |
|
ADDITIONAL INTEREST |
Item |
Enter number: The producer assigned number of the scheduled item which has an additional interest. |
|
ADDITIONAL INTEREST |
Item Description |
Enter text: The description of the item of interest if needed to further clarify. For a vehicle, list the make, model and VIN number. For a scheduled item, list the description, such as three carat diamond in six point setting. |
|
ADDITIONAL INTEREST |
Additional Insured |
Check the box (if applicable): Indicates the additional interest type is an additional insured. |
|
ADDITIONAL INTEREST |
Breach of Warranty |
Check the box (if applicable): Indicates the additional interest type is a breach of warranty. |
|
ADDITIONAL INTEREST |
Co-Owner |
Check the box (if applicable): Indicates the additional interest type is a co-owner. |
|
ADDITIONAL INTEREST |
Employee As Lessor |
Check the box (if applicable): Indicates the additional interest type is an employee as lessor. |
|
ADDITIONAL INTEREST |
Leaseback Owner |
Check the box (if applicable): Indicates the additional interest type is a leaseback owner. |
|
ADDITIONAL INTEREST |
Lienholder |
Check the box (if applicable): Indicates the additional interest type is a lien holder. |
|
ADDITIONAL INTEREST |
Loss Payee |
Check the box (if applicable): Indicates the additional interest type is a loss payee. |
|
ADDITIONAL INTEREST |
Mortgagee |
Check the box (if applicable): Indicates the additional interest type is a mortgagee. |
|
ADDITIONAL INTEREST |
Owner |
Check the box (if applicable): Indicates the additional interest type is an owner. |
|
ADDITIONAL INTEREST |
Registrant |
Check the box (if applicable): Indicates the additional interest type is a registrant. |
|
ADDITIONAL INTEREST |
Trustee |
Check the box (if applicable): Indicates the additional interest type is a trustee. |
|
ADDITIONAL INTEREST |
Other |
Check the box (if applicable): Indicates the additional interest is not any of the types listed on the form. |
|
ADDITIONAL INTEREST |
Describe Other |
Enter text: The description of the type of interest in the item. |
|
ADDITIONAL INTEREST |
Reason for Interest |
Enter text: The description for the interest in the item. |
|
ADDITIONAL INTEREST |
Rank |
Enter number: The ranking of 'this' additional interest when multiple additional interests are associated with the same item. |
ACORD 45 (2009/04) rev. 04-30-2009 9 of 10
|
Section Name |
Field Name |
Field and/or Section Description |
|
ADDITIONAL INTEREST |
Certificate |
Check the box (if applicable): Indicates if the additional interest requires a Certificate of Insurance, |
|
ADDITIONAL INTEREST |
Policy |
Check the box (if applicable): Indicates the additional interest requires a copy of the policy. |
|
ADDITIONAL INTEREST |
Send Bill |
Check the box (if applicable): Indicates the bill should be sent to the additional interest. |
|
ADDITIONAL INTEREST |
Name and Address |
Enter text: The additional interest's full name. |
|
ADDITIONAL INTEREST |
|
Enter text: The additional interest's mailing address line one. |
|
ADDITIONAL INTEREST |
|
Enter text: The additional interest's mailing address line two. |
|
ADDITIONAL INTEREST |
|
Enter text: The additional interest's mailing address city name. |
|
ADDITIONAL INTEREST |
|
Enter code: The additional interest's mailing address state or province code. |
|
ADDITIONAL INTEREST |
|
Enter code: The additional interest's mailing address postal code. |
|
ADDITIONAL INTEREST |
|
Enter code: The additional interest's country code. |
|
ADDITIONAL INTEREST |
Reference / Loan # |
Enter identifier: The loan number, account number or other controlling number that the additional interest may have assigned the insured. |
|
ADDITIONAL INTEREST |
Interest End Date |
Enter date: The date the interest holder's interest terminates. |
|
ADDITIONAL INTEREST |
Lien Amount |
Enter amount: The amount of the loan. |
|
ADDITIONAL INTEREST |
Phone |
Enter number: The primary phone number of the additional interest. |
|
ADDITIONAL INTEREST |
Fax |
Enter number: The primary fax number of the additional interest. |
|
ADDITIONAL INTEREST |
E-Mail Address |
Enter text: The primary e-mail address for the additional interest. |
|
ADDITIONAL INTEREST |
Location |
Enter number: The producer assigned number of the location which has an additional interest. |
|
ADDITIONAL INTEREST |
Building |
Enter number: The producer assigned number of the building which has an additional interest. |
|
ADDITIONAL INTEREST |
Vehicle |
Enter number: The producer assigned number of the vehicle which has an additional interest. |
|
ADDITIONAL INTEREST |
Boat |
Enter number: The producer assigned number of the boat which has an additional interest. |
|
ADDITIONAL INTEREST |
Airport |
Enter identifier: The Federal Aviation Administration's designator for the airport (e.g. ORD -O'Hare International Airport). |
|
ADDITIONAL INTEREST |
Aircraft |
Enter number: The producer assigned number of the aircraft which has an additional interest. |
|
ADDITIONAL INTEREST |
Item Class |
Enter text: The description of the property class of the scheduled item (i.e. Jewelry, Furs, Contractors Equipment, etc.). |
|
ADDITIONAL INTEREST |
Item |
Enter number: The producer assigned number of the scheduled item which has an additional interest. |
|
Section Name |
Field Name |
Field and/or Section Description |
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Enter text: The description of the item of interest if needed to further clarify. For a vehicle, |
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list the make, model and VIN number. For a scheduled item, list the description, such as |
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ADDITIONAL INTEREST |
Item Description |
three carat diamond in six point setting. |
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The edition identifier of the form including the form number and edition (the date is |
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Edition |
Date |
typically formatted YYYY/MM). |
ACORD 45 (2009/04) rev. 04-30-2009 10 of 10
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