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ACORD 50 MI (2007/12) 1 of 9
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Universal wording updates to improve clarity and intent were made to all FIG text for this form on 03/31/2009. |
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Section Name |
Field Name |
Field and/or Section Description |
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TITLE ACORD 50 MI (2007/12) |
State of Michigan Certificate of No-Fault Insurance |
The title of the form. ACORD 50 MI, Michigan Certificate of No-Fault Insurance Card, was created to satisfy Michigan statutory and regulatory requirements with respect to proof of no-fault insurance coverage. There is space provided on the back of the certificate to list excluded drivers. The part of ACORD 50 MI which includes the statement "Secretary of State Copy" should be used by the insured to apply for vehicle registration. The other part must be kept in the insured's vehicle at all times. |
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INSURANCE IDENTIFICATION CARD |
Check box - Commercial One |
Check the box (if applicable): Indicates the policy is a commercial lines policy. |
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INSURANCE IDENTIFICATION CARD |
Check box - Personal One |
Check the box (if applicable): Indicates the policy is a personal lines policy. |
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INSURANCE IDENTIFICATION CARD |
Company One |
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. |
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INSURANCE IDENTIFICATION CARD |
Policy Number One |
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. |
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INSURANCE IDENTIFICATION CARD |
Effective Date One |
Enter date: The effective date of the policy. The date that the terms and conditions of the policy commence. |
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INSURANCE IDENTIFICATION CARD |
Expiration Date One |
Enter date: The date on which the terms and conditions of the policy will expire. |
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INSURANCE IDENTIFICATION CARD |
Year One |
Enter year: The model year of the vehicle. |
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INSURANCE IDENTIFICATION CARD |
Make One |
Enter text: The manufacturer of the vehicle (e.g. Ford, Chevy). |
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INSURANCE IDENTIFICATION CARD |
Model One |
Enter text: The manufacturer's model name for the vehicle. |
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INSURANCE IDENTIFICATION CARD |
Vehicle Identification Number One |
Enter identifier: The vehicle identification number (VIN) or serial number assigned by the manufacturer. |
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INSURANCE IDENTIFICATION CARD |
Agency/Company Issuing Card One |
Enter text: The full name of the producer/agency. |
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INSURANCE IDENTIFICATION CARD |
Insured One |
Enter text: The named insured(s) as it/they will appear on the policy declarations page. |
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INSURANCE IDENTIFICATION CARD |
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Enter text: The named insured's mailing address line one. |
ACORD 50 MI (2007/12) 2 of 9
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Section Name |
Field Name |
Field and/or Section Description |
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INSURANCE |
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IDENTIFICATION CARD |
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Enter text: The named insured's mailing address line two. |
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INSURANCE |
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IDENTIFICATION CARD |
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Enter text: The named insured's mailing address city name. |
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INSURANCE |
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IDENTIFICATION CARD |
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Enter code: The named insured's mailing address state or province code. |
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INSURANCE |
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IDENTIFICATION CARD |
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Enter code: The named insured's mailing address postal code. |
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INSURANCE |
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IDENTIFICATION CARD |
Check box - Commercial Two |
Check the box (if applicable): Indicates the policy is a commercial lines policy. |
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INSURANCE |
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IDENTIFICATION CARD |
Check box - Personal Two |
Check the box (if applicable): Indicates the policy is a personal lines policy. |
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Enter text: The insurer's full legal company name(s) as found in the file copy of the policy. |
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INSURANCE |
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Use the actual name of the company within the group to which the policy has been issued. |
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IDENTIFICATION CARD |
Company Two |
This is not the insurer's group name or trade name. |
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Enter identifier: The identifier assigned by the insurer to the policy, or submission, being |
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INSURANCE |
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referenced exactly as it appears on the policy, including prefix and suffix symbols. If |
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IDENTIFICATION CARD |
Policy Number Two |
required for self-insurance, the self-insured license or contract number. |
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INSURANCE |
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Enter date: The effective date of the policy. The date that the terms and conditions of the |
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IDENTIFICATION CARD |
Effective Date Two |
policy commence. |
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INSURANCE |
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IDENTIFICATION CARD |
Expiration Date Two |
Enter date: The date on which the terms and conditions of the policy will expire. |
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INSURANCE |
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IDENTIFICATION CARD |
Year Two |
Enter year: The model year of the vehicle. |
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INSURANCE |
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IDENTIFICATION CARD |
Make Two |
Enter text: The manufacturer of the vehicle (e.g. Ford, Chevy). |
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INSURANCE |
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IDENTIFICATION CARD |
Model Two |
Enter text: The manufacturer's model name for the vehicle. |
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INSURANCE |
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Enter identifier: The vehicle identification number (VIN) or serial number assigned by the |
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IDENTIFICATION CARD |
Vehicle Identification Number Two |
manufacturer. |
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INSURANCE |
Agency/Company Issuing Card |
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IDENTIFICATION CARD |
Two |
Enter text: The full name of the producer/agency. |
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INSURANCE |
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IDENTIFICATION CARD |
Insured Two |
Enter text: The named insured(s) as it/they will appear on the policy declarations page. |
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INSURANCE |
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IDENTIFICATION CARD |
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Enter text: The named insured's mailing address line one. |
ACORD 50 MI (2007/12) 3 of 9
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Section Name |
Field Name |
Field and/or Section Description |
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INSURANCE |
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IDENTIFICATION CARD |
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Enter text: The named insured's mailing address line two. |
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INSURANCE |
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IDENTIFICATION CARD |
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Enter text: The named insured's mailing address city name. |
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INSURANCE |
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IDENTIFICATION CARD |
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Enter code: The named insured's mailing address state or province code. |
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INSURANCE |
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IDENTIFICATION CARD |
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Enter code: The named insured's mailing address postal code. |
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INSURANCE |
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IDENTIFICATION CARD |
Check box - Commercial Three |
Check the box (if applicable): Indicates the policy is a commercial lines policy. |
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INSURANCE |
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IDENTIFICATION CARD |
Check box - Personal Three |
Check the box (if applicable): Indicates the policy is a personal lines policy. |
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Enter text: The insurer's full legal company name(s) as found in the file copy of the policy. |
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INSURANCE |
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Use the actual name of the company within the group to which the policy has been issued. |
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IDENTIFICATION CARD |
Company Three |
This is not the insurer's group name or trade name. |
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Enter identifier: The identifier assigned by the insurer to the policy, or submission, being |
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INSURANCE |
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referenced exactly as it appears on the policy, including prefix and suffix symbols. If |
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IDENTIFICATION CARD |
Policy Number Three |
required for self-insurance, the self-insured license or contract number. |
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INSURANCE |
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Enter date: The effective date of the policy. The date that the terms and conditions of the |
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IDENTIFICATION CARD |
Effective Date Three |
policy commence. |
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INSURANCE |
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IDENTIFICATION CARD |
Expiration Date Three |
Enter date: The date on which the terms and conditions of the policy will expire. |
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INSURANCE |
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IDENTIFICATION CARD |
Year Three |
Enter year: The model year of the vehicle. |
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INSURANCE |
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IDENTIFICATION CARD |
Make Three |
Enter text: The manufacturer of the vehicle (e.g. Ford, Chevy). |
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INSURANCE |
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IDENTIFICATION CARD |
Model Three |
Enter text: The manufacturer's model name for the vehicle. |
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INSURANCE |
Vehicle Identification Number |
Enter identifier: The vehicle identification number (VIN) or serial number assigned by the |
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IDENTIFICATION CARD |
Three |
manufacturer. |
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INSURANCE |
Agency/Company Issuing Card |
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IDENTIFICATION CARD |
Three |
Enter text: The full name of the producer/agency. |
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INSURANCE |
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IDENTIFICATION CARD |
Insured Three |
Enter text: The named insured(s) as it/they will appear on the policy declarations page. |
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INSURANCE |
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IDENTIFICATION CARD |
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Enter text: The named insured's mailing address line one. |
ACORD 50 MI (2007/12) 4 of 9
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Section Name |
Field Name |
Field and/or Section Description |
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INSURANCE |
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IDENTIFICATION CARD |
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Enter text: The named insured's mailing address line two. |
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INSURANCE |
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IDENTIFICATION CARD |
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Enter text: The named insured's mailing address city name. |
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INSURANCE |
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IDENTIFICATION CARD |
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Enter code: The named insured's mailing address state or province code. |
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INSURANCE |
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IDENTIFICATION CARD |
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Enter code: The named insured's mailing address postal code. |
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INSURANCE |
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IDENTIFICATION CARD |
Check box - Commercial Four |
Check the box (if applicable): Indicates the policy is a commercial lines policy. |
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INSURANCE |
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IDENTIFICATION CARD |
Check box - Personal Four |
Check the box (if applicable): Indicates the policy is a personal lines policy. |
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Enter text: The insurer's full legal company name(s) as found in the file copy of the policy. |
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INSURANCE |
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Use the actual name of the company within the group to which the policy has been issued. |
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IDENTIFICATION CARD |
Company Four |
This is not the insurer's group name or trade name. |
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Enter identifier: The identifier assigned by the insurer to the policy, or submission, being |
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INSURANCE |
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referenced exactly as it appears on the policy, including prefix and suffix symbols. If |
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IDENTIFICATION CARD |
Policy Number Four |
required for self-insurance, the self-insured license or contract number. |
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INSURANCE |
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Enter date: The effective date of the policy. The date that the terms and conditions of the |
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IDENTIFICATION CARD |
Effective Date Four |
policy commence. |
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INSURANCE |
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IDENTIFICATION CARD |
Expiration Date Four |
Enter date: The date on which the terms and conditions of the policy will expire. |
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INSURANCE |
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IDENTIFICATION CARD |
Year Four |
Enter year: The model year of the vehicle. |
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INSURANCE |
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IDENTIFICATION CARD |
Make Four |
Enter text: The manufacturer of the vehicle (e.g. Ford, Chevy). |
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INSURANCE |
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IDENTIFICATION CARD |
Model Four |
Enter text: The manufacturer's model name for the vehicle. |
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INSURANCE |
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Enter identifier: The vehicle identification number (VIN) or serial number assigned by the |
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IDENTIFICATION CARD |
Vehicle Identification Number Four |
manufacturer. |
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INSURANCE |
Agency/Company Issuing Card |
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IDENTIFICATION CARD |
Four |
Enter text: The full name of the producer/agency. |
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INSURANCE |
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IDENTIFICATION CARD |
Insured Four |
Enter text: The named insured(s) as it/they will appear on the policy declarations page. |
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INSURANCE |
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IDENTIFICATION CARD |
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Enter text: The named insured's mailing address line one. |
ACORD 50 MI (2007/12) 5 of 9
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Section Name |
Field Name |
Field and/or Section Description |
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INSURANCE IDENTIFICATION CARD |
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Enter text: The named insured's mailing address line two. |
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INSURANCE IDENTIFICATION CARD |
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Enter text: The named insured's mailing address city name. |
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INSURANCE IDENTIFICATION CARD |
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Enter code: The named insured's mailing address state or province code. |
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INSURANCE IDENTIFICATION CARD |
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Enter code: The named insured's mailing address postal code. |
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INSURANCE IDENTIFICATION CARD |
Excluded Drivers |
Enter text: The driver's first name (given name). As used here, this is an excluded driver. |
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INSURANCE IDENTIFICATION CARD |
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Enter text: The driver's middle name or initial (other given name). As used here, this is an excluded driver. |
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INSURANCE IDENTIFICATION CARD |
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Enter text: The driver's last name (surname). As used here, this is an excluded driver. |
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INSURANCE IDENTIFICATION CARD |
Excluded Drivers |
Enter text: The driver's first name (given name). As used here, this is an excluded driver. |
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INSURANCE IDENTIFICATION CARD |
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Enter text: The driver's middle name or initial (other given name). As used here, this is an excluded driver. |
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INSURANCE IDENTIFICATION CARD |
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Enter text: The driver's last name (surname). As used here, this is an excluded driver. |
|
INSURANCE IDENTIFICATION CARD |
Excluded Drivers |
Enter text: The driver's first name (given name). As used here, this is an excluded driver. |
|
INSURANCE IDENTIFICATION CARD |
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Enter text: The driver's middle name or initial (other given name). As used here, this is an excluded driver. |
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INSURANCE IDENTIFICATION CARD |
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Enter text: The driver's last name (surname). As used here, this is an excluded driver. |
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INSURANCE IDENTIFICATION CARD |
Excluded Drivers |
Enter text: The driver's first name (given name). As used here, this is an excluded driver. |
|
INSURANCE IDENTIFICATION CARD |
|
Enter text: The driver's middle name or initial (other given name). As used here, this is an excluded driver. |
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INSURANCE IDENTIFICATION CARD |
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Enter text: The driver's last name (surname). As used here, this is an excluded driver. |
|
INSURANCE IDENTIFICATION CARD |
Excluded Drivers |
Enter text: The driver's first name (given name). As used here, this is an excluded driver. |
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INSURANCE IDENTIFICATION CARD |
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Enter text: The driver's middle name or initial (other given name). As used here, this is an excluded driver. |
ACORD 50 MI (2007/12) 6 of 9
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Section Name |
Field Name |
Field and/or Section Description |
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INSURANCE IDENTIFICATION CARD |
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Enter text: The driver's last name (surname). As used here, this is an excluded driver. |
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INSURANCE IDENTIFICATION CARD |
Excluded Drivers |
Enter text: The driver's first name (given name). As used here, this is an excluded driver. |
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INSURANCE IDENTIFICATION CARD |
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Enter text: The driver's middle name or initial (other given name). As used here, this is an excluded driver. |
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INSURANCE IDENTIFICATION CARD |
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Enter text: The driver's last name (surname). As used here, this is an excluded driver. |
|
INSURANCE IDENTIFICATION CARD |
Excluded Drivers |
Enter text: The driver's first name (given name). As used here, this is an excluded driver. |
|
INSURANCE IDENTIFICATION CARD |
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Enter text: The driver's middle name or initial (other given name). As used here, this is an excluded driver. |
|
INSURANCE IDENTIFICATION CARD |
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Enter text: The driver's last name (surname). As used here, this is an excluded driver. |
|
INSURANCE IDENTIFICATION CARD |
Excluded Drivers |
Enter text: The driver's first name (given name). As used here, this is an excluded driver. |
|
INSURANCE IDENTIFICATION CARD |
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Enter text: The driver's middle name or initial (other given name). As used here, this is an excluded driver. |
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INSURANCE IDENTIFICATION CARD |
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Enter text: The driver's last name (surname). As used here, this is an excluded driver. |
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INSURANCE IDENTIFICATION CARD |
Check box - Commercial One |
Check the box (if applicable): Indicates the policy is a commercial lines policy. |
|
INSURANCE IDENTIFICATION CARD |
Check box - Personal One |
Check the box (if applicable): Indicates the policy is a personal lines policy. |
|
INSURANCE IDENTIFICATION CARD |
Company One |
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. |
|
INSURANCE IDENTIFICATION CARD |
Policy Number One |
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. |
|
INSURANCE IDENTIFICATION CARD |
Effective Date One |
Enter date: The effective date of the policy. The date that the terms and conditions of the policy commence. |
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INSURANCE IDENTIFICATION CARD |
Expiration Date One |
Enter date: The date on which the terms and conditions of the policy will expire. |
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INSURANCE IDENTIFICATION CARD |
Year One |
Enter year: The model year of the vehicle. |
ACORD 50 MI (2007/12) 7 of 9
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Section Name |
Field Name |
Field and/or Section Description |
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INSURANCE |
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IDENTIFICATION CARD |
Make One |
Enter text: The manufacturer of the vehicle (e.g. Ford, Chevy). |
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INSURANCE |
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IDENTIFICATION CARD |
Model One |
Enter text: The manufacturer's model name for the vehicle. |
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INSURANCE |
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Enter identifier: The vehicle identification number (VIN) or serial number assigned by the |
|
IDENTIFICATION CARD |
Vehicle Identification Number One |
manufacturer. |
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INSURANCE |
Agency/Company Issuing Card |
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IDENTIFICATION CARD |
One |
Enter text: The full name of the producer/agency. |
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INSURANCE |
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IDENTIFICATION CARD |
Insured One |
Enter text: The named insured(s) as it/they will appear on the policy declarations page. |
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INSURANCE |
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IDENTIFICATION CARD |
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Enter text: The named insured's mailing address line one. |
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INSURANCE |
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IDENTIFICATION CARD |
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Enter text: The named insured's mailing address line two. |
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INSURANCE |
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IDENTIFICATION CARD |
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Enter text: The named insured's mailing address city name. |
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INSURANCE |
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|
IDENTIFICATION CARD |
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Enter code: The named insured's mailing address state or province code. |
|
INSURANCE |
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|
IDENTIFICATION CARD |
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Enter code: The named insured's mailing address postal code. |
|
INSURANCE |
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|
IDENTIFICATION CARD |
Excluded Drivers |
Enter text: The driver's first name (given name). As used here, this is an excluded driver. |
|
INSURANCE |
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Enter text: The driver's middle name or initial (other given name). As used here, this is an |
|
IDENTIFICATION CARD |
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excluded driver. |
|
INSURANCE |
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|
IDENTIFICATION CARD |
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Enter text: The driver's last name (surname). As used here, this is an excluded driver. |
|
INSURANCE |
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|
IDENTIFICATION CARD |
Excluded Drivers |
Enter text: The driver's first name (given name). As used here, this is an excluded driver. |
|
INSURANCE |
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Enter text: The driver's middle name or initial (other given name). As used here, this is an |
|
IDENTIFICATION CARD |
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excluded driver. |
|
INSURANCE |
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|
IDENTIFICATION CARD |
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Enter text: The driver's last name (surname). As used here, this is an excluded driver. |
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INSURANCE |
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IDENTIFICATION CARD |
Check box - Commercial Two |
Check the box (if applicable): Indicates the policy is a commercial lines policy. |
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INSURANCE |
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|
IDENTIFICATION CARD |
Check box - Personal Two |
Check the box (if applicable): Indicates the policy is a personal lines policy. |
ACORD 50 MI (2007/12) 8 of 9
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Section Name |
Field Name |
Field and/or Section Description |
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Enter text: The insurer's full legal company name(s) as found in the file copy of the policy. |
|
INSURANCE |
|
Use the actual name of the company within the group to which the policy has been issued. |
|
IDENTIFICATION CARD |
Company Two |
This is not the insurer's group name or trade name. |
|
|
Enter identifier: The identifier assigned by the insurer to the policy, or submission, being |
|
INSURANCE |
|
referenced exactly as it appears on the policy, including prefix and suffix symbols. If |
|
IDENTIFICATION CARD |
Policy Number Two |
required for self-insurance, the self-insured license or contract number. |
|
INSURANCE |
|
Enter date: The effective date of the policy. The date that the terms and conditions of the |
|
IDENTIFICATION CARD |
Effective Date Two |
policy commence. |
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INSURANCE |
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|
IDENTIFICATION CARD |
Expiration Date Two |
Enter date: The date on which the terms and conditions of the policy will expire. |
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INSURANCE |
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IDENTIFICATION CARD |
Year Two |
Enter year: The model year of the vehicle. |
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INSURANCE |
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IDENTIFICATION CARD |
Make Two |
Enter text: The manufacturer of the vehicle (e.g. Ford, Chevy). |
|
INSURANCE |
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|
IDENTIFICATION CARD |
Model Two |
Enter text: The manufacturer's model name for the vehicle. |
|
INSURANCE |
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Enter identifier: The vehicle identification number (VIN) or serial number assigned by the |
|
IDENTIFICATION CARD |
Vehicle Identification Number Two |
manufacturer. |
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INSURANCE |
Agency/Company Issuing Card |
|
|
IDENTIFICATION CARD |
Two |
Enter text: The full name of the producer/agency. |
|
INSURANCE |
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|
IDENTIFICATION CARD |
Insured Two |
Enter text: The named insured(s) as it/they will appear on the policy declarations page. |
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INSURANCE |
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IDENTIFICATION CARD |
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Enter text: The named insured's mailing address line one. |
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INSURANCE |
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IDENTIFICATION CARD |
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Enter text: The named insured's mailing address line two. |
|
INSURANCE |
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IDENTIFICATION CARD |
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Enter text: The named insured's mailing address city name. |
|
INSURANCE |
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|
IDENTIFICATION CARD |
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Enter code: The named insured's mailing address state or province code. |
|
INSURANCE |
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|
IDENTIFICATION CARD |
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Enter code: The named insured's mailing address postal code. |
|
INSURANCE |
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|
|
IDENTIFICATION CARD |
Excluded Drivers |
Enter text: The driver's first name (given name). As used here, this is an excluded driver. |
|
INSURANCE |
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Enter text: The driver's middle name or initial (other given name). As used here, this is an |
|
IDENTIFICATION CARD |
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excluded driver. |
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Section Name |
Field Name |
Field and/or Section Description |
|
INSURANCE IDENTIFICATION CARD |
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Enter text: The driver's last name (surname). As used here, this is an excluded driver. |
|
INSURANCE IDENTIFICATION CARD |
Excluded Drivers |
Enter text: The driver's first name (given name). As used here, this is an excluded driver. |
|
INSURANCE IDENTIFICATION CARD |
|
Enter text: The driver's middle name or initial (other given name). As used here, this is an excluded driver. |
|
INSURANCE IDENTIFICATION CARD |
|
Enter text: The driver's last name (surname). As used here, this is an excluded driver. |
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Edition |
Date |
The edition identifier of the form including the form number and edition (the date is typically formatted YYYY/MM). |
ACORD 50 MI (2007/12) 9 of 9
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