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Section Name |
Field Name |
Field and/or Section Description |
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TITLE ACORD 188 SC (2003/03) |
Associated Auto Insurers Plan of South Carolina - Endorsement Voiding Automobile Insurance while Named Person is Operating Car |
The title of the form. ACORD 188 SC, Associated Auto Insurers Plan of South Carolina -Endorsement Voiding Automobile Insurance while Named Person is Operating Car, is used in connection with insurance written through the Associated Auto Insurers Plan of South Carolina. Refer to the Plan rules to determine how the form should be used. |
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This endorsement, effective [Blank |
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ENDORSEMENT |
Area] 12:01a.m. Standard Time |
Enter date: The effective date of the endorsement. |
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Enter identifier: The identifier assigned by the insurer to the policy, or submission, being |
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Forms a part of policy Number |
referenced exactly as it appears on the policy, including prefix and suffix symbols. If |
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ENDORSEMENT |
[Blank Area] |
required for self-insurance, the self-insured license or contract number. |
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Issued to [Blank Area] (Named |
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ENDORSEMENT |
Insured) |
Enter text: The named insured(s) as it/they will appear on the policy declarations page. |
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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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Use the actual name of the company within the group to which the policy has been issued. |
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ENDORSEMENT |
By [Blank Area] (Insurer) |
This is not the insurer's group name or trade name. |
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ENDORSEMENT |
Name of Person to be Excluded |
Enter text: The full name of the excluded person. |
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ENDORSEMENT |
Named Insured |
Sign here: Accommodates the signature of the applicant or named insured. |
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ENDORSEMENT |
Date |
Enter date: The date the form was signed by the named insured. |
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I have surrendered my driver's |
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license to the Department of |
Check the box (if applicable): Indicates the driver has surrendered their driver's license to |
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ENDORSEMENT |
Public Safety, or [Checkbox] |
the department of public safety. |
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ENDORSEMENT |
I Have obtained a policy of insurance (or other security) to enable me to drive vehicles [Checkbox] |
Check the box (if applicable): Indicates the driver has obtained a policy of insurance or other security to enable them to drive vehicles. |
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Excluded Person or Guardian If a |
Sign here: Accommodates the signature of the driver. As used here, this is the signature |
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SIGNATURES |
Minor |
of the excluded driver or their guardian if they are a minor. |
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SIGNATURES |
Date |
Enter date: The date the driver signed the form. |
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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). |