ACORD 50 KY (2006/01) - COMMONWEALTH OF KENTUCKY PROOF OF INSURANCE

ACORD 50 KY (2006/01) - COMMONWEALTH OF KENTUCKY PROOF OF INSURANCE
ACORD 50 KY, Kentucky Automobile Insurance Identification Card, was created in response to Kentucky regulations. The main differences
between the generic ACORD Automobile Insurance Card, ACORD 50, and the Kentucky card are:
* The size of the card is 3 1/2 inches wide and 2 1/4 inches high (wallet size)
* The order of entries on the front of the card is prescribed by regulation
* The Company number that must be shown is the five digit NAIC code assigned to the individual company issuing the policy.
* The Type of Policy must be indicated. Indicate PL for a personal policy. Indicate CL for a commercial policy.
* The Agency/Company phone number that must be shown is either the local agents number or a toll-free insurer's number.
* State mandated Instructions to Policyholder are included on the back of the card
* Two copies of this ID card must be given to the insured. One will be used to present to the county clerk when renewing motor vehicle registration;
the other must be carried in the identified motor vehicle.
Form Page 1
Section Name
Field Name
Description
INSURANCE
IDENTIFICATION CARD
Company Number
Enter code: The identification code assigned to the insurer by the NAIC.
INSURANCE
IDENTIFICATION CARD
Company Name and
Address
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
Enter text: The first line of the insurer's mailing address.
INSURANCE
IDENTIFICATION CARD
Enter text: The second line of the insurer's mailing address.
INSURANCE
IDENTIFICATION CARD
Enter text: The city of the insurer's mailing address.
INSURANCE
IDENTIFICATION CARD
Enter code: The state or province code of the insurer's mailing address.
INSURANCE
IDENTIFICATION CARD
Enter code: The postal code of the insurer's mailing address.
ACORD 50 KY (2006/01) rev. 06-04-2014
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INSURANCE
IDENTIFICATION CARD
Named Insured & Address
Enter text: The named insured(s) as it / they will appear on the policy declarations page.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address line one.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address line two.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address city name.
INSURANCE
IDENTIFICATION CARD
Enter code: The named insured's mailing address state or province code.
INSURANCE
IDENTIFICATION CARD
Enter code: The named insured's mailing address postal code.
INSURANCE
IDENTIFICATION CARD
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.
INSURANCE
IDENTIFICATION CARD
Type of Policy Personal
(checkbox)
Check the box (if applicable): Indicates the policy is a personal lines policy.
INSURANCE
IDENTIFICATION CARD
Type of Policy Commercial
(checkbox)
Check the box (if applicable): Indicates the policy is a commercial lines policy.
INSURANCE
IDENTIFICATION CARD
Effective Date
Enter date: The effective date of the policy. The date that the terms and conditions of the policy
commence. (MM/DD/YYYY) As used here, if the card is issued mid-term the card shall indicate
the effective date of coverage if different from the inception date of the policy.
INSURANCE
IDENTIFICATION CARD
Expiration Date
Enter date: The date on which the terms and conditions of the policy will expire. (MM/DD/YYYY)
INSURANCE
IDENTIFICATION CARD
Year
Enter year: The model year of the vehicle.
INSURANCE
IDENTIFICATION CARD
Make/Model
Enter text: The manufacturer of the vehicle (e.g., Ford, Chevy).
INSURANCE
IDENTIFICATION CARD
Enter text: The manufacturer's model name for the vehicle.
INSURANCE
IDENTIFICATION CARD
Vehicle Identification
Number
Enter identifier: The vehicle identification number (VIN) or serial number assigned by the
manufacturer.
INSURANCE
IDENTIFICATION CARD
Agency/Company Issuing
Card
Enter text: The full name of the producer / agency.
ACORD 50 KY (2006/01) rev. 06-04-2014
Page 2 of 4
INSURANCE
IDENTIFICATION CARD
Agency/Company Phone #
Enter number: The producer's contact person's phone number. If applicable, include the area
code and extension.
INSURANCE
IDENTIFICATION CARD
Company Number
Enter code: The identification code assigned to the insurer by the NAIC.
INSURANCE
IDENTIFICATION CARD
Company Name and
Address
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
Enter text: The first line of the insurer's mailing address.
INSURANCE
IDENTIFICATION CARD
Enter text: The second line of the insurer's mailing address.
INSURANCE
IDENTIFICATION CARD
Enter text: The city of the insurer's mailing address.
INSURANCE
IDENTIFICATION CARD
Enter code: The state or province code of the insurer's mailing address.
INSURANCE
IDENTIFICATION CARD
Enter code: The postal code of the insurer's mailing address.
INSURANCE
IDENTIFICATION CARD
Named Insured & Address
Enter text: The named insured(s) as it / they will appear on the policy declarations page.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address line one.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address line two.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address city name.
INSURANCE
IDENTIFICATION CARD
Enter code: The named insured's mailing address state or province code.
INSURANCE
IDENTIFICATION CARD
Enter code: The named insured's mailing address postal code.
INSURANCE
IDENTIFICATION CARD
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.
INSURANCE
IDENTIFICATION CARD
Type of Policy Personal
(checkbox)
Check the box (if applicable): Indicates the policy is a personal lines policy.
ACORD 50 KY (2006/01) rev. 06-04-2014
Page 3 of 4
INSURANCE
IDENTIFICATION CARD
Type of Policy Commercial
(checkbox)
Check the box (if applicable): Indicates the policy is a commercial lines policy.
INSURANCE
IDENTIFICATION CARD
Effective Date
Enter date: The effective date of the policy. The date that the terms and conditions of the policy
commence. (MM/DD/YYYY) As used here, if the card is issued mid-term the card shall indicate
the effective date of coverage if different from the inception date of the policy.
INSURANCE
IDENTIFICATION CARD
Expiration Date
Enter date: The date on which the terms and conditions of the policy will expire. (MM/DD/YYYY)
INSURANCE
IDENTIFICATION CARD
Year
Enter year: The model year of the vehicle.
INSURANCE
IDENTIFICATION CARD
Make/Model
Enter text: The manufacturer of the vehicle (e.g., Ford, Chevy).
INSURANCE
IDENTIFICATION CARD
Enter text: The manufacturer's model name for the vehicle.
INSURANCE
IDENTIFICATION CARD
Vehicle Identification
Number
Enter identifier: The vehicle identification number (VIN) or serial number assigned by the
manufacturer.
INSURANCE
IDENTIFICATION CARD
Agency/Company Issuing
Card
Enter text: The full name of the producer / agency.
INSURANCE
IDENTIFICATION CARD
Agency/Company Phone #
Enter number: The producer's contact person's phone number. If applicable, include the area
code and extension.
ACORD 50 KY (2006/01) rev. 06-04-2014
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