ACORD 339 (2009/06)

Section Name
Field Name
Field and/or Section Description
TITLE
ACORD 339 (2009/06)
Aviation Products Liability Change
Request
ACORD 339, Aviation Products Liability Change Request, is used to
submit requested changes to an aviation products liability policy. This form may stand on
its own or be attached to the ACORD 335, Aviation Policy Change Request Applicant
Information Section.
IDENTIFICATION SECTION Agency Customer ID
Enter identifier: The customer's identification number assigned by the producer (e.g.
agency or brokerage).
IDENTIFICATION SECTION Date (MM/DD/YYYY)
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 Effective Date of Change
Enter date: The date on which the change should take effect.
IDENTIFICATION SECTION Effective Time of Change
Enter time: The effective time of the policy change.
IDENTIFICATION SECTION Effective Time AM
Check the box (if applicable): Indicates the effective time of the policy change is in the
morning (AM).
IDENTIFICATION SECTION Effective Time PM
Check the box (if applicable): Indicates the effective time of the policy change is in the
afternoon or evening (PM).
IDENTIFICATION SECTION Named Insured
Enter text: The named insured(s) as it/they will appear on the policy declarations page.
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.
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Section Name
Field Name
Field and/or Section Description
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
COVERAGES
Products Liability Incl Comp Ops
Check the box (if applicable): Indicates completed operations are included in the products
liability coverage.
COVERAGES
Products Liability Excl Comp Ops
Check the box (if applicable): Indicates completed operations are excluded from the
products liability coverage.
COVERAGES
Products Liability Incl Spacecraft
Check the box (if applicable): Indicates spacecraft are included in the products liability
coverage.
COVERAGES
Products Liability Excl Spacecraft
Check the box (if applicable): Indicates spacecraft are excluded from the products liability
coverage.
COVERAGES
Products Liability Limit Ea Occ
Enter limit: The each occurrence limit for products liability coverage.
COVERAGES
Products Liability Limit Aggr
Enter limit: The aggregate limit for products liability coverage.
COVERAGES
Products Liability Deductible Ea
Occ
Enter deductible: The each occurrence deductible amount for products liability coverage.
COVERAGES
Products Liability Deductible Aggr
Enter deductible: The aggregate deductible amount for products liability coverage.
COVERAGES
Products Liability Premium
Enter amount: The premium amount for products liability coverage.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
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Section Name
Field Name
Field and/or Section Description
COVERAGES
Grounding Liability Limit Ea Occ
Enter limit: The each occurrence limit amount for grounding liability coverage.
COVERAGES
Grounding Liability Limit Aggr
Enter limit: The aggregate limit amount for grounding liability coverage.
COVERAGES
Grounding Liability Deductible
Amount
Enter deductible: The deductible amount for grounding liability coverage.
COVERAGES
Grounding Liability Deductible
Percent Each Ground
Enter percentage: The percentage deductible for each ground for grounding liability
coverage.
COVERAGES
Grounding Liability Premium
Enter amount: The premium amount for grounding liability coverage.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
COVERAGES
Foreign Military Aircraft Products
Included
Check the box (if applicable): Indicates foreign military aircraft products coverage is
included in the policy.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
COVERAGES
Coverage Code
Enter code: The code for the coverage.
COVERAGES
Coverage Description
Enter text: The description of other coverage (not the limit) on the policy. Any questions
about appropriate limits or applicable policy coverage(s) should be answered by the
issuing insurer(s)
COVERAGES
Options
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Describe Other Options
Enter text: The description of the option being requested.
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Section Name
Field Name
Field and/or Section Description
COVERAGES
Options
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Describe Other Options
Enter text: The description of the option being requested.
COVERAGES
Limit
Enter limit: The limit amount for the coverage.
COVERAGES
Limit Applies to
Enter code: The code identifying what the limit applies to (i.e. per occurrence).
COVERAGES
Limit
Enter limit: The limit amount for the coverage.
COVERAGES
Limit Applies to
Enter code: The code identifying what the limit applies to (i.e. per occurrence).
COVERAGES
Deductible
Enter deductible: The deductible amount for the coverage.
COVERAGES
Deductible Applies to
Enter code: The code identifying what the deductible applies to.
COVERAGES
Deductible
Enter deductible: The deductible amount for the coverage.
COVERAGES
Deductible Applies to
Enter code: The code identifying what the deductible applies to.
COVERAGES
Premium
Enter amount: The premium amount for the coverage.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
COVERAGES
Coverage Code
Enter code: The code for the coverage.
COVERAGES
Coverage Description
Enter text: The description of other coverage (not the limit) on the policy. Any questions
about appropriate limits or applicable policy coverage(s) should be answered by the
issuing insurer(s)
COVERAGES
Options
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Describe Other Options
Enter text: The description of the option being requested.
COVERAGES
Options
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Describe Other Options
Enter text: The description of the option being requested.
COVERAGES
Limit
Enter limit: The limit amount for the coverage.
COVERAGES
Limit Applies to
Enter code: The code identifying what the limit applies to (i.e. per occurrence).
COVERAGES
Limit
Enter limit: The limit amount for the coverage.
COVERAGES
Limit Applies to
Enter code: The code identifying what the limit applies to (i.e. per occurrence).
COVERAGES
Deductible
Enter deductible: The deductible amount for the coverage.
COVERAGES
Deductible Applies to
Enter code: The code identifying what the deductible applies to.
COVERAGES
Deductible
Enter deductible: The deductible amount for the coverage.
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Section Name
Field Name
Field and/or Section Description
COVERAGES
Deductible Applies to
Enter code: The code identifying what the deductible applies to.
COVERAGES
Premium
Enter amount: The premium amount for the coverage.
EXCESS COVERAGE
Will you be purchasing excess
coverage over this insurance?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Will you be purchasing excess coverage over this insurance?.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
EXCESS COVERAGE
Excess Carrier
Enter text: The insurer name on any other applicable insurance. As used here, this is for
the excess carrier.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
EXCESS COVERAGE
Policy Number
Enter identifier: The policy number on any other applicable insurance. As used here, this is
for the excess policy.
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Section Name
Field Name
Field and/or Section Description
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
EXCESS COVERAGE
Expiration Date
Enter date: The date on which the terms and conditions of the other policy expires. As
used here, this is for the excess policy.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
EXCESS COVERAGE
Describe Excess Coverage
Enter text: The description of the other policy not listed on the form. As used here, this is
for the excess policy.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Customer Name
Enter text: The full name of the principal customer.
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Section Name
Field Name
Field and/or Section Description
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
% of Sales
Enter percentage: The percentage of total sales this principal customer is responsible for.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Description of Product/Service
Enter text: The description of the products and / or services purchased by the principal
customer.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Aircraft Models Utilizing the
Product
Enter text: The description of the aircraft models using the products and / or services
purchased by the principal customer.
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Section Name
Field Name
Field and/or Section Description
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Aircraft Systems Utilizing the
Product
Enter text: The description of the aircraft systems using the products and / or services
purchased the by the principal customer.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Customer Name
Enter text: The full name of the principal customer.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
% of Sales
Enter percentage: The percentage of total sales this principal customer is responsible for.
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Section Name
Field Name
Field and/or Section Description
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Description of Product/Service
Enter text: The description of the products and / or services purchased by the principal
customer.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Aircraft Models Utilizing the
Product
Enter text: The description of the aircraft models using the products and / or services
purchased by the principal customer.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Aircraft Systems Utilizing the
Product
Enter text: The description of the aircraft systems using the products and / or services
purchased the by the principal customer.
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Section Name
Field Name
Field and/or Section Description
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Customer Name
Enter text: The full name of the principal customer.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
% of Sales
Enter percentage: The percentage of total sales this principal customer is responsible for.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Description of Product/Service
Enter text: The description of the products and / or services purchased by the principal
customer.
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Section Name
Field Name
Field and/or Section Description
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Aircraft Models Utilizing the
Product
Enter text: The description of the aircraft models using the products and / or services
purchased by the principal customer.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Aircraft Systems Utilizing the
Product
Enter text: The description of the aircraft systems using the products and / or services
purchased the by the principal customer.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Customer Name
Enter text: The full name of the principal customer.
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Section Name
Field Name
Field and/or Section Description
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
% of Sales
Enter percentage: The percentage of total sales this principal customer is responsible for.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Description of Product/Service
Enter text: The description of the products and / or services purchased by the principal
customer.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Aircraft Models Utilizing the
Product
Enter text: The description of the aircraft models using the products and / or services
purchased by the principal customer.
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Aircraft Systems Utilizing the
Product
Enter text: The description of the aircraft systems using the products and / or services
purchased the by the principal customer.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Customer Name
Enter text: The full name of the principal customer.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
% of Sales
Enter percentage: The percentage of total sales this principal customer is responsible for.
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Section Name
Field Name
Field and/or Section Description
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Description of Product/Service
Enter text: The description of the products and / or services purchased by the principal
customer.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Aircraft Models Utilizing the
Product
Enter text: The description of the aircraft models using the products and / or services
purchased by the principal customer.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Aircraft Systems Utilizing the
Product
Enter text: The description of the aircraft systems using the products and / or services
purchased the by the principal customer.
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Customer Name
Enter text: The full name of the principal customer.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
% of Sales
Enter percentage: The percentage of total sales this principal customer is responsible for.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Description of Product/Service
Enter text: The description of the products and / or services purchased by the principal
customer.
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Aircraft Models Utilizing the
Product
Enter text: The description of the aircraft models using the products and / or services
purchased by the principal customer.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Aircraft Systems Utilizing the
Product
Enter text: The description of the aircraft systems using the products and / or services
purchased the by the principal customer.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Customer Name
Enter text: The full name of the principal customer.
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
% of Sales
Enter percentage: The percentage of total sales this principal customer is responsible for.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Description of Product/Service
Enter text: The description of the products and / or services purchased by the principal
customer.
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Aircraft Models Utilizing the
Product
Enter text: The description of the aircraft models using the products and / or services
purchased by the principal customer.
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Section Name
Field Name
Field and/or Section Description
COVERAGES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRINCIPAL CUSTOMERS
Aircraft Systems Utilizing the
Product
Enter text: The description of the aircraft systems using the products and / or services
purchased the by the principal customer.
IDENTIFICATION SECTION Agency Customer ID
Enter identifier: The customer's identification number assigned by the producer (e.g.
agency or brokerage).
AIRCRAFT PRODUCT
SALES
Year One
Enter year: The year the sales took place.
AIRCRAFT PRODUCT
SALES
Year Two
Enter year: The year the sales took place.
AIRCRAFT PRODUCT
SALES
Year Three
Enter year: The year the sales took place.
AIRCRAFT PRODUCT
SALES
Year Four
Enter year: The year the sales took place.
AIRCRAFT PRODUCT
SALES
Year Five
Enter year: The year the sales took place.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Piston
Airframe Year One
Enter amount: The annual gross receipts amount for fixed wing piston airframes.
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Piston
Airframe Year Two
Enter amount: The annual gross receipts amount for fixed wing piston airframes.
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Piston
Airframe Year Three
Enter amount: The annual gross receipts amount for fixed wing piston airframes.
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Piston
Airframe Year Four
Enter amount: The annual gross receipts amount for fixed wing piston airframes.
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Piston
Airframe Year Five
Enter amount: The annual gross receipts amount for fixed wing piston airframes.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Piston
Engine Year One
Enter amount: The annual gross receipts amount for fixed wing piston engines.
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Piston
Engine Year Two
Enter amount: The annual gross receipts amount for fixed wing piston engines.
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Piston
Engine Year Three
Enter amount: The annual gross receipts amount for fixed wing piston engines.
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Piston
Engine Year Four
Enter amount: The annual gross receipts amount for fixed wing piston engines.
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Piston
Engine Year Five
Enter amount: The annual gross receipts amount for fixed wing piston engines.
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Piston
Propeller Year One
Enter amount: The annual gross receipts amount for fixed wing piston propellers.
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Piston
Propeller Year Two
Enter amount: The annual gross receipts amount for fixed wing piston propellers.
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Piston
Propeller Year Three
Enter amount: The annual gross receipts amount for fixed wing piston propellers.
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Piston
Propeller Year Four
Enter amount: The annual gross receipts amount for fixed wing piston propellers.
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Piston
Propeller Year Five
Enter amount: The annual gross receipts amount for fixed wing piston propellers.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Turbine
Airframe Year One
Enter amount: The annual gross receipts amount for fixed wing turbine airframes.
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Turbine
Airframe Year Two
Enter amount: The annual gross receipts amount for fixed wing turbine airframes.
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Turbine
Airframe Year Three
Enter amount: The annual gross receipts amount for fixed wing turbine airframes.
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Turbine
Airframe Year Four
Enter amount: The annual gross receipts amount for fixed wing turbine airframes.
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Turbine
Airframe Year Five
Enter amount: The annual gross receipts amount for fixed wing turbine airframes.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Turbine
Engine Year One
Enter amount: The annual gross receipts amount for fixed wing turbine engines.
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Turbine
Engine Year Two
Enter amount: The annual gross receipts amount for fixed wing turbine engines.
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Turbine
Engine Year Three
Enter amount: The annual gross receipts amount for fixed wing turbine engines.
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Turbine
Engine Year Four
Enter amount: The annual gross receipts amount for fixed wing turbine engines.
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Turbine
Engine Year Five
Enter amount: The annual gross receipts amount for fixed wing turbine engines.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Turbine
Propeller Year One
Enter amount: The annual gross receipts amount for fixed wing turbine propellers.
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Turbine
Propeller Year Two
Enter amount: The annual gross receipts amount for fixed wing turbine propellers.
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Turbine
Propeller Year Three
Enter amount: The annual gross receipts amount for fixed wing turbine propellers.
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Turbine
Propeller Year Four
Enter amount: The annual gross receipts amount for fixed wing turbine propellers.
AIRCRAFT PRODUCT
SALES
Non Military - Fixed Wing Turbine
Propeller Year Five
Enter amount: The annual gross receipts amount for fixed wing turbine propellers.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Non Military - Helicopter Airframe
Year One
Enter amount: The annual gross receipts amount for helicopter airframes.
AIRCRAFT PRODUCT
SALES
Non Military - Helicopter Airframe
Year Two
Enter amount: The annual gross receipts amount for helicopter airframes.
AIRCRAFT PRODUCT
SALES
Non Military - Helicopter Airframe
Year Three
Enter amount: The annual gross receipts amount for helicopter airframes.
AIRCRAFT PRODUCT
SALES
Non Military - Helicopter Airframe
Year Four
Enter amount: The annual gross receipts amount for helicopter airframes.
AIRCRAFT PRODUCT
SALES
Non Military - Helicopter Airframe
Year Five
Enter amount: The annual gross receipts amount for helicopter airframes.
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Non Military - Helicopter Engine
Year One
Enter amount: The annual gross receipts amount for helicopter engines.
AIRCRAFT PRODUCT
SALES
Non Military - Helicopter Engine
Year Two
Enter amount: The annual gross receipts amount for helicopter engines.
AIRCRAFT PRODUCT
SALES
Non Military - Helicopter Engine
Year Three
Enter amount: The annual gross receipts amount for helicopter engines.
AIRCRAFT PRODUCT
SALES
Non Military - Helicopter Engine
Year Four
Enter amount: The annual gross receipts amount for helicopter engines.
AIRCRAFT PRODUCT
SALES
Non Military - Helicopter Engine
Year Five
Enter amount: The annual gross receipts amount for helicopter engines.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Non Military - Helicopter Rotors
Year One
Enter amount: The annual gross receipts amount for helicopter rotors.
AIRCRAFT PRODUCT
SALES
Non Military - Helicopter Rotors
Year Two
Enter amount: The annual gross receipts amount for helicopter rotors.
AIRCRAFT PRODUCT
SALES
Non Military - Helicopter Rotors
Year Three
Enter amount: The annual gross receipts amount for helicopter rotors.
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Non Military - Helicopter Rotors
Year Four
Enter amount: The annual gross receipts amount for helicopter rotors.
AIRCRAFT PRODUCT
SALES
Non Military - Helicopter Rotors
Year Five
Enter amount: The annual gross receipts amount for helicopter rotors.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Non Military - Remote Piloted
Vehicles Airframe
Enter number: The average number of remote piloted vehicle airframes sold per year.
AIRCRAFT PRODUCT
SALES
Non Military - Remote Piloted
Vehicles Airframe Year One
Enter amount: The annual gross receipts amount for remote piloted vehicle airframes.
AIRCRAFT PRODUCT
SALES
Non Military - Remote Piloted
Vehicles Airframe Year Two
Enter amount: The annual gross receipts amount for remote piloted vehicle airframes.
AIRCRAFT PRODUCT
SALES
Non Military - Remote Piloted
Vehicles Airframe Year Three
Enter amount: The annual gross receipts amount for remote piloted vehicle airframes.
AIRCRAFT PRODUCT
SALES
Non Military - Remote Piloted
Vehicles Airframe Year Four
Enter amount: The annual gross receipts amount for remote piloted vehicle airframes.
AIRCRAFT PRODUCT
SALES
Non Military - Remote Piloted
Vehicles Airframe Year Five
Enter amount: The annual gross receipts amount for remote piloted vehicle airframes.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Non Military - Remote Piloted
Vehicles Engine
Enter number: The average number of remote piloted vehicle engines sold per year.
AIRCRAFT PRODUCT
SALES
Non Military - Remote Piloted
Vehicles Engine Year One
Enter amount: The annual gross receipts amount for remote piloted vehicle engines.
AIRCRAFT PRODUCT
SALES
Non Military - Remote Piloted
Vehicles Engine Year Two
Enter amount: The annual gross receipts amount for remote piloted vehicle engines.
AIRCRAFT PRODUCT
SALES
Non Military - Remote Piloted
Vehicles Engine Year Three
Enter amount: The annual gross receipts amount for remote piloted vehicle engines.
AIRCRAFT PRODUCT
SALES
Non Military - Remote Piloted
Vehicles Engine Year Four
Enter amount: The annual gross receipts amount for remote piloted vehicle engines.
AIRCRAFT PRODUCT
SALES
Non Military - Remote Piloted
Vehicles Engine Year Five
Enter amount: The annual gross receipts amount for remote piloted vehicle engines.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Non Military - Commercial
Spacecraft Satellite Year One
Enter amount: The annual gross receipts amount for commercial spacecraft satellites.
AIRCRAFT PRODUCT
SALES
Non Military - Commercial
Spacecraft Satellite Year Two
Enter amount: The annual gross receipts amount for commercial spacecraft satellites.
AIRCRAFT PRODUCT
SALES
Non Military - Commercial
Spacecraft Satellite Year Three
Enter amount: The annual gross receipts amount for commercial spacecraft satellites.
AIRCRAFT PRODUCT
SALES
Non Military - Commercial
Spacecraft Satellite Year Four
Enter amount: The annual gross receipts amount for commercial spacecraft satellites.
AIRCRAFT PRODUCT
SALES
Non Military - Commercial
Spacecraft Satellite Year Five
Enter amount: The annual gross receipts amount for commercial spacecraft satellites.
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Non Military - Commercial
Spacecraft Other Type
Enter text: The description of the commercial spacecraft sold.
AIRCRAFT PRODUCT
SALES
Non Military - Commercial
Spacecraft Other Type Year One
Enter amount: The annual gross receipts amount for other commercial spacecraft.
AIRCRAFT PRODUCT
SALES
Non Military - Commercial
Spacecraft Other Type Year Two
Enter amount: The annual gross receipts amount for other commercial spacecraft.
AIRCRAFT PRODUCT
SALES
Non Military - Commercial
Spacecraft Other Type Year Three
Enter amount: The annual gross receipts amount for other commercial spacecraft.
AIRCRAFT PRODUCT
SALES
Non Military - Commercial
Spacecraft Other Type Year Four
Enter amount: The annual gross receipts amount for other commercial spacecraft.
AIRCRAFT PRODUCT
SALES
Non Military - Commercial
Spacecraft Other Type Year Five
Enter amount: The annual gross receipts amount for other commercial spacecraft.
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Non Military - Hot Air Balloons
Year One
Enter amount: The annual gross receipts amount for hot air balloons.
AIRCRAFT PRODUCT
SALES
Non Military - Hot Air Balloons
Year Two
Enter amount: The annual gross receipts amount for hot air balloons.
AIRCRAFT PRODUCT
SALES
Non Military - Hot Air Balloons
Year Three
Enter amount: The annual gross receipts amount for hot air balloons.
AIRCRAFT PRODUCT
SALES
Non Military - Hot Air Balloons
Year Four
Enter amount: The annual gross receipts amount for hot air balloons.
AIRCRAFT PRODUCT
SALES
Non Military - Hot Air Balloons
Year Five
Enter amount: The annual gross receipts amount for hot air balloons.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Non Military - Blimps Year One
Enter amount: The annual gross receipts amount for blimps.
AIRCRAFT PRODUCT
SALES
Non Military - Blimps Year Two
Enter amount: The annual gross receipts amount for blimps.
AIRCRAFT PRODUCT
SALES
Non Military - Blimps Year Three
Enter amount: The annual gross receipts amount for blimps.
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Non Military - Blimps Year Four
Enter amount: The annual gross receipts amount for blimps.
AIRCRAFT PRODUCT
SALES
Non Military - Blimps Year Five
Enter amount: The annual gross receipts amount for blimps.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Non Military - Hang Gliders Year
One
Enter amount: The annual gross receipts amount for hang gliders.
AIRCRAFT PRODUCT
SALES
Non Military - Hang Gliders Year
Two
Enter amount: The annual gross receipts amount for hang gliders.
AIRCRAFT PRODUCT
SALES
Non Military - Hang Gliders Year
Three
Enter amount: The annual gross receipts amount for hang gliders.
AIRCRAFT PRODUCT
SALES
Non Military - Hang Gliders Year
Four
Enter amount: The annual gross receipts amount for hang gliders.
AIRCRAFT PRODUCT
SALES
Non Military - Hang Gliders Year
Five
Enter amount: The annual gross receipts amount for hang gliders.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Non Military - Ultralights Year One
Enter amount: The annual gross receipts amount for ultralights.
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Non Military - Ultralights Year Two
Enter amount: The annual gross receipts amount for ultralights.
AIRCRAFT PRODUCT
SALES
Non Military - Ultralights Year
Three
Enter amount: The annual gross receipts amount for ultralights.
AIRCRAFT PRODUCT
SALES
Non Military - Ultralights Year Four
Enter amount: The annual gross receipts amount for ultralights.
AIRCRAFT PRODUCT
SALES
Non Military - Ultralights Year Five
Enter amount: The annual gross receipts amount for ultralights.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Non Military - Home Built Aircraft
Year One
Enter amount: The annual gross receipts amount for home built aircraft.
AIRCRAFT PRODUCT
SALES
Non Military - Home Built Aircraft
Year Two
Enter amount: The annual gross receipts amount for home built aircraft.
AIRCRAFT PRODUCT
SALES
Non Military - Home Built Aircraft
Year Three
Enter amount: The annual gross receipts amount for home built aircraft.
AIRCRAFT PRODUCT
SALES
Non Military - Home Built Aircraft
Year Four
Enter amount: The annual gross receipts amount for home built aircraft.
AIRCRAFT PRODUCT
SALES
Non Military - Home Built Aircraft
Year Five
Enter amount: The annual gross receipts amount for home built aircraft.
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Non Military - Repair & Servicing
Year One
Enter amount: The annual gross receipts amount for repair and servicing of aircraft and
aviation products.
AIRCRAFT PRODUCT
SALES
Non Military - Repair & Servicing
Year Two
Enter amount: The annual gross receipts amount for repair and servicing of aircraft and
aviation products.
AIRCRAFT PRODUCT
SALES
Non Military - Repair & Servicing
Year Three
Enter amount: The annual gross receipts amount for repair and servicing of aircraft and
aviation products.
AIRCRAFT PRODUCT
SALES
Non Military - Repair & Servicing
Year Four
Enter amount: The annual gross receipts amount for repair and servicing of aircraft and
aviation products.
AIRCRAFT PRODUCT
SALES
Non Military - Repair & Servicing
Year Five
Enter amount: The annual gross receipts amount for repair and servicing of aircraft and
aviation products.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Military - Missiles Year One
Enter amount: The annual gross receipts amount for military missiles.
AIRCRAFT PRODUCT
SALES
Military - Missiles Year Two
Enter amount: The annual gross receipts amount for military missiles.
AIRCRAFT PRODUCT
SALES
Military - Missiles Year Three
Enter amount: The annual gross receipts amount for military missiles.
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Military - Missiles Year Four
Enter amount: The annual gross receipts amount for military missiles.
AIRCRAFT PRODUCT
SALES
Military - Missiles Year Five
Enter amount: The annual gross receipts amount for military missiles.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Military - Spacecraft Year One
Enter amount: The annual gross receipts amount for military spacecraft.
AIRCRAFT PRODUCT
SALES
Military - Spacecraft Year Two
Enter amount: The annual gross receipts amount for military spacecraft.
AIRCRAFT PRODUCT
SALES
Military - Spacecraft Year Three
Enter amount: The annual gross receipts amount for military spacecraft.
AIRCRAFT PRODUCT
SALES
Military - Spacecraft Year Four
Enter amount: The annual gross receipts amount for military spacecraft.
AIRCRAFT PRODUCT
SALES
Military - Spacecraft Year Five
Enter amount: The annual gross receipts amount for military spacecraft.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Military - U.S. Aircraft Year One
Enter amount: The annual gross receipts amount for United States military aircraft.
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Military - U.S. Aircraft Year Two
Enter amount: The annual gross receipts amount for United States military aircraft.
AIRCRAFT PRODUCT
SALES
Military - U.S. Aircraft Year Three
Enter amount: The annual gross receipts amount for United States military aircraft.
AIRCRAFT PRODUCT
SALES
Military - U.S. Aircraft Year Four
Enter amount: The annual gross receipts amount for United States military aircraft.
AIRCRAFT PRODUCT
SALES
Military - U.S. Aircraft Year Five
Enter amount: The annual gross receipts amount for United States military aircraft.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Military - Fixed Wing Airframe Year
One
Enter amount: The annual gross receipts amount for military fixed wing airframes.
AIRCRAFT PRODUCT
SALES
Military - Fixed Wing Airframe Year
Two
Enter amount: The annual gross receipts amount for military fixed wing airframes.
AIRCRAFT PRODUCT
SALES
Military - Fixed Wing Airframe Year
Three
Enter amount: The annual gross receipts amount for military fixed wing airframes.
AIRCRAFT PRODUCT
SALES
Military - Fixed Wing Airframe Year
Four
Enter amount: The annual gross receipts amount for military fixed wing airframes.
AIRCRAFT PRODUCT
SALES
Military - Fixed Wing Airframe Year
Five
Enter amount: The annual gross receipts amount for military fixed wing airframes.
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Military - Fixed Wing Engine Year
One
Enter amount: The annual gross receipts amount for military fixed wing engines.
AIRCRAFT PRODUCT
SALES
Military - Fixed Wing Engine Year
Two
Enter amount: The annual gross receipts amount for military fixed wing engines.
AIRCRAFT PRODUCT
SALES
Military - Fixed Wing Engine Year
Three
Enter amount: The annual gross receipts amount for military fixed wing engines.
AIRCRAFT PRODUCT
SALES
Military - Fixed Wing Engine Year
Four
Enter amount: The annual gross receipts amount for military fixed wing engines.
AIRCRAFT PRODUCT
SALES
Military - Fixed Wing Engine Year
Five
Enter amount: The annual gross receipts amount for military fixed wing engines.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Military - Fixed Wing Propeller
Year One
Enter amount: The annual gross receipts amount for military fixed wing propellers.
AIRCRAFT PRODUCT
SALES
Military - Fixed Wing Propeller
Year Two
Enter amount: The annual gross receipts amount for military fixed wing propellers.
AIRCRAFT PRODUCT
SALES
Military - Fixed Wing Propeller
Year Three
Enter amount: The annual gross receipts amount for military fixed wing propellers.
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Military - Fixed Wing Propeller
Year Four
Enter amount: The annual gross receipts amount for military fixed wing propellers.
AIRCRAFT PRODUCT
SALES
Military - Fixed Wing Propeller
Year Five
Enter amount: The annual gross receipts amount for military fixed wing propellers.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Military - Helicopter Airframe Year
One
Enter amount: The annual gross receipts amount for military helicopter airframes.
AIRCRAFT PRODUCT
SALES
Military - Helicopter Airframe Year
Two
Enter amount: The annual gross receipts amount for military helicopter airframes.
AIRCRAFT PRODUCT
SALES
Military - Helicopter Airframe Year
Three
Enter amount: The annual gross receipts amount for military helicopter airframes.
AIRCRAFT PRODUCT
SALES
Military - Helicopter Airframe Year
Four
Enter amount: The annual gross receipts amount for military helicopter airframes.
AIRCRAFT PRODUCT
SALES
Military - Helicopter Airframe Year
Five
Enter amount: The annual gross receipts amount for military helicopter airframes.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Military - Helicopter Engine Year
One
Enter amount: The annual gross receipts amount for military helicopter engines.
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Military - Helicopter Engine Year
Two
Enter amount: The annual gross receipts amount for military helicopter engines.
AIRCRAFT PRODUCT
SALES
Military - Helicopter Engine Year
Three
Enter amount: The annual gross receipts amount for military helicopter engines.
AIRCRAFT PRODUCT
SALES
Military - Helicopter Engine Year
Four
Enter amount: The annual gross receipts amount for military helicopter engines.
AIRCRAFT PRODUCT
SALES
Military - Helicopter Engine Year
Five
Enter amount: The annual gross receipts amount for military helicopter engines.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Military - Helicopter Rotors Year
One
Enter amount: The annual gross receipts amount for military helicopter rotors.
AIRCRAFT PRODUCT
SALES
Military - Helicopter Rotors Year
Two
Enter amount: The annual gross receipts amount for military helicopter rotors.
AIRCRAFT PRODUCT
SALES
Military - Helicopter Rotors Year
Three
Enter amount: The annual gross receipts amount for military helicopter rotors.
AIRCRAFT PRODUCT
SALES
Military - Helicopter Rotors Year
Four
Enter amount: The annual gross receipts amount for military helicopter rotors.
AIRCRAFT PRODUCT
SALES
Military - Helicopter Rotors Year
Five
Enter amount: The annual gross receipts amount for military helicopter rotors.
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Military - Remote Piloted Vehicles
Airframe
Enter number: The average number of military remote piloted vehicle airframes sold per
year.
AIRCRAFT PRODUCT
SALES
Military - Remote Piloted Vehicles
Airframe Year One
Enter amount: The annual gross receipts amount for military remote piloted vehicles
airframes.
AIRCRAFT PRODUCT
SALES
Military - Remote Piloted Vehicles
Airframe Year Two
Enter amount: The annual gross receipts amount for military remote piloted vehicles
airframes.
AIRCRAFT PRODUCT
SALES
Military - Remote Piloted Vehicles
Airframe Year Three
Enter amount: The annual gross receipts amount for military remote piloted vehicles
airframes.
AIRCRAFT PRODUCT
SALES
Military - Remote Piloted Vehicles
Airframe Year Four
Enter amount: The annual gross receipts amount for military remote piloted vehicles
airframes.
AIRCRAFT PRODUCT
SALES
Military - Remote Piloted Vehicles
Airframe Year Five
Enter amount: The annual gross receipts amount for military remote piloted vehicles
airframes.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Military - Remote Piloted Vehicles
Engine
Enter number: The average number of military remote piloted vehicle engines sold per
year.
AIRCRAFT PRODUCT
SALES
Military - Remote Piloted Vehicles
Engine Year One
Enter amount: The annual gross receipts amount for military remote piloted vehicles
engines.
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Military - Remote Piloted Vehicles
Engine Year Two
Enter amount: The annual gross receipts amount for military remote piloted vehicles
engines.
AIRCRAFT PRODUCT
SALES
Military - Remote Piloted Vehicles
Engine Year Three
Enter amount: The annual gross receipts amount for military remote piloted vehicles
engines.
AIRCRAFT PRODUCT
SALES
Military - Remote Piloted Vehicles
Engine Year Four
Enter amount: The annual gross receipts amount for military remote piloted vehicles
engines.
AIRCRAFT PRODUCT
SALES
Military - Remote Piloted Vehicles
Engine Year Five
Enter amount: The annual gross receipts amount for military remote piloted vehicles
engines.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Other - Foreign Aircraft Parts Year
One
Enter amount: The annual gross receipts amount for foreign aircraft parts.
AIRCRAFT PRODUCT
SALES
Other - Foreign Aircraft Parts Year
Two
Enter amount: The annual gross receipts amount for foreign aircraft parts.
AIRCRAFT PRODUCT
SALES
Other - Foreign Aircraft Parts Year
Three
Enter amount: The annual gross receipts amount for foreign aircraft parts.
AIRCRAFT PRODUCT
SALES
Other - Foreign Aircraft Parts Year
Four
Enter amount: The annual gross receipts amount for foreign aircraft parts.
AIRCRAFT PRODUCT
SALES
Other - Foreign Aircraft Parts Year
Five
Enter amount: The annual gross receipts amount for foreign aircraft parts.
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Other - Avionics Year One
Enter amount: The annual gross receipts amount for avionics.
AIRCRAFT PRODUCT
SALES
Other - Avionics Year Two
Enter amount: The annual gross receipts amount for avionics.
AIRCRAFT PRODUCT
SALES
Other - Avionics Year Three
Enter amount: The annual gross receipts amount for avionics.
AIRCRAFT PRODUCT
SALES
Other - Avionics Year Four
Enter amount: The annual gross receipts amount for avionics.
AIRCRAFT PRODUCT
SALES
Other - Avionics Year Five
Enter amount: The annual gross receipts amount for avionics.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Other - Petrol Fuel Lubricants Year
One
Enter amount: The annual gross receipts amount for petroleum fuel lubricants.
AIRCRAFT PRODUCT
SALES
Other - Petrol Fuel Lubricants Year
Two
Enter amount: The annual gross receipts amount for petroleum fuel lubricants.
AIRCRAFT PRODUCT
SALES
Other - Petrol Fuel Lubricants Year
Three
Enter amount: The annual gross receipts amount for petroleum fuel lubricants.
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Other - Petrol Fuel Lubricants Year
Four
Enter amount: The annual gross receipts amount for petroleum fuel lubricants.
AIRCRAFT PRODUCT
SALES
Other - Petrol Fuel Lubricants Year
Five
Enter amount: The annual gross receipts amount for petroleum fuel lubricants.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Other Description
Enter text: The description of other products or services.
AIRCRAFT PRODUCT
SALES
Other Year One
Enter amount: The annual gross receipts amount for other products or services.
AIRCRAFT PRODUCT
SALES
Other Year Two
Enter amount: The annual gross receipts amount for other products or services.
AIRCRAFT PRODUCT
SALES
Other Year Three
Enter amount: The annual gross receipts amount for other products or services.
AIRCRAFT PRODUCT
SALES
Other Year Four
Enter amount: The annual gross receipts amount for other products or services.
AIRCRAFT PRODUCT
SALES
Other Year Five
Enter amount: The annual gross receipts amount for other products or services.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Other Description
Enter text: The description of other products or services.
AIRCRAFT PRODUCT
SALES
Other Year One
Enter amount: The annual gross receipts amount for other products or services.
AIRCRAFT PRODUCT
SALES
Other Year Two
Enter amount: The annual gross receipts amount for other products or services.
AIRCRAFT PRODUCT
SALES
Other Year Three
Enter amount: The annual gross receipts amount for other products or services.
AIRCRAFT PRODUCT
SALES
Other Year Four
Enter amount: The annual gross receipts amount for other products or services.
AIRCRAFT PRODUCT
SALES
Other Year Five
Enter amount: The annual gross receipts amount for other products or services.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Other Description
Enter text: The description of other products or services.
AIRCRAFT PRODUCT
SALES
Other Year One
Enter amount: The annual gross receipts amount for other products or services.
AIRCRAFT PRODUCT
SALES
Other Year Two
Enter amount: The annual gross receipts amount for other products or services.
AIRCRAFT PRODUCT
SALES
Other Year Three
Enter amount: The annual gross receipts amount for other products or services.
AIRCRAFT PRODUCT
SALES
Other Year Four
Enter amount: The annual gross receipts amount for other products or services.
AIRCRAFT PRODUCT
SALES
Other Year Five
Enter amount: The annual gross receipts amount for other products or services.
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Other Description
Enter text: The description of other products or services.
AIRCRAFT PRODUCT
SALES
Other Year One
Enter amount: The annual gross receipts amount for other products or services.
AIRCRAFT PRODUCT
SALES
Other Year Two
Enter amount: The annual gross receipts amount for other products or services.
AIRCRAFT PRODUCT
SALES
Other Year Three
Enter amount: The annual gross receipts amount for other products or services.
AIRCRAFT PRODUCT
SALES
Other Year Four
Enter amount: The annual gross receipts amount for other products or services.
AIRCRAFT PRODUCT
SALES
Other Year Five
Enter amount: The annual gross receipts amount for other products or services.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Other Description
Enter text: The description of other products or services.
AIRCRAFT PRODUCT
SALES
Other Year One
Enter amount: The annual gross receipts amount for other products or services.
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Other Year Two
Enter amount: The annual gross receipts amount for other products or services.
AIRCRAFT PRODUCT
SALES
Other Year Three
Enter amount: The annual gross receipts amount for other products or services.
AIRCRAFT PRODUCT
SALES
Other Year Four
Enter amount: The annual gross receipts amount for other products or services.
AIRCRAFT PRODUCT
SALES
Other Year Five
Enter amount: The annual gross receipts amount for other products or services.
AIRCRAFT PRODUCT
SALES
Grand Total Year One
Enter amount: The annual gross receipts grand total amount.
AIRCRAFT PRODUCT
SALES
Grand Total Year Two
Enter amount: The annual gross receipts grand total amount.
AIRCRAFT PRODUCT
SALES
Grand Total Year Three
Enter amount: The annual gross receipts grand total amount.
AIRCRAFT PRODUCT
SALES
Grand Total Year Four
Enter amount: The annual gross receipts grand total amount.
AIRCRAFT PRODUCT
SALES
Grand Total Year Five
Enter amount: The annual gross receipts grand total amount.
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Describe all aircraft warranties to
be attached
Enter text: The description of all aircraft warranties to be attached.
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
AIRCRAFT PRODUCT
SALES
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
AIRCRAFT PRODUCT
SALES
Describe all product engineering
and testing controls involved in
quality control
Enter text: The description of all product engineering and testing controls involved in
quality control.
IDENTIFICATION SECTION Agency Customer ID
Enter identifier: The customer's identification number assigned by the producer (e.g.
agency or brokerage).
PRODUCTS INFORMATION Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRODUCTS INFORMATION the applicant
Describe all aircraft products,
including containers, designed by
Enter text: The description of products designed by the insured. As used here, describe all
aircraft products, including containers, designed by the applicant.
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Section Name
Field Name
Field and/or Section Description
PRODUCTS INFORMATION Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRODUCTS INFORMATION distributed by the applicant
Describe all aircraft products
manufactured, assembled, or
Enter text: The description of products manufactured by the insured. As used here,
describe all aircraft products manufactured, assembled, or distributed by the applicant.
PRODUCTS INFORMATION Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRODUCTS INFORMATION which coverage is required
List all products discontinued and
companies sold/terminated for
Enter text: The description of all products discontinued and companies sold / terminated
for which coverage is required.
PRODUCTS INFORMATION Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
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Section Name
Field Name
Field and/or Section Description
PRODUCTS INFORMATION months
Describe modifications to current
products and describe all new
aircraft products for the next 12
Enter text: The description of modifications to current products and all new products for
next 12 months.
PRODUCTS INFORMATION Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRODUCTS INFORMATION necessary
Describe why modifications were
Enter text: The reason modifications were necessary.
PRODUCTS INFORMATION Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRODUCTS INFORMATION products
List all liquid chemical aircraft
Enter text: The description of all liquid chemical aircraft products.
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Section Name
Field Name
Field and/or Section Description
PRODUCTS INFORMATION Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRODUCTS INFORMATION any chemical state.
Describe potential hazards of all
aircraft products including if they
are flammable, explosive,
corrosive, poisonous or toxic in
Enter text: The description of potential hazards.
PRODUCTS INFORMATION Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRODUCTS INFORMATION operations.
Describe repair and service
Enter text: The description of repair and/or service operations.
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Section Name
Field Name
Field and/or Section Description
PRODUCTS INFORMATION Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRODUCTS INFORMATION Make One
Enter text: The name of the manufacturer of the aircraft. As used here, describes an
aircraft in which the insured specializes for repair and service operations.
PRODUCTS INFORMATION Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRODUCTS INFORMATION Model One
Enter text: The model name of the aircraft. As used here, describes an aircraft in which
the insured specializes for repair and service operations.
PRODUCTS INFORMATION Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRODUCTS INFORMATION Make Two
Enter text: The name of the manufacturer of the aircraft. As used here, describes an
aircraft in which the insured specializes for repair and service operations.
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Section Name
Field Name
Field and/or Section Description
PRODUCTS INFORMATION Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRODUCTS INFORMATION Model Two
Enter text: The model name of the aircraft. As used here, describes an aircraft in which
the insured specializes for repair and service operations.
PRODUCTS INFORMATION Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRODUCTS INFORMATION Make Three
Enter text: The name of the manufacturer of the aircraft. As used here, describes an
aircraft in which the insured specializes for repair and service operations.
PRODUCTS INFORMATION Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRODUCTS INFORMATION Model Three
Enter text: The model name of the aircraft. As used here, describes an aircraft in which
the insured specializes for repair and service operations.
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Section Name
Field Name
Field and/or Section Description
PRODUCTS INFORMATION Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRODUCTS INFORMATION Make Four
Enter text: The name of the manufacturer of the aircraft. As used here, describes an
aircraft in which the insured specializes for repair and service operations.
PRODUCTS INFORMATION Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRODUCTS INFORMATION Model Four
Enter text: The model name of the aircraft. As used here, describes an aircraft in which
the insured specializes for repair and service operations.
PRODUCTS INFORMATION Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRODUCTS INFORMATION Make Five
Enter text: The name of the manufacturer of the aircraft. As used here, describes an
aircraft in which the insured specializes for repair and service operations.
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Section Name
Field Name
Field and/or Section Description
PRODUCTS INFORMATION Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRODUCTS INFORMATION Model Five
Enter text: The model name of the aircraft. As used here, describes an aircraft in which
the insured specializes for repair and service operations.
PRODUCTS INFORMATION Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRODUCTS INFORMATION Make Six
Enter text: The name of the manufacturer of the aircraft. As used here, describes an
aircraft in which the insured specializes for repair and service operations.
PRODUCTS INFORMATION Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRODUCTS INFORMATION Model Six
Enter text: The model name of the aircraft. As used here, describes an aircraft in which
the insured specializes for repair and service operations.
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Section Name
Field Name
Field and/or Section Description
PRODUCTS INFORMATION Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRODUCTS INFORMATION attached to the application.
Describe Service Contracts to be
Enter text: The description of service contracts to be attached to the application.
PRODUCTS INFORMATION Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
PRODUCTS INFORMATION attached to the application.
Describe all contracts involving
aircraft products in which the
application hold harmless or
indemnification others to be
Enter text: The description of all contracts involving products in which the insured hold
harmless or indemnification others to be attached to the application.
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Section Name
Field Name
Field and/or Section Description
SPACECRAFT PRODUCTS Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
SPACECRAFT PRODUCTS Spacecraft Make
Enter text: The manufacturer of the spacecraft.
SPACECRAFT PRODUCTS Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
SPACECRAFT PRODUCTS Model
Enter text: The model of the spacecraft.
SPACECRAFT PRODUCTS Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
SPACECRAFT PRODUCTS Launch Vehicle
Enter text: The description of the launch vehicle(s) for the item.
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Section Name
Field Name
Field and/or Section Description
SPACECRAFT PRODUCTS Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
SPACECRAFT PRODUCTS Start Date
Enter date: The anticipated start date of the launch window for the spacecraft in which
your products are used.
SPACECRAFT PRODUCTS Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
SPACECRAFT PRODUCTS End Date
Enter date: The anticipated end date of the launch window for the spacecraft in which your
products are used.
SPACECRAFT PRODUCTS Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
SPACECRAFT PRODUCTS Spacecraft Make
Enter text: The manufacturer of the spacecraft.
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Section Name
Field Name
Field and/or Section Description
SPACECRAFT PRODUCTS Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
SPACECRAFT PRODUCTS Model
Enter text: The model of the spacecraft.
SPACECRAFT PRODUCTS Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
SPACECRAFT PRODUCTS Launch Vehicle
Enter text: The description of the launch vehicle(s) for the item.
SPACECRAFT PRODUCTS Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
SPACECRAFT PRODUCTS Start Date
Enter date: The anticipated start date of the launch window for the spacecraft in which
your products are used.
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Section Name
Field Name
Field and/or Section Description
SPACECRAFT PRODUCTS Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
SPACECRAFT PRODUCTS End Date
Enter date: The anticipated end date of the launch window for the spacecraft in which your
products are used.
SPACECRAFT PRODUCTS Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
SPACECRAFT PRODUCTS Spacecraft Make
Enter text: The manufacturer of the spacecraft.
SPACECRAFT PRODUCTS Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
SPACECRAFT PRODUCTS Model
Enter text: The model of the spacecraft.
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Section Name
Field Name
Field and/or Section Description
SPACECRAFT PRODUCTS Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
SPACECRAFT PRODUCTS Launch Vehicle
Enter text: The description of the launch vehicle(s) for the item.
SPACECRAFT PRODUCTS Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
SPACECRAFT PRODUCTS Start Date
Enter date: The anticipated start date of the launch window for the spacecraft in which
your products are used.
SPACECRAFT PRODUCTS Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
SPACECRAFT PRODUCTS End Date
Enter date: The anticipated end date of the launch window for the spacecraft in which your
products are used.
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Section Name
Field Name
Field and/or Section Description
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
OUTSIDE FIRMS
Describe the product or portion of
product that are manufactured or
assembled by outside firms.
Enter text: The description of a product, or portion of a product, that is manufactured or
assembled by an outside firm.
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
OUTSIDE FIRMS
Firm Name
Enter text: The description of the manufacturing, assembly, or specification design firm
involved with a product the insured creates, sells or distributes.
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
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Section Name
Field Name
Field and/or Section Description
OUTSIDE FIRMS
Describe the product or portion of
product that are manufactured or
assembled by outside firms.
Enter text: The description of a product, or portion of a product, that is manufactured or
assembled by an outside firm.
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
OUTSIDE FIRMS
Firm Name
Enter text: The description of the manufacturing, assembly, or specification design firm
involved with a product the insured creates, sells or distributes.
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
OUTSIDE FIRMS
Describe the product or portion of
product that are manufactured or
assembled by outside firms.
Enter text: The description of a product, or portion of a product, that is manufactured or
assembled by an outside firm.
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
OUTSIDE FIRMS
Firm Name
Enter text: The description of the manufacturing, assembly, or specification design firm
involved with a product the insured creates, sells or distributes.
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
OUTSIDE FIRMS
Describe the product or portion of
product that are manufactured or
assembled by outside firms.
Enter text: The description of a product, or portion of a product, that is manufactured or
assembled by an outside firm.
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
OUTSIDE FIRMS
Firm Name
Enter text: The description of the manufacturing, assembly, or specification design firm
involved with a product the insured creates, sells or distributes.
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
OUTSIDE FIRMS
Enter products that are
manufactured to the specifications
of other firms by the applicant or
any subsidiary.
Enter text: The description of a product that is manufactured by the insured or any
subsidiary to the specifications of an outside firm.
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
OUTSIDE FIRMS
Firm Name
Enter text: The description of the manufacturing, assembly, or specification design firm
involved with a product the insured creates, sells or distributes.
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Section Name
Field Name
Field and/or Section Description
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
OUTSIDE FIRMS
Enter products that are
manufactured to the specifications
of other firms by the applicant or
any subsidiary.
Enter text: The description of a product that is manufactured by the insured or any
subsidiary to the specifications of an outside firm.
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
OUTSIDE FIRMS
Firm Name
Enter text: The description of the manufacturing, assembly, or specification design firm
involved with a product the insured creates, sells or distributes.
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
OUTSIDE FIRMS
Enter products that are
manufactured to the specifications
of other firms by the applicant or
any subsidiary.
Enter text: The description of a product that is manufactured by the insured or any
subsidiary to the specifications of an outside firm.
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
OUTSIDE FIRMS
Firm Name
Enter text: The description of the manufacturing, assembly, or specification design firm
involved with a product the insured creates, sells or distributes.
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
OUTSIDE FIRMS
Enter products that are
manufactured to the specifications
of other firms by the applicant or
any subsidiary.
Enter text: The description of a product that is manufactured by the insured or any
subsidiary to the specifications of an outside firm.
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Section Name
Field Name
Field and/or Section Description
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
OUTSIDE FIRMS
Firm Name
Enter text: The description of the manufacturing, assembly, or specification design firm
involved with a product the insured creates, sells or distributes.
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
OUTSIDE FIRMS
Enter products of others that are
sold or distributed by the
applicant or any subsidiary.
Enter text: The description of a product of an outside firm that is sold or distributed by the
insured or any subsidiary.
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ACORD 339 (2009/06)
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Section Name
Field Name
Field and/or Section Description
OUTSIDE FIRMS
Firm Name
Enter text: The description of the manufacturing, assembly, or specification design firm
involved with a product the insured creates, sells or distributes.
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
OUTSIDE FIRMS
Enter products of others that are
sold or distributed by the
applicant or any subsidiary.
Enter text: The description of a product of an outside firm that is sold or distributed by the
insured or any subsidiary.
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
OUTSIDE FIRMS
Firm Name
Enter text: The description of the manufacturing, assembly, or specification design firm
involved with a product the insured creates, sells or distributes.
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Section Name
Field Name
Field and/or Section Description
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
OUTSIDE FIRMS
Enter products of others that are
sold or distributed by the
applicant or any subsidiary.
Enter text: The description of a product of an outside firm that is sold or distributed by the
insured or any subsidiary.
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
OUTSIDE FIRMS
Firm Name
Enter text: The description of the manufacturing, assembly, or specification design firm
involved with a product the insured creates, sells or distributes.
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
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Section Name
Field Name
Field and/or Section Description
OUTSIDE FIRMS
Enter products of others that are
sold or distributed by the
applicant or any subsidiary.
Enter text: The description of a product of an outside firm that is sold or distributed by the
insured or any subsidiary.
OUTSIDE FIRMS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
OUTSIDE FIRMS
Firm Name
Enter text: The description of the manufacturing, assembly, or specification design firm
involved with a product the insured creates, sells or distributes.
IDENTIFICATION SECTION Agency Customer ID
Enter identifier: The customer's identification number assigned by the producer (e.g.
agency or brokerage).
ADDITIONAL INSUREDS
Name (On Current Policy)
Enter text: The additional interest's full name.
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
Name
Enter text: The additional interest's full name.
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Section Name
Field Name
Field and/or Section Description
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
Street
Enter text: The additional interest's mailing address line one.
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
City
Enter text: The additional interest's mailing address city name.
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
State
Enter code: The additional interest's mailing address state or province code.
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Section Name
Field Name
Field and/or Section Description
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
Zip
Enter code: The additional interest's mailing address postal code.
ADDITIONAL INSUREDS
Certificate Required
Check the box (if applicable): Indicates if the additional interest requires a Certificate of
Insurance,
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
Reason for Interest
Enter text: The description for the interest in the item.
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
Phone
Enter number: The primary phone number of the additional interest.
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Section Name
Field Name
Field and/or Section Description
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
Fax
Enter number: The primary fax number of the additional interest.
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
E-Mail
Enter text: The primary e-mail address for the additional interest.
ADDITIONAL INSUREDS
Name (On Current Policy)
Enter text: The additional interest's full name.
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
Name
Enter text: The additional interest's full name.
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Section Name
Field Name
Field and/or Section Description
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
Street
Enter text: The additional interest's mailing address line one.
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
City
Enter text: The additional interest's mailing address city name.
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
State
Enter code: The additional interest's mailing address state or province code.
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Section Name
Field Name
Field and/or Section Description
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
Zip
Enter code: The additional interest's mailing address postal code.
ADDITIONAL INSUREDS
Certificate Required
Check the box (if applicable): Indicates if the additional interest requires a Certificate of
Insurance,
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
Reason for Interest
Enter text: The description for the interest in the item.
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
Phone
Enter number: The primary phone number of the additional interest.
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Section Name
Field Name
Field and/or Section Description
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
Fax
Enter number: The primary fax number of the additional interest.
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
E-Mail
Enter text: The primary e-mail address for the additional interest.
ADDITIONAL INSUREDS
Name (On Current Policy)
Enter text: The additional interest's full name.
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
Name
Enter text: The additional interest's full name.
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Section Name
Field Name
Field and/or Section Description
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
Street
Enter text: The additional interest's mailing address line one.
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
City
Enter text: The additional interest's mailing address city name.
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
State
Enter code: The additional interest's mailing address state or province code.
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Section Name
Field Name
Field and/or Section Description
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
Zip
Enter code: The additional interest's mailing address postal code.
ADDITIONAL INSUREDS
Certificate Required
Check the box (if applicable): Indicates if the additional interest requires a Certificate of
Insurance,
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
Reason for Interest
Enter text: The description for the interest in the item.
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
Phone
Enter number: The primary phone number of the additional interest.
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Section Name
Field Name
Field and/or Section Description
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
Fax
Enter number: The primary fax number of the additional interest.
ADDITIONAL INSUREDS
Type of Change
Enter code: The type of change being requested. Enter either an A-Add, C-Change, D-
Delete or I - Informational Only No Change. Various combinations of changes are
permitted in one submission. Use A to add an item that was not previously in the policy
(e.g., add a vehicle, add a coverage). Use D to delete an item (e.g., delete a vehicle,
delete a driver). Use C to change an item in the policy (e.g., change a deductible,
change coverage limits). Use I to identify a risk or other item that is not being changed
but is related to another change on the form. Example: When adding collision coverage to
a vehicle, enter A in the type of change for Collision. Enter I in the type of change for
the Vehicle. Enter enough information to identify the vehicle that is having coverage
changed (e.g. year, make, model, body, VIN).
ADDITIONAL INSUREDS
E-Mail
Enter text: The primary e-mail address for the additional interest.
GENERAL INFORMATION
Does applicant use airport
premises? If yes, name airport
and describe uses.
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Does applicant use airport premises?.
GENERAL INFORMATION
Explain
Enter text: An explanation of a response to a general information or underwriting question.
Normally, Yes responses require an explanation.
GENERAL INFORMATION
Have there been any incidents in
the past which could result in a
claim?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Have there been any incidents in past which could result in a claim?.
GENERAL INFORMATION
Explain
Enter text: An explanation of a response to a general information or underwriting question.
Normally, Yes responses require an explanation.
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Section Name
Field Name
Field and/or Section Description
GENERAL INFORMATION
Has any subsidiary, affiliated,
owned or managed firm, or
applicants products liability ever
been self-insured or not insured?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Has any subsidiary, affiliated, owned or managed firm, or applicant's products
liability ever been self-insured or not insured?.
GENERAL INFORMATION
Explain
Enter text: An explanation of a response to a general information or underwriting question.
Normally, Yes responses require an explanation.
GENERAL INFORMATION
Have any aircraft products ever
been subject to a manufacturers
factory service bulletin or
advisory?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Have any aircraft products ever been subject to a manufacturers factory service
bulletin or advisory?.
GENERAL INFORMATION
Explain
Enter text: An explanation of a response to a general information or underwriting question.
Normally, Yes responses require an explanation.
GENERAL INFORMATION
Have any aircraft products ever
been subject to an airworthiness
directive?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Have any aircraft products ever been subject to an airworthiness directive?.
GENERAL INFORMATION
Explain
Enter text: An explanation of a response to a general information or underwriting question.
Normally, Yes responses require an explanation.
GENERAL INFORMATION
Have any aircraft products ever
been subjected to an emergency
airworthiness directive?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Have any aircraft products ever been subject to an emergency airworthiness
directive?.
GENERAL INFORMATION
Explain
Enter text: An explanation of a response to a general information or underwriting question.
Normally, Yes responses require an explanation.
GENERAL INFORMATION
Have any aircraft products ever
been subject to a recall by any
applicant?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Have any aircraft products ever been subject to a recall by any applicant?.
GENERAL INFORMATION
Explain
Enter text: An explanation of a response to a general information or underwriting question.
Normally, Yes responses require an explanation.
GENERAL INFORMATION
Have any aircraft products ever
been subject to a recall by any
other firm?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Have any aircraft products ever been subject to a recall by any other firm?.
GENERAL INFORMATION
Explain
Enter text: An explanation of a response to a general information or underwriting question.
Normally, Yes responses require an explanation.
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Section Name
Field Name
Field and/or Section Description
GENERAL INFORMATION
Have any aircraft products ever
been subject to a recall by a
governmental agency?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Have any aircraft products ever been subject to a recall by a governmental
agency?.
GENERAL INFORMATION
Explain
Enter text: An explanation of a response to a general information or underwriting question.
Normally, Yes responses require an explanation.
GENERAL INFORMATION
Do you allow subcontractors to
work without providing a
certificate of insurance?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Do you allow subcontractors to work without providing a certificate of
insurance?.
GENERAL INFORMATION
Explain
Enter text: An explanation of a response to a general information or underwriting question.
Normally, Yes responses require an explanation.
REMARKS
Remarks
Enter text: The remarks associated with a policy change. Attach ACORD 101, Additional
Remarks Schedule, if more space is required.
Edition
Date
The edition identifier of the form including the form number and edition (the date is
typically formatted YYYY/MM).
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