Section Name
Field Name
Field and/or Section Description
TITLE
ACORD 38 DE (2008/04)
Delaware Personal Insurance
Supplement - Notice of Information
Practices (Privacy)
Use ACORD 38 DE, Delaware Personal Insurance Supplement, with all applications for
personal insurance. The form complies with the requirements of DE Regulation 906
(formerly Reg. 87), pertaining to insurance scoring.
IDENTIFICATION SECTION Agency Customer ID
Customer's identification number assigned by the agency or brokerage.
IDENTIFICATION SECTION Agency
Producer's name.
IDENTIFICATION SECTION Applicant / First Name Insured
Full name of the applicant as it should appear on the policy. The First Named Insured is
given certain rights and responsibilities by the policy contract language. If more than one
insured is named, be sure the one intended to receive these rights and responsibilities is
named first and any additional insureds identified as such. If joint ownership, the name
used may include both names (e.g., John and Mary Smith).
IDENTIFICATION SECTION Policy Number
The number assigned by the insurance company for the policy. In general, policy numbers
will not appear on new business applications since they are not known at that point in time.
IDENTIFICATION SECTION Carrier
Name of the insurance company (or residual market plan) that will receive the application.
Do not use group names, use the actual name of the company within the group in which
you wish to have the policy issued.
IDENTIFICATION SECTION NAIC Code
The identification code assigned to the company by the NAIC.
APPLICANT / NAMED
INSURED'S SIGNATURE
Applicant / Named Insured's
Signature
All applicants / named insureds must sign this form.
APPLICANT / NAMED
INSURED'S SIGNATURE
Date (MM/DD/YYYY)
Enter the date the form was signed by the applicant / named insureds. (MM/DD/YYYY)
ACORD 38 DE (2008/04)
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