ACORD 50 TX (2015/05) - TEXAS LIABILITY INSURANCE CARD
ACORD 50 TX (2015/05) - TEXAS LIABILITY INSURANCE CARD
ACORD 50 TX, Texas Liability Insurance Card, was created in response to the Texas State Board of Insurance Order No. 58994 which became
effective September 1, 1991, and subsequent revisions as per changes to the Texas Administrative Code 28 TAC 5.204. The Texas Liability
Insurance Card is similar in data content to the generic ACORD Automobile Insurance Card. The differences between the two cards is that Texas
requires:
* A Spanish translation of the text on the reverse side of the card
* A toll free phone number of the insurer for consumer inquiries
* A phone number of the Agency
* The name and address of each insured or covered person
* The Motor Vehicle Safety Responsibility text
* A warning statement regarding a Named Driver Policy
Please note:
To properly print this form front to back, the Binding Location must be set to the Short Edge in the Printer Properties.
Form Page 1
Section Name
Field Name
Description
INSURANCE
IDENTIFICATION CARD
Commercial (check box)
Check the box (if applicable): Indicates the policy is a commercial lines policy.
INSURANCE
IDENTIFICATION CARD
Personal (check box)
Check the box (if applicable): Indicates the policy is a personal lines policy.
INSURANCE
IDENTIFICATION CARD
Named Driver Policy (check
box)
Check the box (if applicable): Indicates the policy only covers household residents who are
specifically named on the policy.
INSURANCE
IDENTIFICATION CARD
Company Telephone
Number
Enter number: The primary phone number of the insurer.
INSURANCE
IDENTIFICATION CARD
Company
Enter text: The insurer's full legal company name(s) as found in the file copy of the policy. Use
the actual name of the company within the group to which the policy has been issued. This is
not the insurer's group name or trade name.
INSURANCE
IDENTIFICATION CARD
Policy Number
Enter identifier: The identifier assigned by the insurer to the policy, or submission, being
referenced exactly as it appears on the policy, including prefix and suffix symbols. If required for
self-insurance, the self-insured license or contract number.
INSURANCE
IDENTIFICATION CARD
Effective Date
Enter date: The effective date of the policy. The date that the terms and conditions of the policy
commence. (MM/DD/YYYY)
INSURANCE
IDENTIFICATION CARD
Expiration Date
Enter date: The date on which the terms and conditions of the policy will expire. (MM/DD/YYYY)
ACORD 50 TX (2015/05) rev. 04-29-2015
Page 1 of 3
INSURANCE
IDENTIFICATION CARD
Year
Enter year: The model year of the vehicle.
INSURANCE
IDENTIFICATION CARD
Make/Model
Enter text: The manufacturer of the vehicle (e.g., Ford, Chevy).
INSURANCE
IDENTIFICATION CARD
Enter text: The manufacturer's model name for the vehicle.
INSURANCE
IDENTIFICATION CARD
Vehicle Identification
Number
Enter identifier: The vehicle identification number (VIN) or serial number assigned by the
manufacturer.
INSURANCE
IDENTIFICATION CARD
Agency
Enter text: The full name of the producer / agency.
INSURANCE
IDENTIFICATION CARD
Enter text: The mailing address line one of the producer / agency.
INSURANCE
IDENTIFICATION CARD
Enter text: The mailing address city name of the producer / agency.
INSURANCE
IDENTIFICATION CARD
Enter code: The mailing address state or province code of the producer / agency.
INSURANCE
IDENTIFICATION CARD
Enter code: The mailing address postal code of the producer / agency.
INSURANCE
IDENTIFICATION CARD
Agency Phone No.
Enter number: The producer's contact person's phone number. If applicable, include the area
code and extension.
INSURANCE
IDENTIFICATION CARD
Name and Address of Each
Insured or Covered Person
Enter text: The name of each insured or covered person.
INSURANCE
IDENTIFICATION CARD
Enter text: The address line one of each insured or covered person.
INSURANCE
IDENTIFICATION CARD
Enter text: The address city of each insured or covered person.
INSURANCE
IDENTIFICATION CARD
Enter code: The address state or province code of each insured or covered person.
INSURANCE
IDENTIFICATION CARD
Enter code: The address postal code of each named insured or covered person.
INSURANCE
IDENTIFICATION CARD
Name and Address of each
Insured or Covered Person
Enter text: The name of each insured or covered person.
INSURANCE
IDENTIFICATION CARD
Enter text: The address line one of each insured or covered person.
ACORD 50 TX (2015/05) rev. 04-29-2015
Page 2 of 3
INSURANCE
IDENTIFICATION CARD
Enter text: The address city of each insured or covered person.
INSURANCE
IDENTIFICATION CARD
Enter code: The address state or province code of each insured or covered person.
INSURANCE
IDENTIFICATION CARD
Enter code: The address postal code of each named insured or covered person.
Form Page 2
Section Name
Field Name
Description
ACORD 50 TX (2015/05) rev. 04-29-2015
Page 3 of 3