ACORD 50 HI (2008/01)

Universal wording updates to improve clarity and intent were made to all FIG text for this form on 11/21/2008.
Section Name
Field Name
Field and/or Section Description
TITLE
ACORD 50 HI (2008/01)
HAWAII MOTOR VEHICLE
INSURANCE IDENTIFICATION
CARD
ACORD 50 HI, Hawaii Vehicle Insurance Identification Card, is used
as proof of automobile insurance. The Hawaii Automobile Insurance Identification Card
was created in response to Hawaii regulations. The main differences between the generic
ACORD Automobile Insurance Card, ACORD 50, and the Hawaii card are:
* The size of the card is 3 1/2 inches wide by 2 1/4 inches high (wallet size)
* A statement is added to the front of the card referencing an authorized Hawaii insurer
who issued an insurance policy which complies with Hawaiis motor vehicle insurance law
* The order of entries on the front of the card is prescribed by regulation
* The card is printed on watermarked paper. The watermark is the word ACORD.
IMPORTANT: The watermark cannot be reproduced when ACORD 50 HI is downloaded
from this website. Paper copies of ACORD 50 HI that include the watermark can be
ordered from ACORD Member Services at 800-444-3341 or by sending us an e-mail to
memberservices@acord.org. As an alternative, plain paper that includes the watermark
(ACORD 360 WM and 370 WM) can also be ordered. This watermarked paper can be used
INSURANCE
IDENTIFICATION CARD
Commercial (checkbox) One
Check the box (if applicable): Indicates the policy is a commercial lines policy.
INSURANCE
IDENTIFICATION CARD
Personal (checkbox) One
Check the box (if applicable): Indicates the policy is a personal lines policy.
INSURANCE
IDENTIFICATION CARD
Company Number One
Enter code: The identification code assigned to the insurer by the NAIC.
INSURANCE
IDENTIFICATION CARD
Company One
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
Insured Name and Address One
Enter text: The named insured(s) as it/they will appear on the policy declarations page.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address line one.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address city name.
ACORD 50 HI (2008/01)
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Section Name
Field Name
Field and/or Section Description
INSURANCE
IDENTIFICATION CARD
Enter code: The named insured's mailing address state or province code.
INSURANCE
IDENTIFICATION CARD
Enter code: The named insured's mailing address postal code.
INSURANCE
IDENTIFICATION CARD
Agency/Company Issuing Card
One
Enter text: The full name of the producer/agency.
INSURANCE
IDENTIFICATION CARD
Year One
Enter year: The model year of the vehicle.
INSURANCE
IDENTIFICATION CARD
Make One
Enter text: The manufacturer of the vehicle (e.g. Ford, Chevy).
INSURANCE
IDENTIFICATION CARD
Model One
Enter text: The manufacturer's model name for the vehicle.
INSURANCE
IDENTIFICATION CARD
Vehicle ID # One
Enter identifier: The vehicle identification number (VIN).
INSURANCE
IDENTIFICATION CARD
Policy Number One
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 One
Enter date: The effective date of the policy. The date that the terms and conditions of the
policy commence.
INSURANCE
IDENTIFICATION CARD
Expiration Date One
Enter date: The date on which the terms and conditions of the policy will expire.
INSURANCE
IDENTIFICATION CARD
Commercial (checkbox) Two
Check the box (if applicable): Indicates the policy is a commercial lines policy.
INSURANCE
IDENTIFICATION CARD
Personal (checkbox) Two
Check the box (if applicable): Indicates the policy is a personal lines policy.
INSURANCE
IDENTIFICATION CARD
Company Number Two
Enter code: The identification code assigned to the insurer by the NAIC.
INSURANCE
IDENTIFICATION CARD
Company Two
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
Insured Name and Address Two
Enter text: The named insured(s) as it/they will appear on the policy declarations page.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address line one.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address city name.
ACORD 50 HI (2008/01)
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Section Name
Field Name
Field and/or Section Description
INSURANCE
IDENTIFICATION CARD
Enter code: The named insured's mailing address state or province code.
INSURANCE
IDENTIFICATION CARD
Enter code: The named insured's mailing address postal code.
INSURANCE
IDENTIFICATION CARD
Agency/Company Issuing Card
Two
Enter text: The full name of the producer/agency.
INSURANCE
IDENTIFICATION CARD
Year Two
Enter year: The model year of the vehicle.
INSURANCE
IDENTIFICATION CARD
Make Two
Enter text: The manufacturer of the vehicle (e.g. Ford, Chevy).
INSURANCE
IDENTIFICATION CARD
Model Two
Enter text: The manufacturer's model name for the vehicle.
INSURANCE
IDENTIFICATION CARD
Vehicle ID # Two
Enter identifier: The vehicle identification number (VIN).
INSURANCE
IDENTIFICATION CARD
Policy Number Two
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 Two
Enter date: The effective date of the policy. The date that the terms and conditions of the
policy commence.
INSURANCE
IDENTIFICATION CARD
Expiration Date Two
Enter date: The date on which the terms and conditions of the policy will expire.
INSURANCE
IDENTIFICATION CARD
Commercial (checkbox) Three
Check the box (if applicable): Indicates the policy is a commercial lines policy.
INSURANCE
IDENTIFICATION CARD
Personal (checkbox) Three
Check the box (if applicable): Indicates the policy is a personal lines policy.
INSURANCE
IDENTIFICATION CARD
Company Number Three
Enter code: The identification code assigned to the insurer by the NAIC.
INSURANCE
IDENTIFICATION CARD
Company Three
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
Insured Name and Address Three
Enter text: The named insured(s) as it/they will appear on the policy declarations page.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address line one.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address city name.
ACORD 50 HI (2008/01)
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Section Name
Field Name
Field and/or Section Description
INSURANCE
IDENTIFICATION CARD
Enter code: The named insured's mailing address state or province code.
INSURANCE
IDENTIFICATION CARD
Enter code: The named insured's mailing address postal code.
INSURANCE
IDENTIFICATION CARD
Agency/Company Issuing Card
Three
Enter text: The full name of the producer/agency.
INSURANCE
IDENTIFICATION CARD
Year Three
Enter year: The model year of the vehicle.
INSURANCE
IDENTIFICATION CARD
Make Three
Enter text: The manufacturer of the vehicle (e.g. Ford, Chevy).
INSURANCE
IDENTIFICATION CARD
Model Three
Enter text: The manufacturer's model name for the vehicle.
INSURANCE
IDENTIFICATION CARD
Vehicle ID # Three
Enter identifier: The vehicle identification number (VIN).
INSURANCE
IDENTIFICATION CARD
Policy Number Three
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 Three
Enter date: The effective date of the policy. The date that the terms and conditions of the
policy commence.
INSURANCE
IDENTIFICATION CARD
Expiration Date Three
Enter date: The date on which the terms and conditions of the policy will expire.
INSURANCE
IDENTIFICATION CARD
Commercial (checkbox) Four
Check the box (if applicable): Indicates the policy is a commercial lines policy.
INSURANCE
IDENTIFICATION CARD
Personal (checkbox) Four
Check the box (if applicable): Indicates the policy is a personal lines policy.
INSURANCE
IDENTIFICATION CARD
Company Number Four
Enter code: The identification code assigned to the insurer by the NAIC.
INSURANCE
IDENTIFICATION CARD
Company Four
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
Insured Name and Address Four
Enter text: The named insured(s) as it/they will appear on the policy declarations page.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address line one.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address city name.
ACORD 50 HI (2008/01)
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Section Name
Field Name
Field and/or Section Description
INSURANCE
IDENTIFICATION CARD
Enter code: The named insured's mailing address state or province code.
INSURANCE
IDENTIFICATION CARD
Enter code: The named insured's mailing address postal code.
INSURANCE
IDENTIFICATION CARD
Agency/Company Issuing Card
Four
Enter text: The full name of the producer/agency.
INSURANCE
IDENTIFICATION CARD
Year Four
Enter year: The model year of the vehicle.
INSURANCE
IDENTIFICATION CARD
Make Four
Enter text: The manufacturer of the vehicle (e.g. Ford, Chevy).
INSURANCE
IDENTIFICATION CARD
Model Four
Enter text: The manufacturer's model name for the vehicle.
INSURANCE
IDENTIFICATION CARD
Vehicle ID # Four
Enter identifier: The vehicle identification number (VIN).
INSURANCE
IDENTIFICATION CARD
Policy Number Four
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 Four
Enter date: The effective date of the policy. The date that the terms and conditions of the
policy commence.
INSURANCE
IDENTIFICATION CARD
Expiration Date Four
Enter date: The date on which the terms and conditions of the policy will expire.
INSURANCE
IDENTIFICATION CARD
Commercial (checkbox) Five
Check the box (if applicable): Indicates the policy is a commercial lines policy.
INSURANCE
IDENTIFICATION CARD
Personal (checkbox) Five
Check the box (if applicable): Indicates the policy is a personal lines policy.
INSURANCE
IDENTIFICATION CARD
Company Number Five
Enter code: The identification code assigned to the insurer by the NAIC.
INSURANCE
IDENTIFICATION CARD
Company Five
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
Insured Name and Address Five
Enter text: The named insured(s) as it/they will appear on the policy declarations page.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address line one.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address city name.
ACORD 50 HI (2008/01)
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Section Name
Field Name
Field and/or Section Description
INSURANCE
IDENTIFICATION CARD
Enter code: The named insured's mailing address state or province code.
INSURANCE
IDENTIFICATION CARD
Enter code: The named insured's mailing address postal code.
INSURANCE
IDENTIFICATION CARD
Agency/Company Issuing Card
Five
Enter text: The full name of the producer/agency.
INSURANCE
IDENTIFICATION CARD
Year Five
Enter year: The model year of the vehicle.
INSURANCE
IDENTIFICATION CARD
Make Five
Enter text: The manufacturer of the vehicle (e.g. Ford, Chevy).
INSURANCE
IDENTIFICATION CARD
Model Five
Enter text: The manufacturer's model name for the vehicle.
INSURANCE
IDENTIFICATION CARD
Vehicle ID # Five
Enter identifier: The vehicle identification number (VIN).
INSURANCE
IDENTIFICATION CARD
Policy Number Five
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 Five
Enter date: The effective date of the policy. The date that the terms and conditions of the
policy commence.
INSURANCE
IDENTIFICATION CARD
Expiration Date Five
Enter date: The date on which the terms and conditions of the policy will expire.
INSURANCE
IDENTIFICATION CARD
Commercial (checkbox) Six
Check the box (if applicable): Indicates the policy is a commercial lines policy.
INSURANCE
IDENTIFICATION CARD
Personal (checkbox) Six
Check the box (if applicable): Indicates the policy is a personal lines policy.
INSURANCE
IDENTIFICATION CARD
Company Number Six
Enter code: The identification code assigned to the insurer by the NAIC.
INSURANCE
IDENTIFICATION CARD
Company Six
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
Insured Name and Address Six
Enter text: The named insured(s) as it/they will appear on the policy declarations page.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address line one.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address city name.
ACORD 50 HI (2008/01)
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Section Name
Field Name
Field and/or Section Description
INSURANCE
IDENTIFICATION CARD
Enter code: The named insured's mailing address state or province code.
INSURANCE
IDENTIFICATION CARD
Enter code: The named insured's mailing address postal code.
INSURANCE
IDENTIFICATION CARD
Agency/Company Issuing Card Six
Enter text: The full name of the producer/agency.
INSURANCE
IDENTIFICATION CARD
Year Six
Enter year: The model year of the vehicle.
INSURANCE
IDENTIFICATION CARD
Make Six
Enter text: The manufacturer of the vehicle (e.g. Ford, Chevy).
INSURANCE
IDENTIFICATION CARD
Model Six
Enter text: The manufacturer's model name for the vehicle.
INSURANCE
IDENTIFICATION CARD
Vehicle ID # Six
Enter identifier: The vehicle identification number (VIN).
INSURANCE
IDENTIFICATION CARD
Policy Number Six
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 Six
Enter date: The effective date of the policy. The date that the terms and conditions of the
policy commence.
INSURANCE
IDENTIFICATION CARD
Expiration Date Six
Enter date: The date on which the terms and conditions of the policy will expire.
INSURANCE
IDENTIFICATION CARD
Commercial (checkbox) Seven
Check the box (if applicable): Indicates the policy is a commercial lines policy.
INSURANCE
IDENTIFICATION CARD
Personal (checkbox) Seven
Check the box (if applicable): Indicates the policy is a personal lines policy.
INSURANCE
IDENTIFICATION CARD
Company Number Seven
Enter code: The identification code assigned to the insurer by the NAIC.
INSURANCE
IDENTIFICATION CARD
Company Seven
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
Insured Name and Address Seven
Enter text: The named insured(s) as it/they will appear on the policy declarations page.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address line one.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address city name.
ACORD 50 HI (2008/01)
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Section Name
Field Name
Field and/or Section Description
INSURANCE
IDENTIFICATION CARD
Enter code: The named insured's mailing address state or province code.
INSURANCE
IDENTIFICATION CARD
Enter code: The named insured's mailing address postal code.
INSURANCE
IDENTIFICATION CARD
Agency/Company Issuing Card
Seven
Enter text: The full name of the producer/agency.
INSURANCE
IDENTIFICATION CARD
Year Seven
Enter year: The model year of the vehicle.
INSURANCE
IDENTIFICATION CARD
Make Seven
Enter text: The manufacturer of the vehicle (e.g. Ford, Chevy).
INSURANCE
IDENTIFICATION CARD
Model Seven
Enter text: The manufacturer's model name for the vehicle.
INSURANCE
IDENTIFICATION CARD
Vehicle ID # Seven
Enter identifier: The vehicle identification number (VIN).
INSURANCE
IDENTIFICATION CARD
Policy Number Seven
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 Seven
Enter date: The effective date of the policy. The date that the terms and conditions of the
policy commence.
INSURANCE
IDENTIFICATION CARD
Expiration Date Seven
Enter date: The date on which the terms and conditions of the policy will expire.
INSURANCE
IDENTIFICATION CARD
Commercial (checkbox) Eight
Check the box (if applicable): Indicates the policy is a commercial lines policy.
INSURANCE
IDENTIFICATION CARD
Personal (checkbox) Eight
Check the box (if applicable): Indicates the policy is a personal lines policy.
INSURANCE
IDENTIFICATION CARD
Company Number Eight
Enter code: The identification code assigned to the insurer by the NAIC.
INSURANCE
IDENTIFICATION CARD
Company Eight
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
Insured Name and Address Eight
Enter text: The named insured(s) as it/they will appear on the policy declarations page.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address line one.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address city name.
ACORD 50 HI (2008/01)
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Section Name
Field Name
Field and/or Section Description
INSURANCE
IDENTIFICATION CARD
Enter code: The named insured's mailing address state or province code.
INSURANCE
IDENTIFICATION CARD
Enter code: The named insured's mailing address postal code.
INSURANCE
IDENTIFICATION CARD
Agency/Company Issuing Card
Eight
Enter text: The full name of the producer/agency.
INSURANCE
IDENTIFICATION CARD
Year Eight
Enter year: The model year of the vehicle.
INSURANCE
IDENTIFICATION CARD
Make Eight
Enter text: The manufacturer of the vehicle (e.g. Ford, Chevy).
INSURANCE
IDENTIFICATION CARD
Model Eight
Enter text: The manufacturer's model name for the vehicle.
INSURANCE
IDENTIFICATION CARD
Vehicle ID # Eight
Enter identifier: The vehicle identification number (VIN).
INSURANCE
IDENTIFICATION CARD
Policy Number Eight
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 Eight
Enter date: The effective date of the policy. The date that the terms and conditions of the
policy commence.
INSURANCE
IDENTIFICATION CARD
Expiration Date Eight
Enter date: The date on which the terms and conditions of the policy will expire.
EDITION
Date
The edition identifier of the form including the form number and edition (the date is
typically formatted YYYY/MM).
ACORD 50 HI (2008/01)
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