Universal wording updates to improve clarity and intent were made to all FIG text for this form on 04/10/2009.
Section Name
Field Name
Field and/or Section Description
TITLE
ACORD 50 NJ (2005/05)
Temporary State of New Jersey
Insurance Identification Card
ACORD 50 NJ, Temporary State of New Jersey Insurance
Identification Card, is used as temporary proof of insurance. This is the only ACORD ID
card that is acceptable in New Jersey as a temporary ID card under a new regulation
effective April 19, 2004. It cannot be used as a permanent ID card. Use ACORD 50 WM
when a permanent ID card must be issued.
This card contains a watermark (the word ACORD), which is invisible when the form is
photocopied. This feature helps to prevent fraudulent reproduction and is required under
the new regulation.
IMPORTANT: The watermark cannot be reproduced when ACORD 50 NJ is downloaded
from this web site. Paper copies of ACORD 50 NJ that include the watermark can be
ordered from ACORD Member Services at 800-444-3341, ext. 506 or by sending us an e-
mail to memberservices@acord.org. As an alternative, plain paper that includes the
watermark (ACORD 360 WM - 4 part, perforated and ACORD 370 WM - non perforated)
can also be ordered. This watermarked paper can be used in an office printer.
ACORD 50 NJ (2005/05)
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Section Name
Field Name
Field and/or Section Description
TITLE
Two cards should be issued to the insured. One should be retained in the insured vehicle,
and the other used to provide proof of insurance at the time license plates are purchased.
Please note: This temporary ID card will expire 60 days after the effective date listed.
If the card is being used for coverage under the New Jersey Automobile Full Insurance
Underwriting Association, wording must appear on the front of the card to that effect.
The following phrase should be added to the back of the card:
Address for notification of commencement of medical treatment.
All fields on the card must be properly completed to comply with New Jersey regulations.
Note: The Insurance Company Number shown on the card must be the NJ DMV
Insurance Company Number for the company issuing the insurance policy.
INSURANCE
IDENTIFICATION CARD
Company Number
Enter code: The identification code assigned to the insurer by the NAIC.
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.
INSURANCE
IDENTIFICATION CARD
Expiration Date
Enter date: The date on which the terms and conditions of the policy will expire. As used
here, this temporary identification card will expire 60 days after the effective date listed.
INSURANCE
IDENTIFICATION CARD
Year
Enter year: The model year of the vehicle.
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Section Name
Field Name
Field and/or Section Description
INSURANCE
IDENTIFICATION CARD
Make/Model
Enter text: The manufacturer of the vehicle (e.g. Ford, Chevy).
INSURANCE
IDENTIFICATION CARD
Enter text: The manufacturer's model name for the vehicle.
INSURANCE
IDENTIFICATION CARD
Vehicle Identification Number
Enter identifier: The vehicle identification number (VIN) or serial number assigned by the
manufacturer.
INSURANCE
IDENTIFICATION CARD
Agency/Company Issuing Card
Enter text: The full name of the producer/agency.
INSURANCE
IDENTIFICATION CARD
Enter text: The mailing address line one of the producer/agency.
INSURANCE
IDENTIFICATION CARD
Enter text: The mailing address line two 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
Insured
Enter text: The named insured(s) as it/they will appear on the policy declarations page.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address line one.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address line two.
INSURANCE
IDENTIFICATION CARD
Enter text: The named insured's mailing address city name.
INSURANCE
IDENTIFICATION CARD
Enter code: The named insured's mailing address state or province code.
INSURANCE
IDENTIFICATION CARD
Enter code: The named insured's mailing address postal code.
INSURANCE
IDENTIFICATION CARD
Address for Notification
Enter text: The name of the individual, as established by the insurer, to be notified in the
event medical treatment is required.
INSURANCE
IDENTIFICATION CARD
Address for Notification
Enter text: The address of the insurer's medical treatment contact.
INSURANCE
IDENTIFICATION CARD
Address for Notification
Enter text: The city of the insurer's medical treatment contact.
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Section Name
Field Name
Field and/or Section Description
INSURANCE
IDENTIFICATION CARD
Enter code: The state or province of the insurer's medical treatment contact.
INSURANCE
IDENTIFICATION CARD
Enter code: The postal code of the insurer's medical treatment contact.
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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