Acord Form No Loss - Cancellation date date and time signed policy # I understand that ascendant commercial insurance is relying solely upon this statement of no losses as an inducement to reinstate my policy. Producer applicant's signature i certify that there have been no losses, accidents or circumstances that might give rise to a claim under the insurance policy whose number is shown above, from 12:01 am on to. Web since our first paper form was released in 1971, acord has provided the standard forms used by the insurance industry. Acord forms are now available in a variety of formats, including printable pdf, electronic fillable, and eforms. Web acord 37 (1/96) c acord corporation 1996 witness date and time receipt $ amount received by: Web no loss has occurred for which coverage might be claimed under my policy number _____between the date of _____12:01 a.m. I further understand if a Using acord's standardized forms allows for increased efficiency, accuracy, and speed of information processing.
Web since our first paper form was released in 1971, acord has provided the standard forms used by the insurance industry. Using acord's standardized forms allows for increased efficiency, accuracy, and speed of information processing. Web acord 37 (1/96) c acord corporation 1996 witness date and time receipt $ amount received by: Web no loss has occurred for which coverage might be claimed under my policy number _____between the date of _____12:01 a.m. Acord forms are now available in a variety of formats, including printable pdf, electronic fillable, and eforms. I understand that ascendant commercial insurance is relying solely upon this statement of no losses as an inducement to reinstate my policy. I further understand if a Producer applicant's signature i certify that there have been no losses, accidents or circumstances that might give rise to a claim under the insurance policy whose number is shown above, from 12:01 am on to. Cancellation date date and time signed policy #