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Web no loss statement the undersigned named insured under the auto insurance policy listed above hereby affirms that there have been no losses, accidents or circumstances that might give rise to a claim under the policy identified above during the period from _____ 12:01 a.m. To _____ (current date) _____ (current time). Fax carrier naic code policy number named insured.
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To _____ (current date) _____ (current time). Fax carrier naic code policy number named insured approved by the acord name and logo are registered marks of acord. Acord forms are now available in a variety of formats, including printable pdf, electronic fillable, and eforms. Web since our first paper form was released in 1971, acord has provided the standard forms.
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To _____ (current date) _____ (current time). Web no loss statement the undersigned named insured under the auto insurance policy listed above hereby affirms that there have been no losses, accidents or circumstances that might give rise to a claim under the policy identified above during the period from _____ 12:01 a.m. Fax carrier naic code policy number named insured.
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