Printable blank ACORD 101 Additional Remarks Schedule

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What is ACORD 101?

ACORD 101 is a free form that is used to specify the additional remarks for any ACORD form. The representative of the insurance company fills it out. You can file this document online; it is only one page long. 

What do I need ACORD 101 for?

  • To define the additional insureds of the agency, company, or any institution that signs an ACORD blank; 
  • To describe what primary insurance includes, what is considered to be self-insurance, and why it’s not that part of the agreement;
  • If the insurance agency provides professional services, the policy should include liability coverage, and it must be noted in ACORD form 101.

How to fill out ACORD 101?

Fillable ACORD 101 consists of only one page, so it’s not complicated to fill it out. However, you should examine ACORD 101 instructions to complete it successfully.

  1. In the top right-hand corner, indicate the customer’s identification number and the location number if relevant. 
  2. Below, you should write the page number and the total amount of pages that contain additional remarks. 
  3. Fill out the insurance agency name and the policy number.
  4. In the Carrier line, indicate the name of the insurance company that will accept this printable form. 
  5. At the top of the additional remarks schedule, fill out the applicant’s name and the current date.
  6. The fields “Form number” and “Form title” should be taken from the ACORD form to which you will attach PDF ACORD 101. 
  7. Finally, you can enumerate additional remarks in the field.

Organizations that work with ACORD 101


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