Form Numbers Reference

Declaration (Dec) Pages

General/Dec Change Forms

Form Number	Description
D43404	General Declaration - Standard
D43404VA	General Declaration - Virginia
D43404NY	General Declaration - New York
D44421	Dec Change Form - Standard
D44421VA	Dec Change Form - Virginia
D44422NY	Dec Change Form - NY (Alternative)
D42404VA	Dec Change - Virginia Variant
D42404	Dec Change - Alternative
CYL6001	Cyber Dec Page
CYL6002	Cyber Dec Page - Variant 2
D42404NY	Dec Change - NY
CYL6003	Cyber Dec Page - Variant 3

Cancellation Forms

Form Number	LOB Support
D43401	Standard Cancellation
D43401NY	Standard Cancellation - NY
D44406	Mid-Term Cancellation
D44406NY	Mid-Term Cancellation - NY
D42401	Cancellation Variant
CYL3001	Cyber Cancellation
D42401NY	Cancellation - NY

Reinstatement Forms

Form Number	Description
D43409	Reinstatement
D43409NY	Reinstatement - NY
D44433	Mid-Term Reinstatement
D44431NY	Mid-Term Reinstatement - NY
D42409	Reinstatement Variant
CYL3002	Cyber Reinstatement

Extended Reporting Period (ERP)

Form Number	Description
D42405	ERP Form - Variant
D42405VA	ERP - Virginia
D43405	ERP Standard
D43405VA	ERP - Virginia
D43406	ERP - Alternative
D43407	ERP - Alternative 2
D43405NY	ERP - New York
D43407NY	ERP - NY Variant
D44414NY	ERP - NY
D44415NY	ERP - NY
D44413NY	ERP - NY
D44414	ERP Standard
D44415	ERP Variant
D44413	ERP Alternative
D44416	ERP - Alternative
D44416NY	ERP - NY Alternative
CYL5001	Cyber ERP

Note

ERP forms are used when a claims-made policy is cancelled and the insured wants to report claims that occurred during the policy period but are reported after cancellation.

Close-Out Letters

Form Number	Description
COL001	Close-Out Letter 1
COL002	Close-Out Letter 2
COL003	Close-Out Letter 3
COL004	Close-Out Letter 4
COL005	Close-Out Letter 5
COL006	Close-Out Letter 6
COL007	Close-Out Letter 7
COL008	Close-Out Letter 8
COL009	Close-Out Letter 9
COL010	Close-Out Letter 10
COL011	Close-Out Letter 11
COL012	Close-Out Letter 12
COL013	Close-Out Letter 13
COL014	Close-Out Letter 14
COL015	Close-Out Letter 15
COL016	Close-Out Letter 16
COL017	Close-Out Letter 17
COL018	Close-Out Letter 18
COL019NY	Close-Out Letter - NY

Real Estate Standard Endorsements

Form Number	Description
D43412	Business Brokerage Endorsement
D43412NY	Business Brokerage - NY
D43420	Mortgage Brokerage Endorsement
D43420NY	Mortgage Brokerage - NY
D43413	Construction Development Exclusion
D43413NY	Construction Development - NY
D43436	Land Development Exclusion
D43449	OCS Endorsement
D43449KS	OCS - Kansas
D43441	AOP Endorsement
D43441MO	AOP - Missouri
D43441IL	AOP - Illinois
D43441NH	AOP - New Hampshire

Accountants Standard Endorsements

Form Number	Description
D44462	Cyber Extension Endorsement
D44462FL	Cyber - Florida
D44462IL	Cyber - Illinois
D44462KS	Cyber - Kansas
D44462MA	Cyber - Massachusetts
D44462ME	Cyber - Maine
D44462OH	Cyber - Ohio
D44462VA	Cyber - Virginia
D44462WA	Cyber - Washington
D44454NY	NY Cyber
D44455	EPLI Endorsement
D44455FL	EPLI - Florida
D44455IL	EPLI - Illinois
D44455MA	EPLI - Massachusetts
D44455VA	EPLI - Virginia
D44457	Supplementary Endorsement

Cyber-Specific Forms

Form Number	Description
CYL3001	Cyber Cancellation
CYL3002	Cyber Reinstatement
CYL5001	Cyber ERP
CYL6001	Cyber Dec Page
CYL6002	Cyber Dec Page V2
CYL6003	Cyber Dec Page V3

TRIA Forms

Form Number	Description
IL7210	Terrorism Risk Insurance Act Form
IL7368	TRIA Disclosure Form

Non-Mail Forms (Internal Use)

Form Number	Description
DECLINE002	Decline PDF Template
DECLINE001	Decline Template Variant
REFER001	Referral Form
MORE001	More Info Request Form
INVOICE001	Invoice Template

Follow-Up Forms

Form Number	Description
FOLLOW001	Follow-Up Letter 1
FOLLOW002	Follow-Up Letter 2