ACORD 101 Form – Additional Remarks Schedule PDF Free

Additional Remarks Schedule

ACORD 101 (2012/02)

General/Supporting Form

February 2012

01 page

PDF, Fillable PDF


Policyholders, insurers, and insurance providers often require the Acord 101 fillable form to provide remarks or details on the primary form. The additional remarks form is attached to the primary form to support personal and commercial insurance applications. The form helps clarify the property, liability, and auto coverage for accurate risk assessment and reduces underwriting delays.


The Acord 101 form provides enhanced details for underwriting the policy and meets the insurer’s legal obligations.

Additional remarks on an insurance policy avoid miscommunication between the insurer, agent, and policyholder.

The form contains the detailed remarks of customized coverage to help the insurer assess risk for tailored coverage.

The fillable PDF form ensures enhanced coverage details, reducing the approval delays.


Records the insured information to ensure accurate coordination with the primary application.

Ensure the remarks align with the accurate policy and reference the main form.

Records the enhanced coverage details to clarify the purpose and prevent underwriting delays.

Ensure application completeness and support remarks with evidence.


  1. Write the insured’s name and address.
  2. Mention the policy number.
  3. Write the insurer’s name.
  4. Mention the form’s number and title.
  5. Write the additional details or remarks to cover the policy.
  6. Attach the form to the primary policy form.

The form is required when there is insufficient space on the primary insurance application form to provide additional remarks.

Provision of clear and relevant details about the coverage ensures reducing miscommunication to avoid errors and delays.

Multi-location businesses often face complex risks and require additional remarks to clarify the coverage needs.

The form allows customized remarks to meet coverage with the specific requirements.

Yes, we provide a fillable PDF form and allow you to complete it online.

Related Forms

Policyholders require the Acord 70 form to request that insurers change their personal insurance policies (except auto).

Policyholders often require the Acord 83 form to apply for personal umbrella insurance to protect their additional assets and liabilities

The form ensures the desired coverage to protect home and personal property from financial loss