ACORD 71 Personal Auto Policy Change – Fillable Form Online

Personal Auto Policy Change Request

ACORD 71 (2012/03)

Personal Lines

March 2012

02 page

PDF, Fillable PDF


An Acord 71 form serves as a legal document for a personal auto policy change request in the insurance industry. Policyholders require the fillable acord form to request policy changes, including adding vehicles, updating driver information, or modifying coverage limits. The form ensures transparent communication between policyholders and insurance providers to reduce financial loss due to unforeseen accidents.


The form allows the policyholders to customize their auto policy to reflect new vehicles or drivers for legal protection.

The accurate information provided on the form ensures coverage transparency, reducing conflicts during claims.

The flexible billing plans (monthly to annual) promote financial clarity for the premiums.

Policyholders can customize their policies for multiple vehicles to improve security and lower premiums.


The form includes the agency’s detailed information to facilitate the change request and help insurers contact the agency for clarification.

Helps identify the policyholder requesting the policy changes to be applied to the correct policy.

Specify the customized policy details, and ensure accurate processing by the insurer.

Records updating the driver’s information, which impacts discounted premiums and coverage eligibility.

Accurate updation, deletion, or addition of the vehicle information helps calculate the premiums to lower the financial risks.

Modifying the policy’s coverage helps the policyholder to align the policy with the needs for premiums and claims eligibility.

Ensures clarification for the policy changes to the insurers, reducing errors and speeding up the process.


  1. Write the agency’s name, address, contact number, and customer ID.
  2. Write the insured’s name, residential address, and account number.
  3. Mention the insurance company’s name, NAIC number, policy number, effective date, expiration date, and change billing plan.
  4. Mention the vehicle information, including year, make, model, vehicle identification number (VIN), usage, and safety features.
  5. Write the premiums, type of change, and deductibles for the coverage limits.
  6. Write the driver’s name, gender, date of birth, license number, and social security number.
  7. Mention the additional interest’s name, address, and loan number.
  8. Write additional remarks on the policy change.

Contact your insurance provider or agent, and submit it through fax, mail, or the insurance agent’s portal.

The form allows policyholders to request that the insurer update their personal auto policy with customized changes. Policy updating ensures transparency and reduces dispute errors for claims.

Yes, vehicle information is necessary to ensure changes are made for a specific vehicle.

The form allows changes for the vehicle’s addition, deletion, address, coverage limits, and driver’s information.

Policyholders, insurance agents, and insurers often require the form to update customized changes to personal auto insurance.

Related Forms

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

Acord 45 form is often required to list entities with an insurable interest. The form usually covers a loss payee, mortgage holder, or lienholder for personal or commercial insurance policies.

To reinstate or renew an insurance policy, the insurer requires proof of no losses, accidents, or claims occurring during a specified period.