ACORD 101 Additional Remarks Schedule | Fillable PDF

When the remarks box on a certificate, application, or other ACORD form runs out of room, the ACORD additional remarks schedule picks up where it stops. You finish your thoughts on this blank page and attach it behind that form.

This ACORD 101 form has no questions to answer. Its one job is to stay tied to the form it continues. Forms such as ACORD 25, ACORD 35, and ACORD 130 print a short line in their remarks boxes that tells you when to attach it.

Attach one when the form you’re filling in tells you to and its remarks box has no room left.

A certificate needs more wording

The description of operations box on a certificate fills up fast. Extra wording, such as additional insured and waiver of subrogation language, often moves to the schedule.

An answer needs an explanation

Many applications ask you to explain every yes answer or give loss details in the remarks box. Long explanations go on the schedule.

When to use something else

Long lists of vehicles belong on ACORD 129, and long lists of drivers belong on ACORD 163. This page holds words, not lists of items.

One page, five parts, in the order they appear.

1. 1

   Agency Customer ID & LOC #

   Your agency’s ID number for the customer, and the number of the location these remarks cover, if you track locations.

2. 2

   Page __ of __

   Number each page, such as Page 1 of 3, so the set stays together.

3. 3

   Agency, Named Insured & Policy

   The agency, named insured, policy number, carrier, NAIC code, and effective date. Copy them from the form you’re continuing, and write the named insured the way it appears on the policy declarations page.

4. 4

   Schedule To ACORD Form

   Write the form number and full title of the form you’re continuing. This line links the page to its parent form.

5. 5

   Additional Remarks

   The large blank box where your remarks go.

A remarks page that drifts away from its form is useless. Copy the named insured, policy number, and effective date exactly from the form you’re continuing, and write that form’s number and title on the schedule line. Then keep the two together. Attach the page directly behind its form, or save both in the same file. If you send several forms in one package, give each form its own schedule.

Keep each remark short and specific, and put one idea on each line. When a statement depends on an endorsement, name the endorsement’s form number when you can, instead of writing “as required by contract.” Don’t repeat what the main form already says. On a certificate, remember the limit: the certificate doesn’t change the policy, and neither do the remarks attached to it.