The Capdat Acord form, central to anyone needing proof of vehicle insurance across multiple states in the U.S., serves an essential role for drivers, insurance agencies, and legal entities. This versatile document not only fulfills the requirement for drivers to prove they have the minimum insurance coverage mandated by law but also standardizes the process of information exchange after accidents. It details crucial information such as the insurance company's name and address, the policy number, effective and expiration dates of the policy, as well as the year, make, and model of the insured vehicle. Notably, it includes space for both the agency or company issuing the card and the insured individual's name and address, ensuring all parties involved in an incident have access to the necessary details for a smooth claim process. The form is designed to be kept within the insured vehicle and presented on demand, especially in the wake of an accident, highlighting the need to gather information about other drivers, passengers, witnesses, and their respective insurance companies and policy numbers. With specific versions tailored to meet the legal requirements of different states—such as Alaska, Alabama, Arkansas, and beyond—the Capdat Acord form is a critical document for maintaining compliance with vehicle insurance laws nationwide.
| Question | Answer |
|---|---|
| Form Name | Capdat Acord |
| Form Length | 39 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 9 min 45 sec |
| Other names | cat dat com, applications for capdat, capdat, amazon |
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ALASKA |
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INSURANCE IDENTIFICATION CARD |
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(STATE) |
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COMPANY NUMBER |
COMPANY |
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123 |
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Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2003 |
MERZ / C32 |
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WDBRF6SJ13F301306 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
Can Go Here! |
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ALABAMA INSURANCE IDENTIFICATION CARD |
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Policy provides the minimum insurance prescribed by law. |
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COMPANY NUMBER |
COMPANY |
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12345 |
Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2002 |
FORD / MUSTANG |
1FAFP45X42F142005 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
Can Go Here! |
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ARKANSAS PROOF OF INSURANCE CARD |
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COMPANY NAIC NUMBER |
COMPANY NAME AND ADDRESS |
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12345 |
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Any Insurance Company |
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COMPANY PHONE NUMBER |
100 Fifth Ave |
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New York, NY 10010 |
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POLICY NUMBER |
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EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
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5/1/2003 |
5/1/2004 |
AutoIDWEB |
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YEAR |
MAKE/MODEL |
VEHICLE IDENTIFICATION NUMBER |
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2002 |
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BUICK / CENTURY |
2G4WY55J321110951 |
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AGENCY ISSUING CARD |
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(Replace this logo with your company logo) |
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Your Insurance Agency/Company |
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1234 Main Street |
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AnyCity, US 12345 |
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AGENCY PHONE NUMBER |
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INSURED NAME AND ADDRESS |
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Empire Parts |
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210 Washington Ave |
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Albany, NY |
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
Can Go Here! |
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THIS CARD MUST BE KEPT IN THE INSURED
VEHICLE AND PRESENTED UPON DEMAND
IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:
1.Name and address of each driver, passenger and witness.
2.Name of Insurance Company and policy number for each vehicle involved.
ACORD 50 (1/83) |
© ACORD CORPORATION 1983 |
THIS CARD MUST BE KEPT IN THE INSURED
VEHICLE AND PRESENTED UPON DEMAND
IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:
1.Name and address of each driver, passenger and witness.
2.Name of Insurance Company and policy number for each vehicle involved.
ACORD 50 (1/83) |
© ACORD CORPORATION 1983 |
THIS CARD MUST BE KEPT IN THE INSURED
VEHICLE AND PRESENTED UPON DEMAND
IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:
1.Name and address of each driver, passenger and witness.
2.Name of Insurance Company and policy number for each vehicle involved.
ACORD 50 AR (2003/07) |
© ACORD CORPORATION 2003 |
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ARIZONA |
INSURANCE IDENTIFICATION CARD |
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(STATE) |
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COMPANY NUMBER |
COMPANY |
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A123 |
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Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2002 |
TOYOTA / CAMRY |
JTDBE32K420010592 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
Can Go Here! |
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CALIFORNIA INSURANCE IDENTIFICATION CARD |
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The policy meets the requirements of Section 16056 of the California Vehicle Code. |
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COMPANY NUMBER |
COMPANY |
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12345 |
Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2002 |
BUICK / RENDEZVOUS |
3G5DA03E12S504064 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
Can Go Here! |
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COLORADO INSURANCE IDENTIFICATION CARD |
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BI, PD, AND PIP coverages provided as required by law. |
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COMPANY NUMBER |
COMPANY |
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123 |
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Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2002 |
KIA / SD |
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KNADC123526157767 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
Your Custom Message
Can Go Here!
SEE IMPORTANT NOTICE ON REVERSE SIDE
THIS CARD MUST BE KEPT IN THE INSURED
VEHICLE AND PRESENTED UPON DEMAND
IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:
1.Name and address of each driver, passenger and witness.
2.Name of Insurance Company and policy number for each vehicle involved.
ACORD 50 (1/83) |
© ACORD CORPORATION 1983 |
THIS CARD MUST BE KEPT IN THE INSURED
VEHICLE AND PRESENTED UPON DEMAND
IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:
1.Name and address of each driver, passenger and witness.
2.Name of Insurance Company and policy number for each vehicle involved.
ACORD 50 (1/83) |
© ACORD CORPORATION 1983 |
THIS CARD MUST BE KEPT IN THE INSURED
VEHICLE AND PRESENTED UPON DEMAND
IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:
1.Name and address of each driver, passenger and witness.
2.Name of Insurance Company and policy number for each vehicle involved.
ACORD 50 (1/83) |
© ACORD CORPORATION 1983 |
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CONNECTICUT INSURANCE IDENTIFICATION CARD |
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Connecticut Insurance Card Issued Pursuant to Connecticut Law |
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COMPANY NUMBER |
COMPANY |
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123 |
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Any Insurance Company |
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POLICY NUMBER |
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EFFECTIVE DATE |
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ABC987654321 |
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5/1/2003 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2001 |
BUICK / LESABRE |
1G4HP54K514147010 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
|
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
Can Go Here! |
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DISTRICT OF COLUMBIA |
INSURANCE IDENTIFICATION CARD |
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(STATE) |
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COMPANY NUMBER |
COMPANY |
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123 |
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Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2001 |
HONDA / ACCORD |
1HGCF86671A087673 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
Can Go Here! |
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DELAWARE |
INSURANCE IDENTIFICATION CARD |
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(STATE) |
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COMPANY NUMBER |
COMPANY |
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12345 |
Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2001 |
OLDSMOBILE / INTRIGUE |
1GWS52H71F186333 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
Your Custom Message
Can Go Here!
SEE IMPORTANT NOTICE ON REVERSE SIDE
THIS CARD MUST BE KEPT IN THE INSURED
VEHICLE AND PRESENTED UPON DEMAND
IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:
1.Name and address of each driver, passenger and witness.
2.Name of Insurance Company and policy number for each vehicle involved.
ACORD 50 (1/83) |
© ACORD CORPORATION 1983 |
THIS CARD MUST BE KEPT IN THE INSURED
VEHICLE AND PRESENTED UPON DEMAND
IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:
1.Name and address of each driver, passenger and witness.
2.Name of Insurance Company and policy number for each vehicle involved.
ACORD 50 (1/83) |
© ACORD CORPORATION 1983 |
THIS CARD MUST BE KEPT IN THE INSURED
VEHICLE AND PRESENTED UPON DEMAND
IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:
1.Name and address of each driver, passenger and witness.
2.Name of Insurance Company and policy number for each vehicle involved.
THE FRONT OF THIS DOCUMENT CONTAINS AN ARTIFICIAL WATERMARK - HOLD AT AN ANGLE TO VIEW
ACORD 50 WM (2/95) |
© ACORD CORPORATION 1993 |
AutoIDWEB
(Replace this logo with your company logo)
FLORIDA AUTO INSURANCE IDENTIFICATION CARD
COMPANY: Any Insurance Company
POLICY #: |
EFFECTIVE |
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DATE: 5/1/2003 to |
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YEAR: |
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2001 |
MAKE/ |
5/1/2004 |
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MODEL: CHEVROLET / TRUCK |
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VEHICLE ID #: 1GCHK23G81F134609 |
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PERSONAL INJURY PROTECTION |
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BODILY INJURY |
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X |
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X |
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BENEFITS/PROPERTY DAMAGE LIABILITY |
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LIABILITY |
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NAMED Empire Parts
INSURED: 210 Washington Ave
ADDRESS: Albany, NY
(OPTIONAL)
NOT VALID FOR MORE THAN ONE YEAR FROM EFFECTIVE DATE
Your Custom Message |
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Can Go Here! |
PLEASE CUT ALONG ABOVE LINE |
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GEORGIA |
INSURANCE IDENTIFICATION CARD |
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(STATE) |
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COMPANY NUMBER |
COMPANY |
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123 |
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Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
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MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
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2001 |
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CHEVROLET / SILVERADO |
1GCJK39G71E311381 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED |
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Empire Parts |
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210 Washington Ave |
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Albany, NY |
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
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Can Go Here! |
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HAWAII MOTOR VEHICLE INSURANCE IDENTIFICATION CARD |
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COMPANY # |
COMPANY |
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123 |
Any Insurance Company |
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AN AUTHORIZED HAWAII INSURER HAS ISSUED AN INSURANCE POLICY |
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WHICH COMPLIES WITH THE HAWAII MOTOR VEHICLE INSURANCE LAW TO: |
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AutoIDWEB |
INSURED |
Empire Parts |
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NAME AND |
210 Washington Ave |
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ADDRESS: |
Albany, NY |
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AGENCY/COMPANY Your Insurance Agency/Company |
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ISSUING CARD: |
1234 Main Street, AnyCity, US 12345 |
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(Replace this logo with your company logo) |
YEAR: 2001 |
MAKE/MODEL: BUICK / REGAL |
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VEHICLE ID #: |
2G4WB55K611267155 |
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POLICY #: |
ABC987654321 |
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EFFECTIVE DATE: 5/1/2003 |
EXPIRATION DATE: 5/1/2004 |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
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Your Custom Message |
||||
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Can Go Here! |
PLEASE CUT ALONG ABOVE LINE |
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THIS CARD MUST BE KEPT IN THE INSURED
VEHICLE AND PRESENTED UPON DEMAND
IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:
1.Name and address of each driver, passenger and witness.
2.Name of Insurance Company and policy number for each vehicle involved.
Rental car coverage is provided, see outline of coverage.
MISREPRESENTATION OF INSURANCE IS A FIRST DEGREE MISDEMEANOR
ACORD 50 FL (3/94) |
© ACORD CORPORATION 1994 |
THIS CARD MUST BE KEPT IN THE INSURED
VEHICLE AND PRESENTED UPON DEMAND
IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:
1. Name and address of each driver, passenger and witness.
2. Name of Insurance Company and policy number for each vehicle involved.
ACORD 50 (1/83) |
© ACORD CORPORATION 1983 |
THIS CARD MUST BE KEPT IN THE INSURED
VEHICLE AND PRESENTED UPON DEMAND
IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:
1.Name and address of each driver, passenger and witness.
2.Name of Insurance Company and policy number for each vehicle involved.
THE FRONT OF THIS DOCUMENT CONTAINS AN ARTIFICIAL WATERMARK -
HOLD AT AN ANGLE TO VIEW.
ACORD 50 HI (1/99) |
© ACORD CORPORATION 1994 |
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IOWA FINANCIAL LIABILITY COVERAGE CARD |
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COMPANY NUMBER |
COMPANY |
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123 |
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Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
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MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoID |
2001 |
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MITSUBISHI / GALANT |
4A3AA46G61E191633 |
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WEB |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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AGENCY/COMPANY ADDRESS |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED |
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Empire Parts |
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210 Washington Ave |
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Albany, NY |
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Your Custom Message |
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COVERAGE PROVIDED BY THIS POLICY MEETS THE MINIMUM LIABILITY LIMITS PRESCRIBED BY LAW |
Can Go Here! |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
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STATE OF IDAHO LIABILITY INSURANCE IDENTIFICATION CARD |
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(STATE) |
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COMPANY NUMBER |
COMPANY |
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123 |
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Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
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MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2001 |
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KIA / SEPHIA |
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KNAFB121X5052916 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
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Your Custom Message |
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SEE IMPORTANT NOTICE ON REVERSE SIDE |
Can Go Here! |
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ILLINOIS INSURANCE IDENTIFICATION CARD |
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Examine policy exclusions carefully. This form does not constitute any part of your insurance policy. |
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COMPANY NUMBER |
COMPANY |
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12345 |
Any Insurance Company |
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POLICY NUMBER |
EFFECTIVE DATE |
EXPIRATION DATE |
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ABC987654321 |
5/1/2003 |
5/1/2004 |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
AutoIDWEB |
2001 |
BUICK / LESABRE |
1G4HP54K914228687 |
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AGENCY/COMPANY ISSUING CARD |
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Your Insurance Agency/Company |
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(Replace this logo with your company logo) |
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1234 Main Street |
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AnyCity, US 12345 |
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INSURED
Empire Parts
210 Washington Ave
Albany, NY
Your Custom Message
Can Go Here!
SEE IMPORTANT NOTICE ON REVERSE SIDE
THIS CARD MUST BE KEPT IN THE INSURED
VEHICLE AND PRESENTED UPON DEMAND
IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:
1.Name and address of each driver, passenger and witness.
2.Name of Insurance Company and policy number for each vehicle involved.
EMERGENCY PHONE NUMBER OF:
X
Agency:
X
Company:
ACORD 50 IA (2002/12) |
© ACORD CORPORATION 2002 |
THIS CARD MUST BE KEPT IN THE INSURED
VEHICLE AND PRESENTED UPON DEMAND
IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:
1.Name and address of each driver, passenger and witness.
2.Name of Insurance Company and policy number for each vehicle involved.
ACORD 50 (1/83) |
© ACORD CORPORATION 1983 |
THIS CARD MUST BE KEPT IN THE INSURED
VEHICLE AND PRESENTED UPON DEMAND
IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:
1.Name and address of each driver, passenger and witness.
2.Name of Insurance Company and policy number for each vehicle involved.
EXCLUDED DRIVERS
ACORD 50 (1/83) |
© ACORD CORPORATION 1983 |
