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BA Forms List

  Form #  Description

Edition Dates

  BA-9 Optional Basic Economic Loss Endorsement

1/02 

  

  BA-10 Additional P.I.P Endorsement

1/02 

  

  BA-11 Supplementary Uninsured/Underinsured Motorist

1/02

  

  BA-12 NY Mandatory Personal Injury Protection

1/02

  

  BA-13 Uninsured Motorist Endorsement

1/02

  

  BA-14 Split Limits Option

1/02

  

  BA-20 Business Automobile Provisions

1/02

  

  BA-22 NY Cancellation Provisions

1/02

  

  BA-23 Medical Payments Coverage

1/02

  

  BA-24 Drive Other Car Endorsement

1/02

  

  BA-25 NY Business Automobile Changes

1/02

  

  BA-26 Additional Insureds - Employees

1/02

  BA-27 NY Rental Vehicles Coverage

1/02

  

  BA-28 Other Scheduled Automobiles

1/02

  BA-29 Added Rental Reimbursement

1/02

  BA-30 NY Suspension of Insurance

1/02

  BA-31 Suspension of Insurance

1/02

  BA-32 Reinstatement of Insurance

1/02

  BA-33 Discs and Tapes Coverage

1/02

  BA-34 Farm Tractors and Non-Farm Equipment

1/02

  BA-35 An Individual as the Insured

1/02

  BA-36 Loss Payable Endorsement

1/02

  BA-37 Full Glass Endorsement (NY)

1/02

  BA-38 Notice to Policyholders - Rental Vehicle Prov. (NY)

1/02

  BA-39 Employees - Insureds

1/02

  BA-40 Lessor - Additional Insured

1/02

  BA-41 Hired Autos Designated as Covered Autos You Own

1/02

  BA-42 Supplemental Spousal Liability

1/02

  BA-43 Medical Expense Exclusion

1/02

  BA-45 Change Endorsement

1/02

  SSL-NOTICE Supplemental Spousal Liability Coverage Notice

4/02

 

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