[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-284116-105":53,"doc-detail-284116-en":127},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":120,"head_meta":122,"extra_data":124,"updated_unix":126},105,"en","statement-of-no-loss-acord-37-form","Statement of No Loss - ACORD 37 Form","","This document is the official ACORD 37 Statement of No Loss form, designed for insurance industry use to verify the absence of known claims. The form requires the applicant to certify that they are unaware of any losses, accidents, or circumstances that could lead to an insurance claim during a specified coverage period. It includes fields for agency contact details, named insured information, carrier data, policy identification, and official signatures. This standardized template serves as a critical verification document for insurance producers and carriers, ensuring transparency and accountability in policy administration. It is a vital tool for documenting the status of risk at the time of policy issuance or modification, helping to mitigate liability and confirm eligibility for coverage based on the applicant's formal declaration of loss history.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/statement-of-no-loss-acord-37-form/284116/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/statement-of-no-loss-acord-37-form/284116.png","ImageObject",442,249,{"name":88,"@type":89},"Ezra","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-27","2026-09-17",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",20,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"What is the purpose of the ACORD 37 form?","Question",{"text":109,"@type":110},"The form is used to certify that an applicant is unaware of any losses, accidents, or circumstances that could lead to an insurance claim during a specified timeframe.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"What specific information is required to complete the form?",{"text":114,"@type":110},"The form requires details such as the agency contact, named insured, carrier name, NAIC code, policy number, and the certification period, followed by the applicant's signature and the producer's verification.",{"name":116,"@type":107,"acceptedAnswer":117},"Who must sign the Statement of No Loss?",{"text":118,"@type":110},"The applicant must sign to certify the absence of losses, and there is also a designated space for the producer to sign and witness the document.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},284116,1791204779,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":9,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":4},1099514068035,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","STATEMENT OF NO LOSS  \n\n| AGENCY |  | NAMED INSURED |  |\n| --- | --- | --- | --- |\n| CONTACT NAME: |  | CARRIER | NAIC CODE |\n| PHONE\u003Cbr>(A/C, No, Ext): |  |  |  |\n| FAX\u003Cbr>(A/C, No): |  | POLICY NUMBER |  |\n| E-MAIL ADDRESS: |  |  |  |\n| CODE: | SUBCODE: | APPROVED BY |  |\n| AGENCY CUSTOMER ID: |  |  |  |\n| I CERTIFY THAT I AM NOT AWARE OF ANY LOSSES, ACCIDENTS OR CIRCUMSTANCES THAT MIGHT GIVE RISE TO A CLAIM UNDER THE INSURANCE POLICY WHOSE NUMBER IS SHOWN ABOVE, FROM 12:01 AM ON   TO   .\u003Cbr>CANCELLATION DATE DATE AND TIME SIGNED\u003Cbr>APPLICANT'S SIGNATURE\u003Cbr>RECEIPT\u003Cbr>$   AMOUNT RECEIVED BY:  \u003Cbr>PRODUCER\u003Cbr>WITNESS DATE AND TIME |  |  |  |\n\nACORD 37 (2008/01) © 1996-2008 ACORD CORPORATION. All rights reserved.  \nThe ACORD name and logo are registered marks ofACORD","cbCair6Ocq3D9JO5","https://ap.wps.com/l/cbCair6Ocq3D9JO5","pdf",26895,"English","# Statement of No Loss\n## Agency and Insured Information\n## Certification Statement\n## Signatures and Receipt Details","[{\"question\":\"What is the purpose of the ACORD 37 form?\",\"answer\":\"The form is used to certify that an applicant is unaware of any losses, accidents, or circumstances that could lead to an insurance claim during a specified timeframe.\"},{\"question\":\"What specific information is required to complete the form?\",\"answer\":\"The form requires details such as the agency contact, named insured, carrier name, NAIC code, policy number, and the certification period, followed by the applicant's signature and the producer's verification.\"},{\"question\":\"Who must sign the Statement of No Loss?\",\"answer\":\"The applicant must sign to certify the absence of losses, and there is also a designated space for the producer to sign and witness the document.\"}]","Statement of No Loss - ACORD 37 Form | PDF",1789628240]