ACORD 130 - Additional State Rating Worksheet
ACORD 130 - Additional State Rating Worksheet is a standardized ACORD insurance form with 192 fillable fields across 1 page.
- Form number
- Form ACORD 130 STATE RATING WORKSHEET
- Edition
- Edition 2026/08
- Fields
- 192 fields
- Pages
- 1 page
What this form asks for
Examples from the PDF's 192 fields. Bindly uses the full field map to ask only the questions that apply.
- Producer Customer Identifier
- Workers Compensation Rate State Page Number
- Workers Compensation Rate State Total Page Number
- Workers Compensation Rate State State Or Province Name
- Workers Compensation Rate Class Location Producer Identifier
- Workers Compensation Rate Class Classification Code
- Workers Compensation Rate Class Description Code
- Workers Compensation Rate Class Duties Description
- Workers Compensation Rate Class Full Time Employee Count
- Workers Compensation Rate Class Part Time Employee Count
- Workers Compensation Rate Class Sic Code
- Workers Compensation Rate Class NAICS Code
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Frequently asked questions
- What is the ACORD 130 - Additional State Rating Worksheet?
- ACORD 130 - Additional State Rating Worksheet is a standardized ACORD insurance form with 192 fillable fields across 1 page. It is part of Bindly's library of 3,000+ insurance forms.
- Where can I download the ACORD 130 - Additional State Rating Worksheet?
- You can preview and download the blank ACORD 130 - Additional State Rating Worksheet PDF for free on Bindly's form library, or have Bindly fill it for you automatically. No login is required to preview or download.
- How do I fill out the ACORD 130 - Additional State Rating Worksheet?
- Bindly interviews the insured in one plain-language conversation and automatically fills every field on the ACORD 130 - Additional State Rating Worksheet, ready for broker review and e-signature. No manual rekeying, and no logins or downloads for the insured.
- What information does the ACORD 130 - Additional State Rating Worksheet ask for?
- The ACORD 130 - Additional State Rating Worksheet includes fields for Producer Customer Identifier, Workers Compensation Rate State Page Number, Workers Compensation Rate State Total Page Number, Workers Compensation Rate State State Or Province Name, Workers Compensation Rate Class Location Producer Identifier, and Workers Compensation Rate Class Classification Code. These are examples from the PDF; the exact questions that apply depend on the risk and coverage requested.
- How many fields does the ACORD 130 - Additional State Rating Worksheet have?
- The ACORD 130 - Additional State Rating Worksheet has 192 fillable fields across 1 page. Bindly captures them all from a single conversation with the insured.