ACORD 139 - Statement of Values
ACORD 139 - Statement of Values is a standardized ACORD insurance form with 205 fillable fields across 1 page.
- Form number
- Form ACORD 139
- Edition
- Edition 2015/12
- Fields
- 205 fields
- Pages
- 1 page
What this form asks for
Examples from the PDF's 205 fields. Bindly uses the full field map to ask only the questions that apply.
- Form Completion Date
- Producer Full Name
- Producer Mailing Address Line One
- Producer Mailing Address Line Two
- Producer Mailing Address City Name
- Producer Mailing Address State Or Province Code
- Producer Mailing Address Postal Code
- Producer Contact Person Full Name
- Producer Contact Person Phone Number
- Producer Fax Number
- Producer Contact Person Email Address
- Insurer Producer Identifier
Watch Bindly fill this form
A quick preview. With Bindly it runs on your real client and produces a downloadable PDF.
Fill the ACORD 139 - Statement of Values in minutes, not hours
Bindly interviews the insured in one plain-language conversation and auto-fills the fields for you, ready for broker review and e-signature. No logins or downloads for the insured.
5 free fill sessions a month. No card required.
Bindly reads this form, interviews the insured once, and fills every field, skipping questions that don't apply and reusing answers across the whole submission packet. You review, e-sign, and submit.
Frequently asked questions
- What is the ACORD 139 - Statement of Values?
- ACORD 139 - Statement of Values is a standardized ACORD insurance form with 205 fillable fields across 1 page. It is part of Bindly's library of 3,000+ insurance forms.
- Where can I download the ACORD 139 - Statement of Values?
- You can preview and download the blank ACORD 139 - Statement of Values 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 139 - Statement of Values?
- Bindly interviews the insured in one plain-language conversation and automatically fills every field on the ACORD 139 - Statement of Values, ready for broker review and e-signature. No manual rekeying, and no logins or downloads for the insured.
- What information does the ACORD 139 - Statement of Values ask for?
- The ACORD 139 - Statement of Values includes fields for Form Completion Date, Producer Full Name, Producer Mailing Address Line One, Producer Mailing Address Line Two, Producer Mailing Address City Name, and Producer Mailing Address State Or Province 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 139 - Statement of Values have?
- The ACORD 139 - Statement of Values has 205 fillable fields across 1 page. Bindly captures them all from a single conversation with the insured.