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NCE PLAN SURCHARGE NOTICE FORM Appendix S: Safe Driver Insurance Plan Surcharge Notice Form (continued) Data Definitions Field Number 1 Insurance Company Name. This field contains the insurance company name of the insurer that issues the Surcharge Notice. 2 (Insurance Company Code). This field contains the three-digit Insurance Company Code of the insurer that issues the Surcharge Notice. 3 Operator Information: Name. This field contains the full name of the operator involved in the accide.

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