| Combo Group ID(Optional): Must be 9 digits long. Leading
zero's will be appended if less than 9 digits are entered.
|
| Rating Effective Date(Required): Must be a valid date entered
in the format MM/DD/YYYY. Rating Effective Date must be no greater than the
current date plus 210 days.
|
| Interstate Indicator(Optional): The values 'Yes' and 'No' may
be chosen. Default is 'No'.
|
| Number of Policies at 1st, 2nd, and 3rd(Required): Number of
policies contributing data to the experience rating must be at least 1 and no
more than 30(10 per report level).
|
| User's Name(Required)
|
| Employer's Name(Optional)
|
