Coverage description
An Insurance Services Office (ISO) standard form. Declarations page for the Government Crime Policy, showing the named insured, policy period, the limit and deductible for each insuring agreement, and the endorsements attached.
How the form has changed
The 06 22 edition updates the insuring agreement lines in the schedule, its layout and the form date. The declarations wording is otherwise the same.
Editions
Edition dates as filed, newest first. Filing counts include every state submission that lists the edition.
| Edition | Filings | Companies | States | Filed |
|---|---|---|---|---|
| 06 22Jun 2022Latest | 68 | 12 | 44 | Feb 2022 to Dec 2025 |
| 08 13Aug 2013 | 4 | 3 | 2 | Mar 2022 to Oct 2023 |
What the filings show
- Edition in use: in the past 12 months, 1 company filed the 06 22 edition.
- CRDS01 (Crime and Fidelity Coverage Part Declarations (Commercial Entities)) is filed alongside it most often, in 71 of the same filings (99%).
Filed under
Data from admitted P&C filings with state insurance departments, submitted Oct 2021 to Dec 2025, excluding withdrawn and rejected filings. One filing can cover several affiliated companies.
Carriers filing this form
The 10 carrier groups with the most filings that include CR DS 04, out of 10 in total.
| Carrier | Filings | States | Editions, most filed first | Last filed |
|---|---|---|---|---|
| Fairfax Financial Group3 group companies filed it, led by United States Fire Insurance Company and The North River Insurance Company | 50 | 42 | 06 22 | Jun 18, 2025 |
| Insurance Services Office, Inc.Advisory Organization | 10 | 10 | 06 22 | May 2, 2024 |
| WR Berkley Corporation Group2 group companies filed it, led by Intrepid Casualty Company and StarNet Insurance Company | 3 | 1 | 08 13 | Oct 16, 2023 |
| BCBS OF MI Group2 group companies filed it, led by Accident Fund Insurance Company of America and United Wisconsin Insurance Company | 2 | 1 | 06 22 | Jun 11, 2025 |
| Universal Insurance Company GroupUniversal North America Insurance Company | 2 | 2 | 06 22 | Dec 26, 2025 |
| AU Holding Company GroupPennsylvania Insurance Company | 1 | 1 | 06 22 | Nov 4, 2024 |
| Axis Capital GroupAXIS Insurance Company | 1 | 1 | 06 22 | Apr 11, 2025 |
| Berkshire Hathaway GroupAmGUARD Insurance Company | 1 | 1 | 08 13 | Mar 24, 2022 |
| Greater NY Group2 group companies filed it, led by Greater Mid-Atlantic Indemnity Company and Greater Midwestern Indemnity Company | 1 | 1 | 06 22 | Mar 20, 2024 |
| Hawaii Insurance Bureau, Inc. | 1 | 1 | 06 22 | Jun 24, 2022 |
See more forms
Search related forms, compare editions, and research carrier filings with FilingFocus.
States
Number of filings that include CR DS 04 in each state, Oct 2021 to Dec 2025. Darker states have more filings.
Often filed with
Standard-style form numbers that appear in the same filings most often.
- CRDS01Crime and Fidelity Coverage Part Declarations (Commercial Entities)71 filings
- CRDS02Commercial Crime Policy Declarations71 filings
- CRDS03Crime and Fidelity Coverage Part Declarations (Government Entities)71 filings
- CRDS05Commercial Fidelity and Forgery Policy Declarations71 filings
- CRDS08Government Fidelity and Forgery Policy Declarations71 filings
- CR 00 24Government Crime Coverage Form (Discovery Form)20 filings
- CR 04 08Employee Theft – Name Or Position Schedule20 filings
- CR 25 01Exclude Designated Persons Or Classes Of Persons As Employees20 filings
- CR 25 06Include Chairperson And Members Of Specified Committees As Employees20 filings
- CR 25 08Include Specified Non- Compensated Officers As Employees20 filings
Recent filings
Latest filings that include this form number. Filed copies open in FilingFocus.
| Submitted | Company | State | Editions | Tracking number |
|---|---|---|---|---|
| Dec 26, 2025 | Universal North America Insurance Company | SC | 06 22 | UNAC-134780228 |
| Dec 17, 2025 | Universal North America Insurance Company | NV | 06 22 | UNAC-134774841 |
| Jun 18, 2025 | Crum and Forster Indemnity Companyand 2 more | HI | 06 22 | CRUM-134324049 |
| Jun 11, 2025 | Accident Fund Insurance Company of Americaand 1 more | CA | 06 22 | ACCD-G134496426 |
| Jun 11, 2025 | Accident Fund Insurance Company of Americaand 1 more | CA | 06 22 | ACCD-G134496799 |
| Apr 11, 2025 | AXIS Insurance Company | CO | 06 22 | AXSS-G134488954 |
| Nov 4, 2024 | Pennsylvania Insurance Company | LA | 06 22 | APPU-134306922 |
| Aug 29, 2024 | Crum and Forster Indemnity Companyand 2 more | GA | 06 22 | CRUM-134228527 |
| May 2, 2024 | Insurance Services Office, Inc. | GA | 06 22 | ISOF-G134091819 |
| Mar 20, 2024 | Greater Mid-Atlantic Indemnity Companyand 1 more | PA | 06 22 | GNYM-134024033 |
| Oct 16, 2023 | StarNet Insurance Company | CA | 08 13 | BNIC-133853864 |
| Apr 5, 2023 | Crum and Forster Indemnity Companyand 1 more | NY | 06 22 | CRUM-133625159 |
Most filed ISO CR forms
- CR DS 01 Crime And Fidelity Coverage Part Declarations (Commercial Entities
- CR DS 02 Commercial Crime Policy Declarations
- CR 04 08 Employee Theft – Name Or Position Schedule
- CR 04 01 Employee Theft Of Clients' Property
- CR DS 05 Commercial Fidelity And Forgery Policy Declarations
- CR 20 33 Excess Over Underlying Insurance
- CR 00 21 Commercial Crime Coverage Form (Loss Sustained Form)
- CR 25 09 Include Volunteer Workers As Employees
- CR 20 08 Convert To An Aggregate Limit Of Insurance
- CR 25 41 Include Designated Persons Or Classes Of Persons As Employees
- CR 20 42 Exclude Digital Tokens And Other Electronic Instruments
- CR 00 25 Government Crime Coverage Form (Loss Sustained Form)
See more carrier forms
Search forms by carrier, line of business, state, and wording with FilingFocus.