📄 Extracted Text (834 words)
TEMPORARY AUTO
IDENTIFICATION CARDS
STATE FARM.
FAX INSTRUCTIONS: 1. The entire page must be faxed.
2. If submitted to DMV. either the entire page or the second ID card will be retained.
3. A faxed ID card must be replaced with a scannable ID card within 14 days of the effective date.
4. DMV will not accept a faxed ID card without a scannable barcode.
THIS ID CARD MUST BE CARRIED IN THE INSURED VEHICLE FOR PRODUCTION UPON DEMAND
WARNING: Any person who issues cc produces an ID card knowing that an Owner's Policy of Insurance is not in effect may be committing a misdemeanor. In addition, a person who
presents an ID card if insurance is nix n effect may be committing a misdemeanor. The name of the registrant and the name of the insured must coincide.
REPLACEMENT VEHICLE NOTATION: DMV WILL ONLY PROCESS A VEHICLE CHANGE (RE-REGISTRATION) USING THE REPLACED VEHICLES CURRENT REGISTRATION.
IMPORTANT NOTICE: This temporary card will be rep4aced by a card to be issued by the insurance company named on the card. If you do not receive a replacement permanent card
prior to the expiration of this card, contact your insurance company or agent.
IF YOU HAVE AN ACCIDENT - NOTIFY POUCE IMMEDIATELY - 1) Get names. addresses. and phone numbers of persons involved and witnesses. Also get driver license numbers
of persons involved and license plate numbers/states of vehicles. 2) Don't admit fault or discuss the accident with anyone but Slate Farm or police. 3) Promptly notify your agent. log on
to statefarm.00me. or visit State Farm Pocket Agent° to file a claim.
FS-21 (4/72Y TEMPORARY - NEW YORK STATE INSURANCE IDENTIFICATION CARD RaleFarin
COMPANY CODE Name of Issuer
328 STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY al •
ADDRESS OF THE ISSUER
An authorized NEW YORK insurer has issued an Owner's Pobcy of Liability Insurance complying with
Artide 6 (Motor Vehicle Financial Security Act) of the NEW YORK Vehicle and Traffic law to:
EFFECTIVE DATE NORTHEAST ZONE
POLICY NUMBER
The card expires al 12 01 am 60 day$ after the BALLSTON SPA OPERATIONS CENTER
effective date shown. (Not acceptable to Wan 100 STATE FARM PLACE
DARREN;K;INDYKE;PLLC reoistrallon aver 45 0,6S from efleCtwO dale /
BALLSTON SPA, NY 12020-8000
575 LEXINGTON AVE FL 4 SEP-18-2015 12:01 A.M.
NEW YORK, NY, 10022-6146 Applicable with respect to the following Motor Vehicle
Year Make
EXPIRATION DATE
AGENT: ANGELA M CARLUCCI NOV-17-2015 12:01 A.M. 2015 MERCEDES-BENZ ML350
PHONE# 4WD
For Emergency Road Service call 1-877-627-5757 • tit Rd In
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PLEASE DO NOT FOLD CARD ON THE BARCODE
TH S ID CARD MUST BE CARRIED N THE INSURED VEHICLE FOR PRODUCTION UPON DEMAND
WARNING: Any person who issues cc produces an ID card knowing that an Owner's Policy of Insurance is nix in effect may be committing a misdemeanor. In addition, a person who
presents an ID card if insurance is not n effect may be committing a misdemeanor. The name of the registrant and the name of the insured must coincide.
REPLACEMENT VEHICLE NOTATION: DMV WILL ONLY PROCESS A VEHICLE CHANGE (RE-REGISTRATION) USING THE REPLACED VEHICLES CURRENT REGISTRATION.
IMPORTANT NOTICE: This temporary card will be replaced by a card to be issued by the insurance company named on the card. If you do not receive a replacement permanent card
poor to the expiation of this card. contact your insurance company or agent.
IF YOU HAVE AN ACCIDENT - NOTIFY POUCE IMMEDIATELY - 1) Get names. addresses. and phone numbers of persons involved and witnesses. Also get driver license numbers
of persons involved and license plate numbers/states of vehicles. 2) Don't admit fault or discuss the accident vath anyone but State Farm or police. 3) Promptly notify your agent. log on
to statefarm.come. or visit State Farm Pocket Agents to file a claim.
FS-21 (4/72) TEMPORARY - NEW YORK STATE INSURANCE IDENTIFICATION CARD Stafefarm
COMPANY CODE Name of Issuer
328 STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY a. ADDRESS OF THE ISSUER
An authorized NEW YORK insurer has issued an Owner's Pokcy of Liability Insurance complying with
Article 6 (Motor Vehicle Financial Security Act) of the NEW YORK Vehicle and Traffic law to:
POLICY NUMBER EFFECTIVE DATE NORTHEAST ZONE
This card expires al 1201 a.m. 60 days alter the BALLSTON SPA OPERATIONS CENTER
01,60100 date shown (Nei acceptable to otaan 100 STATE FARM PLACE
DARREN;K;INDYKE;PLLC reoistralion one( 45 Cl€6n from elSeCtwO dale /
BALLSTON SPA, NY 12020-8000
575 LEXINGTON AVE FL 4 SEP-18-2015 12:01 A.M.
NEW YORK, NY, 10022-6146 Applicable with respect to the following Motor Vehicle
Year Make
EXPIRATION DATE
AGENT: ANGELA M CARLUCCI NOV-17-2015 12:01 A.M. 2015 MERCEDES-BENZ ML350
PHONE# 4WD
Fo Emergency Road Service call 1-877-627-5757 Vehicle Identification NoImhof
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PLEASE DO NO. FOLD CARD ON THE BARCODE
10002' 10 2005 131146 204 07-01-2013
EFTA00298071
ℹ️ Document Details
SHA-256
1131ff0695264d18e70f1350a0b265038a3dc466d27bff0b2c82084c8586a90e
Bates Number
EFTA00298071
Dataset
DataSet-9
Document Type
document
Pages
1
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