EFTA00298071.pdf

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 al • 328 STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY 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: POLICY NUMBER EFFECTIVE DATE The card expires al 12 01 a m 60 day$ after the effective date shown. (Not acceptable to Wan reoistrallon aver 45 0,6S from efleCtwO dale / SEP-18-2015 12:01 A.M. DARREN;K;INDYKE;PLLC 575 LEXINGTON AVE FL 4 NEW YORK, NY, 10022-6146 AGENT: ANGELA M CARLUCCI PHONE# For Emergency Road Service call 1-877-627-5757 I EXPIRATION DATE NOV-17-2015 12:01 A.M. ADDRESS OF THE ISSUER NORTHEAST ZONE BALLSTON SPA OPERATIONS CENTER 100 STATE FARM PLACE BALLSTON SPA, NY 12020-8000 Applicable with respect to the following Motor Vehicle Year Make 2015 MERCEDES-BENZ ML350 4WD ti latigif.514114:11ErffrkMNighla 11'frgigi htiVlgi ' I I I II 1Priti 4.1 • tit Rd In 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 COMPANY CODE Name of Issuer 328 STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY 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 This card expires al 1201 a.m. 60 days alter the 01,60100 date shown (Nei acceptable to otaan reoistralion one( 45 Cl€6n from elSeCtwO dale / SEP-18-2015 12:01 A.M. DARREN;K;INDYKE;PLLC 575 LEXINGTON AVE FL 4 NEW YORK, NY, 10022-6146 AGENT: ANGELA M CARLUCCI PHONE# Fo Emergency Road Service call 1-877-627-5757 I Stafefarm a. EXPIRATION DATE NOV-17-2015 12:01 A.M. ADDRESS OF THE ISSUER NORTHEAST ZONE BALLSTON SPA OPERATIONS CENTER 100 STATE FARM PLACE BALLSTON SPA, NY 12020-8000 Applicable with respect to the following Motor Vehicle Year Make 2015 MERCEDES-BENZ ML350 4WD Vehicle Identification No Imhof I l ig ralft i r tig Rgt CAE P1 rgiggr IS gg iantile faUMAt allerni P it iJkli lligg ig li‘ jOgrai rargri PLEASE DO NO. FOLD CARD ON THE BARCODE 10002'10 2005 131146 204 07-01-2013 EFTA00298071