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State Farm ®
Providing Insurance and Financial Services
PO Box 89000
Atlanta GA 30356-9900

Attached as requested is a courtesy copy of your replacement insurance identification cards. You will receive your
printed replacement cards in the mail. In the meantime, if the attached copies are not accepted by a law
enforcement agency or your Department of Motor Vehicle office, please contact your agent to receive additional
assistance.
Thank you for choosing State Farm for your insurance needs.

FS-20 (4-72) NEW YORK STATE INSURANCE IDENTIFICATION CARD

Name & Address of Insurer
PLEASE CHECK NAME(S) LISTED FOR ACCURACY Company State Farm Mutual Automobile Insurance Company
The name(s) printed below must match the name(s) shown on your
Code PO Box 89000
registration with regard to spelling and number of characters for 328 Atlanta GA 30356-9900
the insured vehicle. If they do not match, you may not be able to An authorized NEW YORK insurer has issued an Owner's Policy of Liability
register your vehicle or may be subject to other action by the DMV. Insurance complying with Article 6 (Motor Vehicle Financial Security Act) of
Please contact your agent for information and assistance if the the NEW YORK Vehicle and Traffic law to:
names(s) do not match. POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE
327 3111-D09-52 JUL 07 2021 12:01 a.m. OCT 09 2021 12:01 a.m.
(Not acceptable to obtain registration after 45 days from effective date)
DEMA,EDVIN Applicable with respect to the following Motor Vehicle
DEMA,EDVIN PO BOX 696 Year Make
PO BOX 696 BEDFORD NY 10506-0696 2015 NISSAN
BEDFORD NY 10506-0696 Vehicle Identification Number
KNMAT2MV9FP549225 07D2-CAC NAIC 25178
AGENT PHONE # (914)725-5000

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MUTL VOL
SEE IMPORTANT MESSAGE ON REVERSE SIDE

THIS CARD MUST BE CARRIED IN THE INSURED VEHICLE 1. Attached are two identical insurance I.D. cards. They are to be used to verify
coverage and include your name, address, policy number, effective date,
FOR PRODUCTION UPON DEMAND. expiration date and a description of the insured vehicle.
WARNING: Any person who issues or produces an ID card knowing that an Owner's 2. One of the cards must be kept in the vehicle at all times, preferably in the glove
Policy of Insurance is not in effect may be committing a misdemeanor. In addition, a compartment. It must, upon demand, be shown to a police officer, judge, hearing
person who presents an ID card if financial security is not in effect may be committing a officer, or a person with whom you or the driver of your car is involved in an
misdemeanor. accident. You may also ask to see the other driver's I.D. card. A driver's failure to
show the I.D. card at the request of a police officer is presumptive evidence of
The name of the registrant and the name of the insured must coincide. operating an uninsured vehicle for which the driver may be given a summons.

REPLACEMENT VEHICLE NOTATION: DMV WILL ONLY PROCESS A VEHICLE CHANGE 3. The other I.D. card should be kept in a safe place. It must be presented to the
Department of Motor Vehicles for any type of registration transaction involving the
(RE-REGISTRATION) TRANSACTION USING THE REPLACED VEHICLE'S CURRENT insured vehicle including renewal, amendment, and replacement of plates or
REGISTRATION. stubs. The card will be held by the Department to verify insurance coverage.
FS-20 (4-72) For Emergency Road Service call 1-877-627-5757. 4. If you lose your I.D. cards or discover an error, please contact your agent for
replacement or corrected cards. Do not contact the Department of Motor
IF YOU HAVE AN ACCIDENT - NOTIFY POLICE IMMEDIATELY Vehicles.
1. Write down names, addresses, telephone numbers, and license numbers of persons 5. WARNING: These cards become void and useless if the policy identified by the
involved and of witnesses. Also write down the license plate number and state of each cards expires or is terminated. Use after policy expiration or termination may be a
vehicle involved. violation of New York law. Fraudulent use of an I.D. card is a misdemeanor. Failure
to return registration items on an uninsured motor vehicle can result in license
2. Notify your agent promptly or log on to statefarm.com ® to initiate the claim filing and/or registration suspension or revocation. Operating or permitting operation of
process. an uninsured motor vehicle can result in a heavy fine and/or imprisonment, in
addition to a civil penalty.
3. Do not admit fault, do not discuss the accident with anyone except State Farm or
Police.

143432.3 (o1ecny2d) 12-09-2014(o1ecny3a) (o1ecny5a) JUL 19 2021