State Farm Mutual Automobile Insurance Company

PO Box 2358
Bloomington IL 61702-2358

AT2 A-2420 A
DAVIS, WILLIAM S JR
PO BOX 321 AUTO RENEWAL
JOHNSON CITY TX 78636-0321

AMOUNT DUE: $919.85

Payment is due by May 23, 2024

Your State Farm Agent

JOSE LUIS JIMENEZ INS AGCY INC
Office: 713-699-5673
Address: 4001 N SHEPHERD DR STE 227
Policy Number: C03 8391-E23-53Q HOUSTON, TX 77018-5589
Policy Period: May 23, 2024 to November 23, 2024
If you have a new or different car, have added any drivers, or have moved,
12:01 A.M. Standard Time at the address of the named insured as stated herein
please contact your agent.
Vehicle:
Thank you for choosing State Farm.
2023 TOYOTA TUNDRA
Principal Driver:
WILLIAM S DAVIS JR

CONVENIENT PAYMENT OPTION: You may use one of
State Farm's alternate payment plans which divides your
present premium into two separate payments.
You may pay one half of the amount due, $459.92 on MAY
23 2024.
The remaining half will be due on JUL 22 2024. We'll send
you a reminder notice.
We also have available a plan to let you pay your premium
in monthly installments. For details on this plan and to
determine if you qualify, please contact your State Farm
agent.
Location used to determine rate charged-CAR 4 224
HILL TOP, JOHNSON CITY TX 78636.
Your policy has the Guaranteed Renewal Endorsement.
(continued on next page )

Policy Number: C03 8391-E23-53Q Page number 1 of 4

Prepared April 2, 2024
1004583 Please fold and tear here 143562 202 01-15-2018

Power To Pay Online Mobile Call Mail Visit your

statefarm.com/pay Use the Automated Line: 1-800-440-0998 Send us State Farm
Your Way Your agent: 713-699-5673 a check agent
State Farm mobile app
Key code: 3487634979

Insured: DAVIS, WILLIAM S JR 2509406202

Policy Number: C03 8391-E23-53Q State Farm Insurance Companies
P.O. Box 680001
Amount Due: $919.85 Dallas, TX 75368-0001
Please pay by May 23, 2024
Make payment to State Farm
For Office Use Only AUTO REN $919.85 0620
1-A1 A 2420-FA87
APP DT 07-02-2024 MUTL VOL
30045992 159414400091985 653111303839111125>
When you provide a check as payment, you authorize us
either to use information from your check to make a
one-time electronic fund transfer from your account or to
process the payment as a check transaction. When we use
information from your check to make an electronic fund
transfer, funds may be withdrawn from your account as soon
as the same day we receive your payment, and you will not
receive your check back from your financial institution.

VEHICLE INFORMATION
Review your policy information carefully. If anything is incorrect, or if there are any changes to your vehicle information, please
let us know right away.
Vehicle Identification
Vehicle Description Number (VIN) Who principally drives this vehicle? How is this vehicle normally used?

2023 TOYOTA TUNDRA 5TFLA5DA7PX088993 WILLIAM DAVIS JR, a widowed male, who To Work, School or Pleasure.
will be age 82 as of May 23, 2024.

Premium Adjustment annually to determine which makes and models have

Each year, we review our medical payments and personal
injury protection coverages claim experience to determine
the vehicle safety discount that is applied to each make and
model. In addition, we review the comprehensive, collision,
bodily injury and property damage claim experience
earned decreases or increases from State Farm's standard
rates. If any changes result from our reviews, adjustments
are reflected in the rates shown on this renewal notice.

DRIVER INFORMATION
Principal Driver & Assigned Drivers premium may be influenced by the information shown for
For each automobile, the Principal Driver is the individual these drivers.
who most frequently drives it.
Each driver is designated as an Assigned Driver on the
household automobile that they most frequently drive. Your

Policy Number: C03 8391-E23-53Q Page number 2 of 4

Prepared April 2, 2024

Drive Safe & Save™ puts you in

the driver's seat of your discount.
Get a discount just for enrolling. From there,
how you drive determines how much you save.
If you haven't already, download the app and
enroll. Text SAVEMORE to 42407 or contact
your agent, JOSE LUIS JIMENEZ INS AGCY
INC, at 713-699-5673.

Discounts may exceed 30% and vary state-to-state (NY capped at 30%).
Not available in CA, MA, RI. A discount may not be available in NC
depending on individual facts and circumstances. Setup required. TP41
IMPORTANT NOTICE REGARDING YOUR PREMIUM
State Farm works hard to offer you the best combination of You have the right to request, no more than once during a
price, service, and protection. The amount you pay for 12-month period, that your policy be re-rated using a current
automobile insurance is determined by many factors such credit-based insurance score. Re-rating could result in a
as the coverages you have, where you live, the kind of car lower rate, no change in rate, or a higher rate.
you drive, how your car is used, who drives the car, and
information from consumer reports including credit history.

COVERAGE AND LIMITS See your policy for an explanation of these coverages.
A Liability Bodily Injury 100,000/300,000 $127.67
Property Damage 50,000 $125.41
P Personal Injury Protection 2,500 $10.41
D 1000 Deductible Comprehensive $228.77
G 1000 Deductible Collision $303.85
H Emergency Road Service $3.05
U Uninsured/Underinsured Motorist:
Bodily Injury 100,000/300,000 $76.28
Property Damage 25,000 $44.41
Amount Due $919.85

Your premium has been adjusted on our make and model

rating plan.

DISCOUNTS These adjustments have already been applied to your premium.

Multiple Line P
Antitheft P
Vehicle Safety P
Renewal P
Total Discounts $539.61

EXCEPTIONS AND ENDORSEMENTS

Your policy consists of this declarations page, the policy booklet - form 9843A, and any endorsements that apply, including those issued to you with any
subsequent renewal notice.

CREDITOR- TOYOTA MOTOR CREDIT CORP TMCC INSURANCE SERVICE CENTER, PO BOX
30203, COLLEGE STA TX 77842-3203.

6091AD CERTIFICATE OF GUARANTEED RENEWAL.

6128DV AMENDATORY ENDORSEMENT.

Policy Number: C03 8391-E23-53Q Page number 3 of 4

Prepared April 2, 2024
ADDITIONAL INFORMATION
If any information on this renewal notice is incomplete or information regarding discounts or coverages, see your
inaccurate, or if you want to confirm the information we have State Farm agent or visit statefarm.com®.
in our records, please contact your agent. For additional

Drive Safe & SaveTM - it's that simple

Our Drive Safe & Save discount is one more way we help you save money on your auto insurance. How much you drive
determines the size of your discount, and good drivers can save even more. There are multiple ways you can participate
depending on the vehicle you drive. You'll receive an initial participation discount just for enrolling, which will be replaced, after an
introductory period, by a discount adjusted at the policy renewal based on information collected.
Contact your State Farm agent or visit drivesafeandsave.com for details.

Buying a new car? Remember to contact your agent!

When you buy an additional car or one that replaces a car already on your policy, you need to report the change to your agent
promptly. Even though the dealership you purchased the car from may offer to notify your agent or insurance company, you, as
the named insured, are responsible for reporting all changes to your auto policy. By contacting your agent, you can help:
• avoid any complications or lack of coverage in the event of an accident or loss,
• avoid insurance verification problems with a lienholder, the police, or the department of motor vehicles, and
• ensure that you receive any new discounts you may be entitled to.
Your current State Farm policy automatically provides certain coverages for a new or replacement car for up to a specified, limited
number of days after you take possession of the car. Please refer to your policy for the number of days that applies in your state.
If you have any questions about coverage for a newly acquired car, please contact your State Farm agent.
Disclaimer: This message is provided for informational purposes only and does not grant any insurance coverage. The terms and
conditions of coverage are set forth in your State Farm Car Policy booklet, the most recently issued Declarations Page, and any
applicable endorsements.

Policy Number: C03 8391-E23-53Q Page number 4 of 4

Prepared April 2, 2024