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Temporary Auto Identification Card

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TEMPORARY AUTO

IDENTIFICATION CARD
STATE FARM®
This card is invalid if the policy for which it was issued lapses or is terminated.

Please compare your vehicle's identification number with the numbers that
COMMONWEALTH OF KENTUCKY PROOF OF INSURANCE appear on your insurance I.D. cards and motor vehicle title and registration.
If the vehicle number on your insurance I.D. card is not correct, contact your
agent. If the number on your motor vehicle title and registration is incorrect,
State Farm Mutual Automobile Insurance Company
contact your county clerk.
POLICY NUMBER 17 -2582-U47 PERSONAL
IF YOU HAVE AN ACCIDENT- NOTIFY POLICE IMMEDIATELY
INSURED ORTIZ,ISRAEL
1. Get names, addresses, and phone numbers of persons involved and
witnesses. Also get driver license numbers of persons involved and license
EFFECTIVE DATE JUL-06-2022 EXPIRATION DATE SEP-03-2022
plate numbers/states of vehicles.
CAR-YEAR/MAKE/VEHICLE IDENTIFICATION NUMBER
1996 HONDA ACCORD "LX" 4D SED 2. Don't admit fault or discuss the accident with anyone but State Farm or
1HGCD5537TA167313 police.
COVERAGES 3. Promptly notify your agent, log on to statefarm.com®, or use the State
A BODILY INJURY/PROPERTY
DAMAGE LIABILITY Farm mobile app to file a claim.
P NO-FAULT For EMERGENCY ROAD SERVICE use the State Farm mobile app,
H log on to statefarm.com, or call 877-627-5757.

NAIC # 25178 HOW TO IDENTIFY YOUR COVERAGES


AGENT
TEMPORARY
Norris, Shalimar
108 Pasadena Dr Ste 100
Lexington, KY 40503-2966 A Liability
SEE POLICY FOR FULL NAME AND DEFINITION
R1,R2 Car Rental and Travel Expense
C Medical Payments S Death, Dismemberment and
PHONE# 859-266-9820 D Comprehensive Loss of Sight
G Collision U Uninsured Motor Vehicle
THIS CARD MUST BE CARRIED IN THE INSURED MOTOR
H Emergency Road Service W Underinsured Motor Vehicle
VEHICLE FOR PRODUCTION UPON DEMAND.
L Physical Damage Z Loss of Earnings
STATE FARM® P No-Fault

Insurance information on personal vehicles is reported electronically to the Department


of Vehicle Regulation. If the VIN does not appear in the database, only one copy of this
card must be given to the county clerk for registration renewal. The other card must be
carried in the vehicle and shown to peace officers on request.
Because many states require evidence of insurance on demand, one copy of this form
should be carried in the vehicle at all times.
Emergency Road Service information is located on your insurance card.
1002861 2005 144787 202 02-22-2018

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