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State Farm Mutual Automobile Insurance Company <br />PO Box 2358 <br />Bloomington IL 61702-2358 <br />AT2 A-6406 A <br />ROMERO, ANTONIO & AIDE & <br />KARINA <br />13841 MALENA DR <br />TUSTIN CA 92780-1920 <br />Digitally signed <br />Tu Tran byTuTran <br />APPROVED Nguyen <br />By Tu Tran Nguyen at 11:33 am, Apr 21, 2025 N g uyen D, 34 032O04.21 <br />Policy Number: 711 6355-A27-75A <br />Policy Period: January 27, 2025 to July 27, 2025 <br />Vehicle: <br />2018 ACURA TLX <br />Principal Driver: <br />KARINAA ROMERO <br />Notice of insurance information collection practices - <br />personal, family, or household insurance transactions: <br />We may collect customer information from persons other <br />than the individual or individuals applying for coverage. <br />Such customer information as well as other personal or <br />privileged information subsequently collected may, in certain <br />circumstances, be disclosed to third parties without your <br />authorization as permitted by law. <br />Policy Number: 711 6355-A27-75A <br />Prepared December 5, 2024 <br />1004583 <br />AUTO RENEWAL <br />PREMIUM PAID: $1,091.49 <br />DO NOT PAY. <br />Your premium is billed through the State Farm Payment Plan <br />State Farm Payment Plan Number: 1329070423 <br />Your State Farm Agent <br />ARACELI PADILLA INS AGENCY INC <br />Office: 714-543-5858 <br />Address: 2424 N GRAND AVE STE B <br />SANTA ANA, CA 92705-8757 <br />If you have a new ordierent car, have added any ddvers orhave moved, <br />please contact your agent. <br />Thank you for choosing State Farm. <br />You have the right to submit a written request to access, <br />correct, amend, or delete your personal information and the <br />right to receive a response within 30 days of submitting your <br />request. If we deny your request, you have the right to file a <br />statement with us containing the information you feel is <br />accurate and fair along with the reasons you disagree with <br />our denial. Instructions on how to file such request and our <br />full privacy notice can be found <br />(continued on next page) <br />Page number 1 of 5 <br />143562 202 01-15-2018 <br />Thanks for being part <br />of our neighborhood. <br />You mean a lot to us. If you need anything, <br />call State Farm' Agent ARACELI PADILLA <br />INS AGENCY INC at 714-543-5858. <br />TP31 <br />