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State Farm Mutual Automobile Insurance Company <br />PO Box 2368 <br />Bloomington it 61702-2368 <br />j&StateFarm' <br />AT2 A-2CC1 A <br />MELGOZA, JORGE B & MELGOZA, <br />ANNA <br />6867 GOLFCREST DR APT 51 <br />SAN DIEGO CA 92119-2444 <br />Policy Number: 583 7885-D15-55A <br />Policy Period: October 15, 2024 to April 15, 2025 <br />Vehicle: <br />2012 HONDA ACCORD <br />Principal Driver: <br />JORGE B MELGOZA <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 patties without your <br />authorization as permitted by law. <br />Policy Number: 583 7885-D15-55A <br />Prepared August 23, 2024 <br />1004583 <br />AUTO RENEWAL <br />PREMIUM PAID: $838.94 <br />DO NOT PAY. <br />Your premium is billed through the State Farm Payment Plan <br />State Farm Payment Plan Number:1235506212 <br />Your State Farm Agent <br />LAZARO INSURANCE AGENCY INC <br />Office:619-229-6799 <br />Address: 3924 EL CAJON BLVD <br />SAN DIEGO, CA 92105-1023 <br />If you have a newordilierent car, have added anydrivers, orhave moved, <br />please contact)our 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 LAZARO <br />INSURANCE AGENCY INC at <br />619-229-6799. <br />TP31 <br />