New York State Insurance Identification Card: FS-20 Form 1390 NY (02/15)

Form_SCTNID_CTGRY.
NY02151390_IDCARD
<docindex><index>IDCARD</index></docindex>
NEW YORK STATE INSURANCE IDENTIFICATION CARD
Policy Number
932442456
413 Progressive Casualty Insurance Co
Name & Address of Issuer Progressive Casualty Insurance Co Effective Date Expiration Date
6300 Wilson Mills Road Customer Service:
01/28/2021 02/28/2021
Mayfield Village, Ohio 44143 1-800-876-5581
12:01 a.m. 12:01 a.m.
THIS ID CARD MUST BE CARRIED IN THE
(Not acceptable to obtain registration
An authorized NEW YORK insurer has issued an Owner's Policy of Liability INSURED VEHICLE FOR PRODUCTION UPON
after 45 days from effective date.)
Insurance complying with Article 6 (Motor Vehicle Financial Security Act) of Applicable with respect to the DEMAND
the NEW YORK Vehicle and Traffic Law to: following Motor Vehicle:
WARNING: Any person who issues or produces
1988 CADIL an ID card knowing that an Owner's Policy of
WARE,JEREMY Year Make insurance is not in effect may be committing a
PO BOX 66 1G6KS5158JU813268 misdemeanor. In addition, a person who
HANNIBAL NY 13074 Vehicle Identification Number presents an ID card if insurance is not in effect
may be committing a misdemeanor.
The name of the registrant and the name of the

OOEDFJ_LBADDAHNCDM_HLGKACJDBDAJA_FKINFGDACJFCIIDAK_IAMLDBCKJHHDAAIJ_HDDHFJC_BNNDADFF_HELNEFC_COJBI_
OOEDGMFNCNBEIOKFNNHM_GMCGCHELMAKNDOADBGIE_BIOIMGLBNIHOIGNMAJIN_IODMLLBGAFHOKKOAEMNBABODLCGJHBCOJBI_
OOEDEFCNBFAGAGAHNIHDNEBGHBHMOADMO_NGJNGAOEKMKNIJGNBINDAELDLCAOFM_GBLOJAMGEOIJDCGMFOGNHNIHGNKBCOJBI_
OOEDGJDOBHDBACGC_HDLLFNLHCLIGIJFG_HDCCGD_KJNNBANDKLMCCHDBAIKJ_EMGGA_IGALE_FCCMNFMGANLNKCLEB_DCOJBI_
insured must coincide.

OOEDEGI_CMCCAJGLNODDHFBAMCGGLIMHGDMGHCFGGMCDGDALELLNHCDFKLAKLDBENBABMHGJDACMCMFFAFKO_NIHAFKHACOJBI_
OOEDEBO_BGGCMODNHNICODADGJ_JCMG_K_OJAMFHOLJNGCM_LILJB_OFBDOJE_OAHODLIHAGFDIOCICNIMBGNHN_KGEOKCOJBI_
OOEDECLGKJ_EMGGA_OBENFIILCHM_MFAJ_NFHLFDCGBHNNANEANIHLBENODBGCJADFC_LNCBDDLCCHNEAII_HMCCHFHHLCOJBI_
OOEDGJDBCCKNIJCJ_NBNFGDAJCEN_MIMODMAM_GAGCCJ_MAJO_FLNOJFHNHCHKIIM_FHOEIHEJOLCJF_ELHNLKACOGMBFCOJBI_
OOEDGDOJCJDOMALAFIDANFCDGJMHGIMBGNHN_KDJ_OCAJCMFLCLNICOEOAHKGHKA_NBFMCODGDIOJ_JCM_EANMLBNGJGJCOJBI_
OOEDFHEHCFHBAJFG_HLGFDD_JC_MDAMAALMCCHDBAIKJ_EMGGA_OBENFIILBA_LMM_BNKKHHGIBOCDLNA_HFFNHAGGDBCKOJBI_
OOEDGDOGCHKIIM_FHMGHCFAALKIILEO_IFKGNLFKLAKCKNIJCJ_NBNFGDAJCEN_MIMODNHLBGLFJBAGJADO_DLHCIFILACOJBI_
OOEDFHOMBOKAAFNOHKNCAGDIOJCHBMBHCLLFHOEK_OCJDOMALAFIDANFCDGJMHGIMBGNHN_KDJANCGM_ICMLNJAANGJCMCOJBI_
REPLACEMENT VEHICLE NOTATION: DMV WILL

OOEDE_DDCIDGAJNO_LGCDDINOCDLNA_HFFNHAGEMLDCLIGIJFG_HDCCGD_KJNNBANDKLMCCHDBAIJHCAIAIHDIMM_E_BHCOJBI_
OOEDGJCCBIOCA_HOBLKHBGHEIJBCLEJO_FLNOJFHNHCHK_INJ_HMCLFGBAICMBAAIG_DOBLLFINAJINDALDGFNHFBGDFHCOJBI_
OOEDFE_OJBBCMBIN_HAIGDNAAKLKMAGIA_NICODG_EJE_GIHMANKFANGDIOJCHBMBHCLHMG_EDANCDBOIDCGLNLIOGBIOKOJBI_
OOEDGBLOBDMHAOEOJM_NODFF_JLFDALDHNNGKAFIILBA_LMM_BNKKHHDKHNBHCAINOCFLABFDADBCBNOADAHLOGIKDKILCOJBI_
OOEDGJABC_DGELKA_MGHLGJGGCNBHMJ_NBLHCJDINHCDGAAAGLFIHOJDAGICOCBMNHHHM_CJFFCMBBOBANBE_ODDHEAOAKOJBI_
OOEDGFKNBAACMFA_NLOBLGCGNKDDOI_NHFHGJBFGBCJOB_IMBGNHN_KDJ_OBCELAOJLHMAOIEMMNBGMMIHNKHNEOKGBOMKOJBI_
OOEDFDK_CMFGMKA_HKHNAFAJDCGGCAJAKHNFHLFNGCBHA_EHHMLM_MLDMLLBFGFALFDLIGG_E_DDBGGMMKFL_LIC_GFLNCOJBI_
OOEDGDAICLMLMMFA_OBHAFD_NKDCJAOFJ_MCLFGBNAKLEAA_DODM_NDFKLAKCKNIJCJ_NBNFGDCBBHOBAKCLHKNELGJ_ICOJBI_
OOEDGNMMBM_GAMKOBOMFBDIKNCOACEFAINIFGLFIOIBHNOMNHOBHJGHELK_COEHIBFOHOLDMFNILB_NDMJGNDJCKOEK_GKOJBI_
ONLY PROCESS A VEHICLE CHANGE
OOEDDIMLCJACILHELNFHLGJLOKLICMI_DFHILNGGKBBHMHANHENNHDNFBMLBDOGINKCNLHFGGKMDBABAALLBFJCF_DINOCOJBI_
OOEDGLKGBIOKIGIANHKNFDBANKDNHAHHGDOACCGLIFCMILMJO_FHHGIGKCBCMGCILLNBJCLHGFGIKJGCAOGCDLAGDGIDACOJBI_
OOEDEIALCJGLI_LDNHFBGDCLMJCLHIJCOBIJG_ECKOCIMCM_MALIDANG_KNJOMMALOJLNFEOE_HOCGDCIKLBFIOFAGFEOCOJBI_
OOEDGBBGCCADAJCG_LNGCFGCIJHCCAMHDFM_LNGGAIKFDAALKGHLCBAEAMLCIAGAKCF_NECHFBHLBHHBAAB_HMGCLEIHDCOJBI_
(RE-REGISTRATION) USING THE REPLACED
VEHICLE'S CURRENT REGISTRATION.
OOEDDKLBCNAEIDGHHKOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHFENFCOJBI_
OOEDFLENCAOBEHOIBLGLIFCNDKAOBEHOIBLGLIFCNDKAOBEHOIBLGLIFCNDKAOBEHOIBLGLIFCNDKAOBEHOIBLGLIGBCNKOJBI_
OOEDEINCJAHLI_LFDHFCBDCAIBAHLI_LFDHFCBDCAIBAHLI_LFDHFCBDCAIBAHLI_LFDHFCBDCAIBAHLI_LFDHFCBFLDDCOJBI_
OOEDGLIAJOMFAGNK_KOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHGIBDCOJBI_
OOEDEHBCKAOBEHOIBLGLIFCNDKAOBEHOIBLGLIFCNDKAOBEHOIBLGLIFCNDKAOBEHOIBLGLIFCNDKAOBEHOIBLGLIEHFGKOJBI_
OOEDDHFLBAHLI_LFDHFCBDCAIBAHLI_LFDHFCBDCAIBAHLI_LFDHFCBDCAIBAHLI_LFDHFCBDCAIBAHLI_LFDHFCBDHFAKOJBI_
OOEDFDNABOMFAGNK_KOEHEOJLBOMFAGNK_OLMCGDCIJGNDMNLCBNAKIDENHCIC_IGNDLNAFHGMFNCAGHMCCNDOEA_FMNDCOJBI_
OOEDFFKLCG_EMGMLLMGNDDNHAJLACIMCNHNOELEOAHKJOMICLDBOFOJFCMFCKLEMFHG_OEOFDFHGBEANAFBCHLLDOGAGLKOJBI_
Form 1390 NY (02/15) FS-20

Policy Number
932442456
01/28/2021 02/28/2021
12:01 a.m. 12:01 a.m.
An authorized NEW YORK insurer has issued an Owner's Policy of Liability after 45 days from effective date.) INSURED VEHICLE FOR PRODUCTION UPON
Insurance complying with Article 6 (Motor Vehicle Financial Security Act) of DEMAND
Applicable with respect to the
1988 CADIL an ID card knowing that an Owner's Policy of
PO BOX 66 1G6KS5158JU813268 misdemeanor. In addition, a person who
may be committing a misdemeanor.



OOEDGJABC_DGELKA_MGHLGJGGCNBHMJ_NBLHCJDINHCDGAAAGLFIHOJDAGICOCBMNHHHM_CJFFCMBBOBANBE_ODDHEAOAKOJBI_
OOEDGFKNBAACMFA_NLOBLGCGNKDDOI_NHFHGJBFGBCJOB_IMBGNHN_KDJ_OBCELAOJLHMAOIEMMNBGMMIHNKHNEOKGBOMKOJBI_
OOEDFDK_CMFGMKA_HKHNAFAJDCGGCAJAKHNFHLFNGCBHA_EHHMLM_MLDMLLBFGFALFDLIGG_E_DDBGGMMKFL_LIC_GFLNCOJBI_
OOEDEIALCJGLI_LDNHFBGDCLMJCLHIJCOBIJG_ECKOCIMCM_MALIDANG_KNJOMMALOJLNFEOE_HOCGDCIKLBFIOFAGFEOCOJBI_
OOEDGBBGCCADAJCG_LNGCFGCIJHCCAMHDFM_LNGGAIKFDAALKGHLCBAEAMLCIAGAKCF_NECHFBHLBHHBAAB_HMGCLEIHDCOJBI_
OOEDDKLBCNAEIDGHHKOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHFENFCOJBI_
OOEDFDNABOMFAGNK_KOEHEOJLBOMFAGNK_OLMCGDCIJGNDMNLCBNAKIDENHCIC_IGNDLNAFHGMFNCAGHMCCNDOEA_FMNDCOJBI_
OOEDFFKLCG_EMGMLLMGNDDNHAJLACIMCNHNOELEOAHKJOMICLDBOFOJFCMFCKLEMFHG_OEOFDFHGBEANAFBCHLLDOGAGLKOJBI_
Form 1390 NY (02/15) FS-20
FAX: Scanable Bar Code

FAX INSTRUCTIONS:
OOEDFJ_LBADDAHNCDM_HLGKACJDBDAJA_FKINFGDACJFCIIDAK_IAMLDBCKJHHDAAIJ_HDDHFJC_BNNDADFF_HELNEFC_COJBI
OOEDGMFNCNBEIOKFNNHM_GMCGCHELMAKNDOADBGIE_BIOIMGLBNIHOIGNMAJIN_IODMLLBGAFHOKKOAEMNBABODLCGJHBCOJBI
OOEDEFCNBFAGAGAHNIHDNEBGHBHMOADMO_NGJNGAOEKMKNIJGNBINDAELDLCAOFM_GBLOJAMGEOIJDCGMFOGNHNIHGNKBCOJBI
OOEDGJDOBHDBACGC_HDLLFNLHCLIGIJFG_HDCCGD_KJNNBANDKLMCCHDBAIKJ_EMGGA_IGALE_FCCMNFMGANLNKCLEB_DCOJBI
OOEDEGI_CMCCAJGLNODDHFBAMCGGLIMHGDMGHCFGGMCDGDALELLNHCDFKLAKLDBENBABMHGJDACMCMFFAFKO_NIHAFKHACOJBI
1. The entire page must be faxed.

OOEDEBO_BGGCMODNHNICODADGJ_JCMG_K_OJAMFHOLJNGCM_LILJB_OFBDOJE_OAHODLIHAGFDIOCICNIMBGNHN_KGEOKCOJBI
OOEDECLGKJ_EMGGA_OBENFIILCHM_MFAJ_NFHLFDCGBHNNANEANIHLBENODBGCJADFC_LNCBDDLCCHNEAII_HMCCHFHHLCOJBI
OOEDGJDBCCKNIJCJ_NBNFGDAJCEN_MIMODMAM_GAGCCJ_MAJO_FLNOJFHNHCHKIIM_FHOEIHEJOLCJF_ELHNLKACOGMBFCOJBI
OOEDGDOJCJDOMALAFIDANFCDGJMHGIMBGNHN_KDJ_OCAJCMFLCLNICOEOAHKGHKA_NBFMCODGDIOJ_JCM_EANMLBNGJGJCOJBI
OOEDFHEHCFHBAJFG_HLGFDD_JC_MDAMAALMCCHDBAIKJ_EMGGA_OBENFIILBA_LMM_BNKKHHGIBOCDLNA_HFFNHAGGDBCKOJBI
OOEDGDOGCHKIIM_FHMGHCFAALKIILEO_IFKGNLFKLAKCKNIJCJ_NBNFGDAJCEN_MIMODNHLBGLFJBAGJADO_DLHCIFILACOJBI
OOEDFHOMBOKAAFNOHKNCAGDIOJCHBMBHCLLFHOEK_OCJDOMALAFIDANFCDGJMHGIMBGNHN_KDJANCGM_ICMLNJAANGJCMCOJBI
OOEDE_DDCIDGAJNO_LGCDDINOCDLNA_HFFNHAGEMLDCLIGIJFG_HDCCGD_KJNNBANDKLMCCHDBAIJHCAIAIHDIMM_E_BHCOJBI
OOEDGJCCBIOCA_HOBLKHBGHEIJBCLEJO_FLNOJFHNHCHK_INJ_HMCLFGBAICMBAAIG_DOBLLFINAJINDALDGFNHFBGDFHCOJBI
2. If submitted to DMV, either the entire page
OOEDFE_OJBBCMBIN_HAIGDNAAKLKMAGIA_NICODG_EJE_GIHMANKFANGDIOJCHBMBHCLHMG_EDANCDBOIDCGLNLIOGBIOKOJBI
OOEDGBLOBDMHAOEOJM_NODFF_JLFDALDHNNGKAFIILBA_LMM_BNKKHHDKHNBHCAINOCFLABFDADBCBNOADAHLOGIKDKILCOJBI
OOEDGJABC_DGELKA_MGHLGJGGCNBHMJ_NBLHCJDINHCDGAAAGLFIHOJDAGICOCBMNHHHM_CJFFCMBBOBANBE_ODDHEAOAKOJBI
or the second ID card and large scanable
bar code will be retained
OOEDGFKNBAACMFA_NLOBLGCGNKDDOI_NHFHGJBFGBCJOB_IMBGNHN_KDJ_OBCELAOJLHMAOIEMMNBGMMIHNKHNEOKGBOMKOJBI
OOEDFDK_CMFGMKA_HKHNAFAJDCGGCAJAKHNFHLFNGCBHA_EHHMLM_MLDMLLBFGFALFDLIGG_E_DDBGGMMKFL_LIC_GFLNCOJBI
OOEDGDAICLMLMMFA_OBHAFD_NKDCJAOFJ_MCLFGBNAKLEAA_DODM_NDFKLAKCKNIJCJ_NBNFGDCBBHOBAKCLHKNELGJ_ICOJBI
OOEDGNMMBM_GAMKOBOMFBDIKNCOACEFAINIFGLFIOIBHNOMNHOBHJGHELK_COEHIBFOHOLDMFNILB_NDMJGNDJCKOEK_GKOJBI
OOEDDIMLCJACILHELNFHLGJLOKLICMI_DFHILNGGKBBHMHANHENNHDNFBMLBDOGINKCNLHFGGKMDBABAALLBFJCF_DINOCOJBI
3. A faxed ID card must be replaced with a

OOEDGLKGBIOKIGIANHKNFDBANKDNHAHHGDOACCGLIFCMILMJO_FHHGIGKCBCMGCILLNBJCLHGFGIKJGCAOGCDLAGDGIDACOJBI
OOEDEIALCJGLI_LDNHFBGDCLMJCLHIJCOBIJG_ECKOCIMCM_MALIDANG_KNJOMMALOJLNFEOE_HOCGDCIKLBFIOFAGFEOCOJBI
OOEDGBBGCCADAJCG_LNGCFGCIJHCCAMHDFM_LNGGAIKFDAALKGHLCBAEAMLCIAGAKCF_NECHFBHLBHHBAAB_HMGCLEIHDCOJBI
OOEDDKLBCNAEIDGHHKOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHFENFCOJBI
OOEDFLENCAOBEHOIBLGLIFCNDKAOBEHOIBLGLIFCNDKAOBEHOIBLGLIFCNDKAOBEHOIBLGLIFCNDKAOBEHOIBLGLIGBCNKOJBI
OOEDEINCJAHLI_LFDHFCBDCAIBAHLI_LFDHFCBDCAIBAHLI_LFDHFCBDCAIBAHLI_LFDHFCBDCAIBAHLI_LFDHFCBFLDDCOJBI
OOEDGLIAJOMFAGNK_KOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHGIBDCOJBI
scanable ID card within 14 days of the
OOEDEHBCKAOBEHOIBLGLIFCNDKAOBEHOIBLGLIFCNDKAOBEHOIBLGLIFCNDKAOBEHOIBLGLIFCNDKAOBEHOIBLGLIEHFGKOJBI
OOEDDHFLBAHLI_LFDHFCBDCAIBAHLI_LFDHFCBDCAIBAHLI_LFDHFCBDCAIBAHLI_LFDHFCBDCAIBAHLI_LFDHFCBDHFAKOJBI
OOEDFDNABOMFAGNK_KOEHEOJLBOMFAGNK_OLMCGDCIJGNDMNLCBNAKIDENHCIC_IGNDLNAFHGMFNCAGHMCCNDOEA_FMNDCOJBI
effective date.
OOEDFFKLCG_EMGMLLMGNDDNHAJLACIMCNHNOELEOAHKJOMICLDBOFOJFCMFCKLEMFHG_OEOFDFHGBEANAFBCHLLDOGAGLKOJBI
4. DMV will not accept a faxed ID card

without a scanable barcode
Form_SCTNID_CTGRY.NY02151390_IDCARD
<docindex><index>IDCARD</index></docindex>
Policy Number
932442456
01/28/2021 02/28/2021
12:01 a.m. 12:01 a.m.
An authorized NEW YORK insurer has issued an Owner's Policy of Liability INSURED VEHICLE FOR PRODUCTION UPON
after 45 days from effective date.)
Insurance complying with Article 6 (Motor Vehicle Financial Security Act) of Applicable with respect to the DEMAND
2006 DODGE an ID card knowing that an Owner's Policy of
PO BOX 66 1B3AL46TX6N219551 misdemeanor. In addition, a person who
REPLACEMENT VEHICLE may be committing a misdemeanor.



OOEDGJABC_DGELKA_MGHLGJGGCNBHMJ_NBLHCJDINHCDGAAAGLFIHOJF_KMKJAMIJGHLMIOCF_EMCGEOINACFNIMHEAOAKOJBI_
OOEDGFKNCEAOAMDOLNMOJELHFBHINADAKNHHBODO_HKOEHEMBGNHN_KDJ_OBCELAOJLHMAOIEMMNBCLDEGHCFLGIFGBOMKOJBI_
OOEDFDK_CMFGMKA_HKHNAFAJDBOGJAJAKHHKILGKHEJLOKMFGILM_MLFBCCJDCFAAB_HNAJCE_DDBGGMMKFL_LIC_GFLNCOJBI_
OOEDEIALCJGLI_LDNHFBGDCLMJCLHIJCOBIJG_ECKOCIMCM_MALIDANG_KNJCLDIGLFHHAIGFIOHKMOJMHKODOMCBGFEOCOJBI_
OOEDGBBGCMFGMDDA_IKHLGGKIJGGBAFGMNJC_LFNOCJNOKIFFB_MCKLEAHLBAK_EIAMNNCBFGAACKDGGILGFFOGCGEIHDCOJBI_
OOEDDKLBCNECALILLKOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHFENFCOJBI_
OOEDFDNABOMFAGNK_KOEHEOJLBOMFAGNK_HNOMGMJ_KBOAIODAFNNGIGMJACGLKMLBFDKLDOE_OACHLNENADBNIJ_FMNDCOJBI_
OOEDFFKLBMHGIGDAHJBO_EMILBNLGAILHNLHKNEI_GBCHIIALBFKLHADFDCKIGLIKEN_IHHGELACBOHLEIODHMODHGAGLKOJBI_
Form 1390 NY (02/15) FS-20

Policy Number
932442456
01/28/2021 02/28/2021
12:01 a.m. 12:01 a.m.
An authorized NEW YORK insurer has issued an Owner's Policy of Liability after 45 days from effective date.) INSURED VEHICLE FOR PRODUCTION UPON
Insurance complying with Article 6 (Motor Vehicle Financial Security Act) of DEMAND
Applicable with respect to the
2006 DODGE an ID card knowing that an Owner's Policy of
PO BOX 66 1B3AL46TX6N219551 misdemeanor. In addition, a person who
REPLACEMENT VEHICLE may be committing a misdemeanor.



OOEDGJABC_DGELKA_MGHLGJGGCNBHMJ_NBLHCJDINHCDGAAAGLFIHOJF_KMKJAMIJGHLMIOCF_EMCGEOINACFNIMHEAOAKOJBI_
OOEDGFKNCEAOAMDOLNMOJELHFBHINADAKNHHBODO_HKOEHEMBGNHN_KDJ_OBCELAOJLHMAOIEMMNBCLDEGHCFLGIFGBOMKOJBI_
OOEDFDK_CMFGMKA_HKHNAFAJDBOGJAJAKHHKILGKHEJLOKMFGILM_MLFBCCJDCFAAB_HNAJCE_DDBGGMMKFL_LIC_GFLNCOJBI_
OOEDEIALCJGLI_LDNHFBGDCLMJCLHIJCOBIJG_ECKOCIMCM_MALIDANG_KNJCLDIGLFHHAIGFIOHKMOJMHKODOMCBGFEOCOJBI_
OOEDGBBGCMFGMDDA_IKHLGGKIJGGBAFGMNJC_LFNOCJNOKIFFB_MCKLEAHLBAK_EIAMNNCBFGAACKDGGILGFFOGCGEIHDCOJBI_
OOEDDKLBCNECALILLKOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHFENFCOJBI_
OOEDFDNABOMFAGNK_KOEHEOJLBOMFAGNK_HNOMGMJ_KBOAIODAFNNGIGMJACGLKMLBFDKLDOE_OACHLNENADBNIJ_FMNDCOJBI_
OOEDFFKLBMHGIGDAHJBO_EMILBNLGAILHNLHKNEI_GBCHIIALBFKLHADFDCKIGLIKEN_IHHGELACBOHLEIODHMODHGAGLKOJBI_
Form 1390 NY (02/15) FS-20
FAX: Scanable Bar Code

FAX INSTRUCTIONS:
OOEDFJ_LBADDAHNCDM_HLGKACJDBDAJA_FKINFGDACJFCIIDAK_IAMLDBCKJHHDAAIJ_HDDHFJC_BNNDADFF_HELNEFC_COJBI
OOEDGMFNCNBEIOKFNNHM_GMCGCHELMAKNDOADBGIE_BIOIMGLBNIHOIGNMAJIN_IODMLLBGAFHOKKOAEMNBABODLCGJHBCOJBI
OOEDEFCNBFAGAGAHNIHDNEBGHBHMOADMO_NGJNGAOEKMKNIJGNBINDAELDLCAOFM_GBLOJAMGEOIJDCGMFOGNHNIHGNKBCOJBI
OOEDGJDOBHDBACGC_HDLLFNLHCLIGIJFG_HDCCGD_KJNNBANDKLMCCHDBAIKJ_EMGGA_IGALE_FCCMNFMGANLNKCLEB_DCOJBI
OOEDEGI_CMCCAJGLNODDHFBAMCGGLIMHGDMGHCFGGMCDGDALELLNHCDFKLAKLDBENBABMHGJDACMCMFFAFKO_NIHAFKHACOJBI
1. The entire page must be faxed.

OOEDEBO_BGGCMODNHNICODADGJ_JCMG_K_OJAMFHOLJNGCM_LILJB_OFBDOJE_OAHODLIHAGFDIOCICNIMBGNHN_KGEOKCOJBI
OOEDECLGKJ_EMGGA_OBENFIILCHM_MFAJ_NFHLFDCGBHNNANEANIHLBENODBGCJADFC_LNCBDDLCCHNEAII_HMCCHFHHLCOJBI
OOEDGJDBCCKNIJCJ_NBNFGDAJCEN_MIMODMAM_GAGCCJ_MAJO_FLNOJFHNHCHKIIM_FHOEIHEJOLCJF_ELHNLKACOGMBFCOJBI
OOEDGDOJCJDOMALAFIDANFCDGJMHGIMBGNHN_KDJ_OCAJCMFLCLNICOEOAHKGHKA_NBFMCODGDIOJ_JCM_EANMLBNGJGJCOJBI
OOEDFHEHCFHBAJFG_HLGFDD_JC_MDAMAALMCCHDBAIKJ_EMGGA_OBENFIILBA_LMM_BNKKHHGIBOCDLNA_HFFNHAGGDBCKOJBI
OOEDGDOGCHKIIM_FHMGHCFAALKIILEO_IFKGNLFKLAKCKNIJCJ_NBNFGDAJCEN_MIMODNHLBGLFJBAGJADO_DLHCIFILACOJBI
OOEDFHOMBOKAAFNOHKNCAGDIOJCHBMBHCLLFHOEK_OCJDOMALAFIDANFCDGJMHGIMBGNHN_KDJANCGM_ICMLNJAANGJCMCOJBI
OOEDE_DDCIDGAJNO_LGCDDINOCDLNA_HFFNHAGEMLDCLIGIJFG_HDCCGD_KJNNBANDKLMCCHDBAIJHCAIAIHDIMM_E_BHCOJBI
OOEDGJCCBIOCA_HOBLKHBGHEIJBCLEJO_FLNOJFHNHCHK_INJ_HMCLFGBAICMBAAIG_DOBLLFINAJINDALDGFNHFBGDFHCOJBI
2. If submitted to DMV, either the entire page
OOEDFE_OJBBCMBIN_HAIGDNAAKLKMAGIA_NICODG_EJE_GIHMANKFANGDIOJCHBMBHCLHMG_EDANCDBOIDCGLNLIOGBIOKOJBI
OOEDGBLOBDMHAOEOJM_NODFF_JLFDALDHNNGKAFIILBA_LMM_BNKKHHDKHNBHCAINOCFLABFDADBCBNOADAHLOGIKDKILCOJBI
OOEDGJABC_DGELKA_MGHLGJGGCNBHMJ_NBLHCJDINHCDGAAAGLFIHOJF_KMKJAMIJGHLMIOCF_EMCGEOINACFNIMHEAOAKOJBI
or the second ID card and large scanable
bar code will be retained
OOEDGFKNCEAOAMDOLNMOJELHFBHINADAKNHHBODO_HKOEHEMBGNHN_KDJ_OBCELAOJLHMAOIEMMNBCLDEGHCFLGIFGBOMKOJBI
OOEDFDK_CMFGMKA_HKHNAFAJDBOGJAJAKHHKILGKHEJLOKMFGILM_MLFBCCJDCFAAB_HNAJCE_DDBGGMMKFL_LIC_GFLNCOJBI
OOEDGDAICLMLMMFA_OBHAFD_NKDCJAOFJ_MCLFGBNAKLEAA_DODM_NDFKLAKCKNIJCJ_NBNFGDCBBHOBAKCLHKNELGJ_ICOJBI
OOEDGNMMBM_GAMKOBOMFBDIKNCOACEFAINIFGLFIOIBHNOMNHOBHJGHELK_COEHIBFOHOLDMFNILB_NDMJGNDJCKOEK_GKOJBI
OOEDDIMLCJACILHELNFHLGJLOKLICMI_DFHILNGGKBBHMHANHENNHDNFBMLBDOGINKCNLHFGGKMDBABAALLBFJCF_DINOCOJBI
3. A faxed ID card must be replaced with a

OOEDGLKGBIOKIGIANHKNFDBANKDNHAHHGDOACCGLIFCMILMJO_FHHGIGKCBCMGCILLNBJCLHGFGIKJGCAOGCDLAGDGIDACOJBI
OOEDEIALCJGLI_LDNHFBGDCLMJCLHIJCOBIJG_ECKOCIMCM_MALIDANG_KNJCLDIGLFHHAIGFIOHKMOJMHKODOMCBGFEOCOJBI
OOEDGBBGCMFGMDDA_IKHLGGKIJGGBAFGMNJC_LFNOCJNOKIFFB_MCKLEAHLBAK_EIAMNNCBFGAACKDGGILGFFOGCGEIHDCOJBI
OOEDDKLBCNECALILLKOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHFENFCOJBI
OOEDFLENCAOBEHOIBLGLIFCNDKAOBEHOIBLGLIFCNDKAOBEHOIBLGLIFCNDKAOBEHOIBLGLIFCNDKAOBEHOIBLGLIGBCNKOJBI
OOEDEINCJAHLI_LFDHFCBDCAIBAHLI_LFDHFCBDCAIBAHLI_LFDHFCBDCAIBAHLI_LFDHFCBDCAIBAHLI_LFDHFCBFLDDCOJBI
OOEDGLIAJOMFAGNK_KOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHEOJLBOMFAGNK_KOEHGIBDCOJBI
scanable ID card within 14 days of the
OOEDEHBCKAOBEHOIBLGLIFCNDKAOBEHOIBLGLIFCNDKAOBEHOIBLGLIFCNDKAOBEHOIBLGLIFCNDKAOBEHOIBLGLIEHFGKOJBI
OOEDDHFLBAHLI_LFDHFCBDCAIBAHLI_LFDHFCBDCAIBAHLI_LFDHFCBDCAIBAHLI_LFDHFCBDCAIBAHLI_LFDHFCBDHFAKOJBI
OOEDFDNABOMFAGNK_KOEHEOJLBOMFAGNK_HNOMGMJ_KBOAIODAFNNGIGMJACGLKMLBFDKLDOE_OACHLNENADBNIJ_FMNDCOJBI
effective date.
OOEDFFKLBMHGIGDAHJBO_EMILBNLGAILHNLHKNEI_GBCHIIALBFKLHADFDCKIGLIKEN_IHHGELACBOHLEIODHMODHGAGLKOJBI
4. DMV will not accept a faxed ID card

without a scanable barcode

New York State Insurance Identification Card: FS-20 Form 1390 NY (02/15)

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Copyright:

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New York State Insurance Identification Card: FS-20 Form 1390 NY (02/15)

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Form_SCTNID_CTGRY.

The name of the registrant and the name of the

insured must coincide.

REPLACEMENT VEHICLE NOTATION: DMV WILL

Form 1390 NY (02/15) FS-20