Identification Cards = -38-- “peinistieay FaNeIAL FIRST ACCEPTANCE INS. co, INC. 1 must be carrie for production upon demand, [evr snopes hat you cay card nthe inured vehicle Policy Number: Eifecve Date Expiration Date: ' WARNING: Any owner regis of moor eile who dives ce Tapa 000001355 01/13/2023 on/ha/a0ad 3 pana a motor veil o be drven inthis State without the rquced 12 RR Spe Seats pmaeroe NOT. YALIO MORE THAN 1 YEAREROM EIFECTE OTE 1 ‘NOTE: THUS CARDS REQUIRED WHEN ote oer ve Rrceeteeere ee | OYS irvene 2096 nomen oot sermndseseetosein $8 SP yorum pins SP ig te We AG. "esaeemeeaetecmer Insured LUIS FeLi Agent Prone number | Fee Raper Al Ach meaty Repro Fat Igoncy: MULTNBURANCE (croseraee Fo areas eeu aatestiomce teva is sce “Seta PA 620 04.17‘Company: First Acceptance Insurance Company, Inc. (acceptance Typeof insurance: Personal Auto iainichetnestenss DECLARATIONS PAGE P.O. Box 23410 Policy Number: JAPA 000001355 Nashville, TN 37202 Effective Date: 01/3/2023 10:58 AM Policy Period: 0113/2023 to 07/13/2023, Be Customer Service: 1-800-321-0899 Se Habla Espanol 1-888-922-7767 mu gree LTINSURANCE 707 S FILMORE ST A10N7TH ST ALLENTOWN, PA18102 ALLENTOWN, PA 18103 610-351-6462 3 VEHICLE INFORMATION ar wooee T Dasa wo | "vear | __ axe Bil ree ECcEE vw mci | am | rains | competion or 2008 HONOR ooveeeY Rca (The aut eras) descanes nis ploy la poncpaly garaged atthe aboveadiess unless cthenisestaied —__ LIENHOLDER INFORMATION Wwe le payment to the neued fr comprehen or olson insurance, we py the insured a he fowng Henle adionl interest INTEREST NAME I INTEREST ADDRESS INTEREST PHONE NUMBER ‘COVERAGES AND PREMIUMS BY VEHICLE ‘purchased the comprehensive olson ddl select foreach vehicle sted Inthe "Vehicle Information” sation. [suas von | peo [et [pe [aoe [rae Bayi re ee. vm Tar REPRE —— 00 . IF YOU PAY A PREMIUM FOR COLLISION COVERAGE, YOUR POLICY EXTENDS TO A SUBSTITUTE VEHICLE RENTED BY YOU OR A RELATIVE FROM [A Ucensen RENTAL AGENCY OR CAR OEALERGNIP, SUBJECT TO THE DEFINITIONS AND PROVISIONS CONTAINED IM YOUR POLICY, INCLUDING “Ths policy doesnot provie protection aginst damages caused by uninsured ot underinsured motorists Ityou wish oa his important coverage loase contact yourlcal agent s hal he proper paperwork can beled out and processed bythe company. PA 2004.17DRIVER INFORMATION No onven NAME oo so Mis __|_pustare custarus | stars + wis Lz ‘aaa « s ra ‘tive 2 Luciano GUTIERREZ ‘on s962 « * Pa Excluded a CCHRIGTINA KRAFT corarse83 F . Pa Excused 4 ALEMBERT MONEGRO-RUZ oamser7 " 5 Pa Excluded 5 [BRANDALYW NIELSEN oraxser2 F 5 Pa Excluded ‘ JONATHAN RODRIGUEZ ‘ousaieen " . Pa Excluded PREMIUM SUMMARY Pouer Fee 3000 TOTALGHARGES: 240.00 “AEE OF 1200 1S CHARGED FOR EACH INSTALLMENT. Diecounts: We oer Pasve Restraint Discount, Aa Theft Ducount and Driver Improvement Curse Discount in acordance with Tite 75.0 he Pennsyvania ‘ometeeaSetter [ aw wee 4 i ENDORSEMENT CHANGES 2 ELibisen eeeeeess ENDORSEMENT GRANGE NN The above endorsement(s) has increased/decreased your premium by $xxx.x4] PA 100447 PERSONAL AUTO POLICY ENDORSMENTS MADE PART OF THIS POLICY AT TIME OF ISSUE 'PAA2 NAMED ORVER EXCLUSION ‘Any parson whe knowingly and with intnt to defraud any insures company eof pern fle an application for insurance o statement of cain Cchusring any matty false infomation or eons fore purpose afmileding, Ifemadan concerning. any fact material thereto commits = itaudlen surance 8c which sa cite and sjecs such person to tina and cil penalties Note: i you fal to receive any ofthe above poley forms or endorsements or for adetionalcople, please contact: Acceptance Auto Insurance, P.O Bex 16076, Nashville, TW 37215 PA 2000.17