HomeMy WebLinkAboutInsurance Certificate: Baldwin, Randy & Michelle (2)
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DATE OF NOTICE: JUN 25 2015
PO Box 799100 CODE:
Dallas TX 75379
126
AT1 15 A
002979 ooss NOTE: PLEASE NOTIFY STATE FARM AT THE
CITY OF ASHLAND ADDRESS LISTED AT THE TOP, LEFT CORNER
20 E MAIN ST OF THIS PAGE REGARDING ANY CHANGE OF
ASHLAND OR 97520-1850 ADDRESS INFORMATION.
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NOTICE OF TERMINATION OF A THIRD PARTY INTEREST 7771
State Farm Mutual Automobile Insurance Company 2339-FAE&A
NAMED INSURED: POLICY NO: 263 7835-A16-37B COVERAGE:
BALDWIN, RANDY & MICHELLE YR/MAKE/MODEL: 2012 CHEVROLET PICKUP
0 2852 FREDRICK DR VIN/CAMPER: 1GCNCPEX4CZ127877
c: MEDFORD OR 97504-5179 AGENT NAME: RUSS WIMMER INS AGENCY INC
AGENT PHONE: (541)776-7877
c 3RD PARTY INTEREST TERMINATED
EFFECTIVE JUL 08 2015
POLICY MESSAGES:
* Protection of the third party's interest provided by this policy is terminated as of the effective date above for the following reason: Third party
o interest terminated. This advance notice is solely to protect the third party's interests as they are affected by the ownership, maintenance, or
co use of the car described in the policy.
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