Home State County Mutual Insurance Company Policy Number:

Underwritten Through
SNAP Insurance Service, LLC
P.O. Box 548 Rockwall, TX 75087 SNH363846-003
P(214) 304-2979 / (800) 297-9762 F(800) 474-3136
www.snapmga.com

TEXAS
RENEWAL POLICY DECLARATIONS PAGE
This Declarations is subject to all of the terms and conditions of the policy and shall continue in force for the period shown, provided the required premium is paid.
Policy Period Producer
Effective Date: STATEWIDE INSURANCE AGENCY-EDINBURG (421012003)
06/17/2023 at 12:01 AM CST 1317 S CLOSNER BLVD
Expiration Date: EDINBURG, TX 78539
07/17/2023 at 12:01 AM CST 956-318-0013
Policyholder(s)
Phone Number: 956-450-9576
VERONICA GARCIA AGUILAR
E-mail Address:
3028 BOARDERS DR
EDINBURG, TX 78542
Vehicle(s)
Veh Year Make/Model/Body Style VIN# Symbol 4WD Conv Vehicle Usage Dr Class Terr
1 2017 Volkswagen / JETTA SE / 4 Door S 3VWDB7AJ4HM292382 23 N N Pleasure MF49 57
2
3
4
Lienholder / Loss Payee / Additional Interest
Veh Name / Financial Institution Address City State Zip

Driver(s)
Drv Name DOB Age Mar Status Sex Dr. Lic# Lic State Points Surcharges Status SR-22
1 VERONICA GARCIA AGUILAR 02/03/1974 49 M F 202866758 IT 0 Non-US Rated No
2 RAUL RUIZ 03/01/1969 54 M M 00745969 TX 0 Rated No

The Named Insured warrants there are no other drivers in the household other than those listed in the Application or Endorsement.
Coverages
Coverages Limits of Liability Veh 1 Veh 2 Veh 3 Veh 4
Bodily Injury Liability $30,000/$60,000 each Person/each Accident $29.36
Property Damage Liability $25,000 each Accident $20.48
Mexico 550A Mexico Coverage Endorsement REJECTED
Personal Injury Protection REJECTED each Person
Uninsured/Underinsured Bodily Injury Liability REJECTED each Person/each Accident Rejected
Uninsured/Underinsured Property Damage Liability REJECTED each Accident Rejected
Comprehensive V1: Rejected Deductible
Collision V1: Rejected Deductible
Towing and Labor V1: Rejected each Disablement
Rental ($ per Day / $ Max) V1:Rejected each Accident
Custom Equipment V1: Rejected
Vehicle Totals $49.84
Forms and Endorsements made part of this policy Total Premiums $49.84
515A, AE.HSCM.2018, AT.HSCM.2006, BU.HSCM.2013, CI.HSCM.2010, CIRP.HSCM.2010, CL.HSCM.2006, DF.HSCM.06.B, Application Fee $13.00
DV.HSCM.2016, HSCM.TX-App ed.4, HSCMTX. F&L ed.2, MF.HSCM.2010, OOS.HSCM.2006, PD.HSCM.2016, PUN.HSCM. SR-22 Fee $0.00
2008, RP.HSCM.2020, ST.HSCM.2006, TempVeh.HSCM.2020, YCA.HSCM.2013, MVCPA Fees $0.34
For a copy of our Notice of Privacy Policy, please visit our website at https://snapmga.com/downloads/en/en_texas_privacy_policy.pdf Total Policy Premium $63.18
Discounts Surcharges
Prior Insurance,In Agency Transfer,Veh 1:Business Use Exclusion Non US Citizen Surcharge

The Insurance afforded is only with respect to the coverage or groups of coverages as are Indicated herein by a specific premium charge or charges. The limit of the Company’s liability against
each such coverage shall be as stated herein, subject to all the terms of this policy having reference thereto and shall not be increased regardless of the number of premiums charged or the number
of automobiles or trailers to which this policy applies.
We agree to make available to you an installment payment plan as described in Rule 14 of the Texas Automobile Rules and Rating
Manual, except when an installment payment plan is prohibited by other rule or statue.
NOTICE: Your payment includes a _______$0.34 fee. This fee goes to help fund: (1) auto burglary, theft, and fraud prevention, (2) criminal
justice efforts, and (3) trauma care and emergency medical services for victims of accidents due to traffic offenses. By law, we send this
fee to the Motor Vehicle Crime Prevention Authority (MVCPA).

The insured can access a copy of the Texas Personal Auto Policy at:https://snapmga.com/downloads/en/en_texas_snh.pdf
or request a free copy of the policy by contacting their agent or calling our office at (800)-297-9762 COUNTERSIGNED:

***This Policy Contains a Named Driver Exclusion*** SNAP Insurance Service, LLC
HSCMTX-Dec ed.3
 Home State County Mutual Insurance Company Policy Number:
Administrated Through SNH363846-003
SNAP Insurance Service, LLC
P.O. Box 548
www.snapmga.com Rockwall, Texas 75087
(214) 304-2979 / (800) 297-9762
Fax (800) 474-3136

TEXAS LIABILITY INSURANCE CARD

INSURANCE COMPANY: HOME STATE COUNTY MUTUAL INSURANCE COMPANY
TO REPORT A CLAIM: NAME OF INSURED(S): POLICY NUMBER: SNH363846-003
(800) 297-9762 VERONICA GARCIA AGUILAR
EFFECTIVE DATE: 06/17/2023
RAUL RUIZ EXPIRATION DATE: 07/17/2023

AGENT/PRODUCER: ***This policy contains a named driver exclusion***

***No coverage for damage to rental vehicles***
STATEWIDE INSURANCE
AGENCY-EDINBURG
(421012003)
1317 S CLOSNER BLVD
EDINBURG, TX 78539
956-318-0013

ADDRESS OF INSURED(S): VERONICA GARCIA AGUILAR

3028 BOARDERS DR
EDINBURG, TX 78542

VEHICLES
YEAR MAKE / MODEL / BODY STYLE VIN
2017 Volkswagen / JETTA SE / 4 Door S 3VWDB7AJ4HM292382

This policy provides at least the minimum amounts of liability insurance required by the Texas Motor Vehicle Safety Responsibility Act for the specified
vehicles and named insureds and may provide coverage for other persons and vehicles as provided by the insurance policy.
Please call (800) 297-9762 to verify coverage.

Texas Liability Insurance Card Tarjeta de Seguro de

Responsabilidad Civil de Texas
Keep this card Guarde esta tarjeta

IMPORTANT: You must show this card or a copy of IMPORTANTE: Usted debe mostrar esta tarjeta o una copia de su
your insurance policy when you apply for or renew your: póliza de seguro cuando solicite o renueve su:
• motor vehicle registration • registro del vehículo de motorizado
• driver's license • licencia de conducir
• motor vehicle safety inspection sticker. • etiqueta de inspección de seguridad para su vehiculo.

You also may be asked to show this card or your policy if También se puede pedir que usted muestre esta tarjeta o su
you have an accident or if a peace officer asks to see it. póliza si tiene un accidente o si se la pide un official de
policía.
All drivers in Texas must carry liability insurance on their
Todos los conductores en Texas deben tener un seguro de
vehicles or otherwise meet legal requirements for financial
responsabilidad civil para sus vehículos, o de lo contrario
responsibility. If you do not meet your financial
deben cumplir con los requisitos legales de responsabilidad
responsibility requirements, you could be fined up to
financiera. Si usted no cumple con los requisitos de
$1,000, your driver's license and motor vehicle
responsabilidad financiera, podría estar sujeto a pagar una
registration could be suspended, and your vehicle could be
multa de hasta $1,000, mas la suspensión de su licencia de
impounded for up to 180 days (at a cost of $15 per day).
conducir y la suspensión del registro del vehículo, y además su
IMPORTANTE: Si usted desea una tarjeta official de vehículo podría ser confiscado por hasta 180 días (a un costo
comprobante de seguro escrita en español, comuníquese de $15 por día).
con su agente de seguros a este número: (800) 297-9762.
SNAP Insurance Service, LLC
HSCM-ID-2020