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---
type: insurance
category: auto insurance
person: Yanxin Lu, Xuewei Jiang
date: 2021-06-28
source: insurance.pdf
---
# GEICO Insurance Policy - Cover Letter & ID Cards
## Cover Letter
**Policy Number:** 4573-97-12-09
**Policyholder:**
YANXIN LU AND XUEWEI JIANG
11950 IDAHO AVE APT 113
LOS ANGELES CA 90025-5794
**Active Drivers:**
- YANXIN LU
- XUEWEI JIANG
Dear Policyholder,
Policy Identification Cards (Insurance ID Cards) have been provided for each insured vehicle.
**Any driver covered on your policy can present the attached ID Cards as valid proof of insurance. You do not need a separate ID Card for each driver.** For your convenience, we have listed all Active Drivers on this policy below.
This letter is for informational purposes only and is not official proof of insurance. Please notify us promptly of any changes in your address to be sure you receive all important policy documents. Prompt notification will enable us to better serve you. If you need additional ID Cards for a new vehicle, vehicle registration or just another card for your records, you can log into the GEICO Mobile app or visit geico.com.
IDCOVLTR (08-19)
---
## Evidence of Insurance - Instructions
Here are your Evidence of Liability Insurance Cards. Two cards have been provided for each vehicle insured. One card must be carried in the proper insured vehicle. Proof of insurance is required to register or renew the registration of your vehicle. A law enforcement officer can ask you to prove that you have liability insurance meeting the basic requirements of California law.
A violation of these requirements can result in a fine of up to:
- $1,000 for the first time
- $2,000 for additional times
Also, a judge can have your vehicle impounded. False proof of insurance may result in a fine up to $750 and 30 days in prison.
Due to space limitations on the ID card, only the Named Insured and the Co-insured are listed. For a full list of drivers covered under this policy, please reference the Drivers section of your Declarations Page, which is included with your insurance packet.
If you would like additional ID cards you can go online to geico.com or call us at 1-800-841-3000.
---
## California Evidence of Liability Insurance Card
| Field | Details |
|---|---|
| **Insurer** | GEICO GENERAL INSURANCE COMPANY |
| **Address** | P.O. Box 509090, San Diego, CA 92150-9090 |
| **Phone** | 1-800-841-3000 |
| **NAIC Code** | 35882 |
| **Policy Number** | 4573-97-12-09 |
| **Effective Date** | 06-28-21 |
| **Expiration Date** | 12-28-21 |
### Vehicle Information
| Year | Make | Model | Vehicle ID No. |
|---|---|---|---|
| 2016 | HONDA | CIVIC | 19XFC2F7XGE093564 |
### Insured
Yanxin Lu
Xuewei Jiang
11950 Idaho Ave Apt 113
Los Angeles CA 90025-5794
The coverage provided by this policy meets the minimum requirements of sections 16056 & 16500.5 of the California Vehicle Code, minimum liability limits prescribed by the law.
---
## What To Do at the Time of an Accident
- Do not admit fault.
- Do not reveal the limits of your liability coverage to anyone.
- Exchange contact information; get year, make, model, plate number, insurance carrier and policy number of all involved. Also, identify witnesses and collect contact information.
- Contact the police or 911 if applicable.
- Contact GEICO by calling **1-800-841-3000** or visit **geico.com** to report the accident.
**Need a tow or roadside assistance?**
Call **1-800-424-3426** to reach GEICO's **Emergency Road Service (ERS)**.
U-4-CA (11-09)

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---
type: dmv form
category: title/registration application
person: Xuewei Jiang
date: 2021-07-29
source: title_application.pdf
---
# Application for Title or Registration (REG 343)
**Form:** REG 343 (REV. 4/2021) WWW
**Agency:** State of California, Department of Motor Vehicles - A Public Service Agency
---
## Section 1 -- Vehicle Information
| Field | Value |
|---|---|
| **Vehicle Identification Number** | 19XFC2F7XGE093564 |
| **Vehicle Make** | Honda |
| **Year Model** | 2016 |
| **Fuel Type** | Gas |
| **California License Number** | *(blank)* |
| **Model or Series** | Civic |
| **Body Type Model** | EX |
| **Motorcycle Engine Number** | *(blank)* |
**Type of Vehicle:** [X] Auto (includes truck or pickup)
**For Trailer Coaches Only:** *(not applicable)*
- Will this vehicle be used for the transportation of persons for hire, compensation, or profit? **No** [X]
- Is this a commercial vehicle that operates at 10,001 lbs. or more? **No** [X]
**For Commercial Vehicles Only:** *(not applicable)*
---
## Section 2 -- Owner Information
| Field | Value |
|---|---|
| **True Full Name of Owner** | *(blank)* |
| **Driver License/ID Card Number** | *(blank)* |
| **Co-Owner/Lessee** | *(blank)* |
| **Physical Residence or Business Address** | 11950 Idaho Ave. |
| **Apt./Space/Ste. No.** | Apt. 113 |
| **City** | *(blank)* |
| **State** | CA |
| **Zip Code** | 90025 |
| **County of Residence** | Los Angeles |
| **Equipment Number** | *(blank)* |
| **Mailing Address** | *(blank)* |
| **Lessee Address** | *(blank)* |
---
## Section 3 -- Legal Owner (Lien Holder/Title Holder)
**True Full Name of Bank/Finance Company or Individual:** None
---
## Section 4 -- Odometer Information
- [X] As of this date is (if no change in ownership): **28,579** miles
- Odometer reading reflects the **ACTUAL** mileage
- No odometer discrepancy noted
---
## Section 5 -- Date Information
| Field | Value |
|---|---|
| **Date Vehicle Entered or Will Enter California** | Month: 11, Day: 21, Year: 2020 |
| **Date Vehicle First Operated in California** | *(blank)* |
| **Date You Went to Work in CA / Obtained CA DL / Became a Resident** | *(blank)* |
| **Date Vehicle Was Purchased or Acquired** | Month: 10, Day: 23, Year: 2016 |
| **Condition** | [X] New |
| **Purchased** | [X] Outside CA |
---
## Section 6 -- Cost Information
- [X] **PURCHASE** -- I purchased the vehicle for the price of $ *(amount blank)*
**Vehicle Was Purchased or Acquired From:**
- [X] Dealer
**Body type modifications made?** *(not checked -- implied No)*
---
## Section 7 -- For Out-of-State or Out-of-Country Vehicles
- Sales Tax paid to another state? [X] **N/A**
- Disposition of Out-of-State Plates: [X] **Expired**, or will be or were
---
## Section 8 -- Military Service Information
- Are you or your spouse on active duty as a member of the U.S. Uniformed Services? **No** [X]
- When this vehicle was last licensed, were you or your spouse on active duty? **No** [X]
---
## Section 9 -- Certifications
*I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct.*
| Field | Value |
|---|---|
| **Printed Name** | Xuewei Jiang |
| **Owner's Signature** | X *(signed)* |
| **Date** | 07/29/2021 |
| **Daytime Telephone Number** | (254) 214-9350 |
| **Co-Owner** | *(blank)* |