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PREMIUM NOTICE <br /> STATE FARM INSURANCE COMPANIES <br /> AGENT ISSUED DECLARATIONS <br /> 1 POLICY NUMBER 1 BILLING PERIOD 1 AGENT CODE 1 <br /> 1 34 -BR- 5615 -1 1 FROM 12/20/2013 1 TO 12/20/2014 I 968A <br /> LOCATION <br /> 458 N SEDONA DR <br /> WEST FARGO, ND 58078 -8104 <br /> INSURED PREMIUM 2,070.00 <br /> VOLK, CALVIN STEPHANIE <br /> 458 N SEDONA DR AMOUNT PAID SFPP <br /> WEST FARGO, ND 58078 -8104 <br /> AMOUNT DUE SFPP <br /> DATE DUE <br /> ADDITIONAL INSURED AGENT NAME ADDRESS <br /> CASS COUNTY GOVERNMENT JEFFERSON, THOMAS E <br /> PO BOX 2806 3330 FIECHTNER DRIVE SW <br /> FARGO, ND 58108 -2806 FARGO, ND <br /> Loan Number: 58103 -2321 (701)234 -0507 <br /> This is the only notice you will receive. Please make check payable <br /> to STATE FARM and return it with this notice to the address shown below. <br /> Your canceled check is your receipt. Thanks for letting us serve you. <br /> STATE FARM INSURANCE COMPANIES <br /> 222 SOUTH 84TH STREET <br /> LINCOLN NE 68510 <br />