NOTICE OF CANCELLATION FOR NON PAYMENT OF PREMIUMCITIZENS
Citizens Property
Insurance Corporation
Citizens Service Center
6676 Corporate Center Parkway
Jacksonville, FL 32216 -0973
Date of Notice: October 21, 2013
First Llenholder:
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CITY OF CLEARWATER
2205 ISAOA - ATIMA
112 S. OSCEOLA AVE
CLEARWATER, FL 33756
CANP1 04 08
Send All Remittances To:
Citizens
PO Box 17850
Jacksonville, FL 32245 -7850
Policy Number: FRJH0807956
Named Insured:
MARTHA L. LITTLETON
1750 FULTON AVE
CLEARWATER, FL 33755
NOTICE OF CANCELLATION FOR NON PAYMENT OF PREMIUM
EFFECTIVE 11/2/2013 AT 12:01 A.M. EASTERN TIME
We have not received premium payment on policy FRJH0807956. Therefore, your policy will be cancelled as of the
date and time shown above.
If payment of the amount past due is received before the effective date of cancellation, the policy will continue in full
force and effect and we will mail you a notice withdrawing this cancellation.
Please contact your agent if you have any questions:
INSURANCE BUREAU, INC. Loan Number: Not Provided
2170 RAINBOW DRIVE
CLEARWATER, FL 33765
(800) 891-4222
MID: 2077 / AID: 2097 / Fib: 1
Please detach and submit this portion with your payment.
FRJH0807956 MARTHA L. LITTLETON
Payment must be received before
11/2/2013
First Lienholder Copy
Citizens
PO Box 17850
Jacksonville, FL 32245 -7850
$327.00
Total Payment Enclosed
Make Checks Payable to
Citizens
FRJH080795I89999999999000000327007