Property & Casualty Transmittal Document (Revised 1/1/05) 2. Insurance Department Use only a.Date the filing is received: b.Analyst: c.Disposition: d.Date of disposition of the filing: e.Effective date of filing: f.State Filing #: Reserved for Insurance Dept. Use Onlyg.SERFF Filing #: 3.Group NameGroup NAIC # The Allstate Group008 4.Company Name(s)DomicileNAIC #FEIN # Allstate Indemnity CompanyIL1924036-6115679 5.Company Tracking NumberR16067 Contact Info of Filer(s) or Corporate Officer(s)[include toll-free number] 6.Name and AddressTitleTelephone #sFAX #e-mail John F. Brady 2775 Sanders Road, SuiteA5NorthbrookIL60062 State FilingsDirector800-366-2958 Ext.25659 847-402-9757[email protected] 7.Signature of authorized filerJohn Brady 8.Please print name of authorized filerJohn F. Brady Filing Information(see General Instructions for descriptions of these fields) 9.Type of Insurance (TOI)Private Passenger Auto (800) 10.Sub-Type of Insurance (Sub-TOI) Personal Auto (106) 11.State Specific Product Code(s) (if applicable) [See State Specific Requirements] 12.Company Program Title(Marketing Title) Rate/Loss CostRulesRates/Rules FormsCombination Rates/Rules/Forms WithdrawalOther (give description) 13.Filing Type14.Effective Date(s) RequestedNew:8-15-2005Renewal:9-24-2005 15.Reference Filing?YesNo 16.Reference Organization(if applicable) N/A 17.Reference Organization # & Title 18.Company's Date of Filing 7-7-2005 19.Status of filing in domicileNot FiledPendingAuthorizedDisapproved
Effective January 1, 2005 PC TD-1 Page 2 of 2 INS01472Property & Casualty Transmittal Document 20.This filing transmittal is part of Company Tracking #R16067 21.Filing Description[This area should be similar to the body of a cover letter and is a free-form text] This is our annual EGR update filing.We are filing new 2006 S&I and EGR factor pages, as well as updates to model years 2004-2005.The attached Filing Memorandum provides details of our filing
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