Florida Departments Busines Professidrral Regulation Rick Scott, Gevemor . Ken Lawson, Secretary SON, BECTELATY PAGE 7 RE: CASE NUMBER 2016008716 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO PETITIONER, VS. MAHMOUD! KHALED D/B/A JAX CONVENIENCE FOOD STORE LICENSE NUMBER BEV2603171 SERIES 2APS RESPONDENT ADMINISTRATIVE COMPLAINT Comes now, the Division of Alcoholic Beverages and Tobacco, herein after referred to as “petitioner,” and files this administrative complaint against MAHMOUD! KHALED herein after referred to as “respondent,” and alleges: 1. 904.727.5550, Petitioner is the state agency charged with supervising businesses licensed under the Florida beverage, tobacco and tax, and tobacco products permit laws pursuant to sections 559.061, 561.07, 561.15, 561.19, 561.29, 561.501, 210.15, 210.16, 210.45, 210.50, 569.003, and 569.006, Florida Statutes. , Respondent is, and has been at all times material hereto, the holder of a valid license/permit, issued in the State of Florida, by the Division of Alcoholic Beverages and Tobacco. Respondent's last known mailing address is as follows: MAHMOUDI KHALED D/B/A JAX CONVENIENCE FOOD STORE 3467 LAKESHORE BLVD JACKSONVILLE, FL 32210 . And the division has not been notified of any other designated person or address for the service of process and notices authorized by Rule 61A-2.012, Florida Administrative Code. : Petitioner intends to revoke; suspend; annul; impose civil penalties, investigative costs, and late penalties; or any combination of these authorized penalties. This intended action is based on the below described facts or conduct. 4161 Carmichael Avenue www. MyFloridalicense.com 3300 Bidg., Suite 200A License Efficiently. Regulate Fairly. * Jacksonville FL 32207 Florida Department Business (0 Professiorral Regulation xe Sat. Gover PAGE 8 RE: CASE NUMBER 2016008716 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO VS. MAHMOUD! KHALED D/B/A JAX CONVENIENCE FOOD STORE LICENSE NUMBER BEV2603171 You, MAHMOUD! KHALED, D/B/A JAX CONVENIENCE FOOD STORE, are charged with the following count(s): 1, On or ‘about 02/23/2016, you, the aforementioned licensee, holding a license issued by the Division of Alcoholic Beverages and Tobacco, or your agent(s), officer(s), servant(s), or employee(s) did unlawfully and who knowingly sells or offers to sell 533 packs of cigarettes in violation of section 633.142(4), Florida Statutes, within 210.16, or 210.50, or 561.29(1)(a), Florida Statutes. Signed this February 23, 2016 Thomas R. Philpot, Director Division of Alcoholic Beverages & Tobacco Hawn Lawrence Hayes Law Enforcement Captain Explanation of Service: Date Served Received By. Personal Service By (sign) Personal Service By ___(print) Service Location Certified Mail # *Altach Receipt if Served by Mail. 904.727.5550 . 4161 Carmichael Avenue www. MyFloridaLicense.com 3300 Bidg., Suite 200A License Efficiently. Regulate Fairly. Jacksonville FL 32207

Docket for Case No: 16-001855