Lb B45 P- FILED JUN 26 2002 THE TREASURER OF THE STATE OF FLORIDA DEPARTMENT OF INSURANCE TOM GALLAGHER IN THE MATTER OF: JACK J. BIRDENS ADMINISTRATIVE COMPLAINT TO: JACK J. BIRDENS 12125 Florida Avenue Hobe Sound, FL 33475-0130 JACK J. BIRDENS PO Box 131 Hobe Sound, FL 33475-0131 You, JACK J. BIRDENS, license I.D. #D077305, are hereby notified that the Insurance Commissioner of the State of Florida has caused to be made an investigation of your activities while licensed as an insurance agent in this state, as a result of which it is alleged: GENERAL ALLEGATIONS 1. Pursuant to Chapter 642, Florida Statutes, you, JACK J. BIRDENS, are currently licensed in this state as a Legal Expense Insurance (2-56) agent. 2. Pursuant to Chapter 642, Florida Statutes, the Florida Department of Insurance (hereinafter “Department”) has jurisdiction over your insurance license and appointments. 3. On or about October 20, 1993, in the Nineteenth Judicial Circuit Court in and for Martin County, Florida, you, JACK J. BIRDENS, pled nolo contendere to Aggravated Child Abuse, a felony. On or about October 20, 1993, you, JACK J. BIRDENS, were adjudicated guilty and were placed on five (5) years of probation. COUNT I 4. The above general allegations are realleged and fully incorporated herein by reference. 5. On or about May 7, 2001, you, JACK J. BIRDENS, did swear to and sign an application for licensure as a Legal Expense Insurance (2-56) agent, which was filed with the Department. 6. On the aforementioned application, you, JACK J. BIRDENS, while under oath, and in response to the question: "Have you ever been convicted, found guilty, or pleaded guilty or nolo contendere (no contest) to a felony under the laws of any municipality, county, state, territory, or country, whether or not adjudication was withheld or a judgment of conviction was entered?”, did answer in the negative. 7. On the aforementioned application, you, JACK J. BIRDENS, while under oath, and in response to the question: "Have you ever been convicted, found guilty, or pleaded guilty or nolo contendere (no contest) to a crime punishable by imprisonment of one (1) year or more under the laws of any municipality, county, state, territory, or country, whether or not adjudication was withheld or a judgment of conviction was entered?”, did answer in the negative. 8. On the aforementioned application, you, JACK J. BIRDENS, in your answers to the above-referenced questions, knew or should have known that your responses to said questions were false and material misrepresentations of fact, based upon you previously having pleaded nolo contendere to felony charge referenced in paragraph 3 above. 9. Relying, in part, on your sworn denial of having pleaded nolo contendere to any prior felony charges in your application for licensure, the Department did license you, JACK J. BIRDENS, as a Legal Expense (2-56) agent on May 30, 2001. IT IS THEREFORE CHARGED that you, JACK J. BIRDENS, have violated or are accountable under the following provisions of the Florida Insurance Code and Rules of the Department of Insurance which constitute grounds for the suspension or revocation of your licenses and appointments: (a) Material misstatement, misrepresentation, or fraud in attempting to obtain the license or appointment. [Section 642.041(1), Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of legal expense insurance. [Section 642.041(5), Florida Statutes]; (c) Willful failure to comply with, or willful violation of, any proper order or rule of the department or willful violation of any provision of ss. 642.011-642.049, [Section 642.041(10), Florida Statutes]; (d) Any cause for which issuance of the license or permit could have been refused had it then existed and been known to the department at the time of application. [Section 642.043(1), Florida Statutes]; (e) Having been found guilty of or having pleaded guilty or nolo contendere to a felony or a crime punishable by imprisonment of 1 year or more under the law of the United States of America or of any state thereof or under the law of any other country, whether or not a judgment of conviction has been entered. [Section 642.043(6), Florida Statutes]. WHEREFORE, you, JACK J. BIRDENS, are hereby notified that the Treasurer and Insurance Commissioner intends to enter an Order suspending or revoking your licenses and Los) appointments as an insurance agent or to impose such penalties as may be provided under the provisions of Sections 642.041, 642.043, 642.045, and 642.047, Florida Statutes, and under the other referenced sections of the Florida Statutes as set out in this Administrative Complaint. NOTICE OF RIGHTS You have the right to request a proceeding to contest this action by the Department pursuant to sections 120.569 and 120.57, Florida Statutes, and Rule 28-107, Florida Administrative Code. The proceeding request must be in writing, signed by you, and must be filed with the Department within twenty-one (21) days of your receipt of this notice. Completion of the attached Election of Proceeding form and/or a petition for administrative hearing will suffice as a written request. The request must be filed with the General Counsel as acting Agency Clerk, at the Florida Department of Insurance, 612 Larson Building, 200 East Gaines Street, Tallahassee, Florida 32399-0333. The Department must receive your written response no later than 5:00 p.m. on the twenty-first day after your receipt of this notice. Mailing the response on the twenty-first day will not preserve your right to a hearing. YOUR FAILURE TO RESPOND IN WRITING WITHIN TWENTY-ONE (21) DAYS OF YOUR RECEIPT OF THIS NOTICE WILL CONSTITUTE A WAIVER OF YOUR RIGHT TO REQUEST A PROCEEDING ON THE MATTERS ALLEGED HEREIN AND AN ORDER OF REVOCATION WILL BE ENTERED AGAINST YOU. If you request a proceeding, you must provide information that complies with the requirements of Rule 28-107.004, Florida Administrative Code. As noted above, completion of the attached Election of Proceeding form conforms to these requirements. Specifically, your response must contain: (a) The name and address of the party making the request, for purpose of service; (b) A statement that the party is requesting a hearing involving disputed issues of material fact, or a hearing not involving disputed issues of material fact; and (c) A reference to the notice, order to show cause, administrative complaint, or other communication that the party has received from the agency. ‘ Ifa hearing of any type is requested, you have the right to be represented by counsel or other qualified representative at your expense, to present evidence and argument, to call and cross-examine witnesses, and to compel the attendance of witnesses and the production of documents by subpoena. If a proceeding is requested and there is no dispute of material fact, the provisions of section 120.57(2), Florida Statutes, apply. In this regard, you may submit oral or written evidence in opposition to the action taken by the Department or a written statement challenging the grounds upon which the Department has relied. While a hearing is normally not required in the absence of a dispute of fact, if you feel that a hearing is necessary, one will be conducted in Tallahassee, Florida, or by telephonic conference call upon your request. However, if you dispute material facts, which are the basis for the Department’s action, you must request an adversarial proceeding pursuant to sections 120.569 and 120.57(1), Florida Statutes. These proceedings are held before a State administrative law judge of the Division of Administrative Hearings. Unless the majority of witnesses are located elsewhere, the Department will request that the hearing be conducted in Tallahassee, Florida. Failure to follow the procedure outlined with regard to your response to this notice may result in the request being denied. All prior oral communication or correspondence in this matter shall be considered freeform agency action, and no such oral communication or correspondence shall operate as a valid request for an administrative proceeding. Any request for an administrative proceeding received prior to the date of this notice shall be deemed abandoned unless timely renewed in compliance with the guidelines as set out above. Mediation of this matter pursuant to section 120.573, Florida Statutes, is not available. No Department attorney will discuss this matter with you until the response has been received by the Department of Insurance. DATED and SIGNED this 2.6% day of June, _, 2002. iA KENNEY SHIPLEY Deputy Insurance Commissioner CERTIFICATE OF SERVICE [ HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT and ELECTION OF RIGHTS has been furnished to: JACK J. BIRDENS, 12125 Florida Avenue, Hobe Sound, FL 33475-0130; JACK J. BIRDENS, PO Box 131, Hobe Sound, 2. PL 33475-0131; by Certified Mail this 25 day of J rye , 200 t WILLIAM W. THARPE, JR. Florida Bar Number 0312411 Division of Legal Services 612 Larson Building 200 East Gaines Street Tallahassee, Florida 32399-0333 Phone: (850) 413-4110 Fax: (850) 487-4907 ERY Loe Article Number COMPLETE THIS SECTION ON DELIV! 1M 7ubo 301 qauy 7724 WubS ifyes, enter delivery addrass below: Ta, Service Type CERTIFIED MAIL { 4, Restricted Delivery? (Extra Fee) Nike i ot Article Addressed (0: JACK J. BIRDENS BONIS ing o. HOBE SOUND! FIBA IH-0131 61776 0 AG ct BD 7 roanelca GOO a pee B. Date of Delivery 7 -\\r02% ‘A. Received by (Please Print Giearly) Neck Bwa ers C. Signal Agent x LA Address D. Is delfery address different from item 1? Clyes {J No j PS Form 3811, July 2001 Domestic Return Receipt

Docket for Case No: 02-003915PL