FLORIDA Z DEPARTMENT OF FINANCIAL SERVICES TOM GALLAGHER F i L E D a CHIEF FINANCIAL OFFICER . =z % e STATE OF FLORIDA M AY 23 200 By 3 a] “_ on 2 REG, Booksted by- E Ze E28: 23 IN THE MATTER OF: ana nnnen Boa a cs) CASENO.: 85349-06-AG ~ JEFFREY LAVERN KLEIN / Ole BI 59PL ADMINISTRATIVE COMPLAINT TO: JEFFREY LAVERN KLEIN 411 8. Lakeside Drive No. 14 . Lake Worth, FL 33460 You, JEFFREY LAVERN KLEIN, license I.D. #A142683, are hereby notified that the Chief Financial Officer 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 626, Florida Statutes, you, JEFFREY LAVERN KLEIN, are currently licensed in this state as a Life Including Variable Annuity (2-14), Life Incl Var Annuity 2 & Health (2-15), Life (2-16), Life & Health (2-18), Agent. At all times pertinent to the dates and occurrences referred to herein, you, JEFFREY KLEIN, were so licensed as a Life and Variable & Annuity agent (2-14), Life, Health, and variable Annuity Agent and Health Insurance Agent (2-15), Life Insurance Agent (2- 16), Life and health insurance agent (2-18) Agent. 3. Pursuant to Chapter 626, Florida Statutes; the Florida Department of Financial Services has jurisdiction over all licenses and eligibility for licensure which you, JEFFREY . LAVERN KLEIN, currently hold. , COUNTI 4. The above general allegations are hereby realleged and fully incorporated herein by reference. 5. On or about February 3, 2004, in the Superior Court of Erie County, in Buffalo, New York, Indictment No. AG-020541-2002, you, JEFFREY LAVERN KLEIN, pled guilty to one count of Scheme to Defraud, a first degree felony, and one count of Grand Larceny, a second degree felony. 6. On or about August 13, 2004, you, JEFFREY LAVERN KLEIN, were sentenced to 5 Years Probation, Restitution in the amount of $10,000, and payment of court costs. 7. You, JEFFREY LAVERN KLEIN, failed to report in writing your plea of guilty to the Department of Financial Services as is dictated by statute, IT IS THEREFORE CHARGED that you, JEFFREY LAVERN KLEIN, have violated or are accountable under the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services which constitute grounds for the suspension or revocation of your licenses and appointments: (a) The department shall deny an application for, suspend, revoke, or refuse to renew or continue the license or appointment of any applicant, agent, title agency, adjuster, customer representative, service representative, or managing general agent, and it shall suspend or revoke the eligibility to hold a license or appointment of any such person, if it finds that as to the applicant, licensee, or appointee any one or more of the following applicable grounds exist. [Section 626.611, F lorida Statutes] (b) 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 which involves moral turpitude, without regard to whether a judgment of conviction has been entered by the court having jurisdiction of such cases. [Section 626.61 1(14), Florida Statutes] | (c) The department may, in its discretion, deny an application for, suspend, revoke, or refuse to renew or continue the license or appointment of any applicant agent, adjuster, customer representative, service representative, or managing general agent, and it may suspend or revoke the eligibility to hold a license or appointment of any such person, if it finds that as to the applicant, licensee, or appointee any one or more of the following applicable grounds exist under circumstances for which denial, suspension, revocation or refusal is not mandatory under s. 626.611. [Section 626.621, Florida Statutes] (d) 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, without regard to whether a judgment of conviction has been entered by the court having jurisdiction of such cases. [Section 626.621(8), Florida Statutes] (e) Failure to inform the department in writing within 30 days after pleading guilty or nolo contendere to or being convicted or found guilty of, any felony or a crime punishable by imprisonment of 1 year or more under the law of the United States or any state thereof or under - the law of any other country without regard to whether a judgment of conviction has been entered for the court having jurisdiction of the case. [Section 626.621(11), Florida Statutes] COUNT II 8. The above general allegations are hereby realleged and fully incorporated herein by reference. 9. The residence and business address which you, JEFFREY LAVERN KLEIN, submitted to the Department is 501 Emory Oak Street, Ocoee, FL 34761, 10. On or about May 11, 2005, you, JEFFREY LAVERN KLEIN, changed your address to 411 South Lakeside Dr. #4, Lake Worth, Florida 33460, This is the information that appears on your drivers license, and the address at which you, JEFFREY LAVERN KLEIN, received the Department’s Settlement Stipulation for Consent Order, 11. You, JEFFREY LAVERN KLEIN, failed to notify the Department of your change of address within thirty (30) days. ) IT IS THEREFORE CHARGED that your, JEFFREY LAVERN KLEIN, have violated or are accountable under the following provisions of the Florida Insurance Code which constitute grounds for the suspension or revocation of your licenses and appointments: (a) Failure to notify the Department in writing of a change of name, residence address, principal business street address, or mailing address within 30 days, as specified in this code. [Section 626.551, Florida Statutes]; (b) Willful failure to comply with, or willful violation of, any proper order or rule of the department or willful violation of any provision of this code. [Section 626.61 1(13), Florida Statutes]; (c) Violation of any provision of this code or of any other law applicable to the business of insurance in the course of dealing under the license or appointment. [Section 626.621(2), Florida Statutes]; COUNT II 12. The above several allegations are realleged and incorporated by reference herein. 13. YouJEFFREY LAVERN KLEIN, did swear to and sign an application for licensure as a Life and Variable Annuity Agent (2-14), Life Health and variable Annuity and Health Insurance Agent (2-15), Life Insurance Agent (2-16), Life and Health Insurance Agent (2-18). 14. On the aforementioned application, you, JEFFREY LAVERN KLEIN, while under oath did swear that, “... I understand the Laws of Florida and the Rules promulgated by the Insurance Commissioner for the class of business for which I hereby request a license”. 15. On the aforementioned application, you, JEFFREY LAVERN KLEIN, in. your final statement quoted above, knew or should have known that your failing to report disciplinary and or punitive orders against you, JEFF REY LAVERN KLEIN, by the Florida Department of Business and Professional Regulation, was a violation of §626.536 of the Florida Statutes, 16. You, JEFFREY LAVERN KLEIN, have had five (5) hearings in which you, JEFFREY LAVERN KLEIN, were the Respondent and the Department of Business and Professional Regulation was the Petitioner, since March of 2003. 17, You, JEFFREY LAVERN KLEIN, have had five (5) final orders issued against you wherein disciplinary action was taken, including but not limited to revocation of your real estate license, revocation of your certified residential contractor license, required restitution to injured parties, and punitive fines. 18. You, JEFFREY LAVERN KLEIN, failed to inform the Department of these prior disciplinary actions when you applied for licensure to the Department. IT IS THEREFORE CHARGED that you, JEFFREY LAVERN KLEIN, have violated or are accountable under the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services which constitute grounds for the suspension or revocation of your licenses and appointments as an insurance agent: (a) An agent shall submit to the department, within 30 days after the final disposition of any administrative action taken against the agent by a governmental agency in this or any, other state or jurisdiction relating to the business of insurance, the sale of securities, or activity involving fraud, dishonesty, trustworthiness, or breach of a fiduciary duty, a copy of the order, consent to order, or other relevant legal documents. The department may adopt rules implementing the provisions of this section. [Section 626.61 1(2), Florida Statutes]; (b) Any cause of which issuance of the license or appointment could have been refused had it then existed and been known to the department. [Section 626.611(2), Florida Statutes]; WHEREFORE you, JEFFREY LAVERN KLEIN, are hereby notified that the Chief Financial Officer or his designee intends to enter an Order suspending or revoking your license(s) and eligibility for licensure and appointment as an insurance agent or to impose such penalties as may be provided under the provisions of Sections 626.61 1(2), Florida Statutes, and under the other referenced sections of the Florida Statutes as set out in this Administrative Complaint. You are further notified that any order entered in this case revoking or suspending any license or eligibility for licensure held by you shall also apply to all other licenses and eligibility held by you under the Florida Insurance Code. 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 Financial Services, 612 Larson Building, 200 East Gaines Street, Tallahassee, Florida 32399-0333. Your written response must be received by the Department 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. Ifa 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 Financial Services. mote _ J DATED and SIGNED this_ 23° day of -_ [MA Y_, 2006. KAREN CHANDLER Deputy Chief Financial Officer CERTIFICATE OF SERVICE THEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT and ELECTION OF PROCEEDING has been furnished to: JEFFREY LAVERN 9 ard KLEIN, 411 S. Lakeside Drive No. 4, Lake Worth, Florida 33460 by Certified Mail this 23 day of May, 2006. ‘On of Legal Services 200 East Gaines St. 612 Larson Building Tallahassee, Florida 32399-0333 (850) 413-4210

Docket for Case No: 06-003289PL