Civil Remedy Notice of Insurer Violations
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Filing Number:     809961
Filing Accepted:  3/6/2025
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Complainant
Last/Business Name *  
MAYBACK   First Name   CORY & CAROLE
Street Address * 628 WOODLEY ROAD
City, State Zip * MAITLAND, FL 32751
Email Address * WITHHELD
Complainant Type: * Insured
Insured
Last/Business Name*   MAYBACK   First Name   CORY & CAROLE
Policy # * 59-CN-A519-6 Claim #* 59-69V2-57H
Attorney
Attorney is Applicable
Last Name* MULLINAX First Name * MATTHEW Initial
Street Address* 908 W HORATIO STREET
City, State Zip* TAMPA , FL 33606
Email Address * MATT@MAKRISMULLINAX.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   STATE FARM FLORIDA INSURANCE COMPANY
NAIC Company Code 10739
 
Name of individual responsible for violation (if any):* JOEL VARGAS
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Claim Delay
Unsatisfactory Settlement Offer
Unfair Trade Practice
* Statutory provision(s) which the insurer allegedly violated.
 
624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
624.155(1)(b)(3) Except as to liability coverages, failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear, under one portion of the insurance policy coverage in order to influence settlements under other portions of the insurance policy coverage.
626.9541(1)(i)(2) A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
626.9541(1)(i)(3)(c) Failing to acknowledge and act promptly upon communications with respect to claims.
626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information.
626.9541(1)(i)(3)(e) Failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.
626.9541(1)(i)(3)(f) Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement.
626.9541(1)(i)(3)(g) Failing to promptly notify the insured of any additional information necessary for the processing of a claim.
626.9541(1)(i)(3)(h) Failing to clearly explain the nature of the requested information and the reasons why such information is necessary.
626.9541(1)(i)(3)(j) Altering or amending an insurance adjuster’s report without: (I) Providing a detailed explanation as to why any change that has the effect of reducing the estimate of the loss was made; and (II) Including on the report or as an addendum to the report a detailed list of all changes made to the report and the identity of the person who ordered each change; or (III) Retaining all versions of the report, and including within each such version, for each change made within such version of the report, the identity of each person who made or ordered such change;
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

THE PERILS INSURED AGAINST SECTION. THE LOSS PAYMENT PROVISION. THE LOSS SETTLEMENT PROVISION. THE POLICY PROVISIONS CITED IN STATE FARM FLORIDA INSURANCE COMPANY’S (“STATE FARM”) LETTERS TO THE INSURED ON THIS CLAIM, INCLUDING THE LETTER DATED JULY 19, 2024. ANY OTHER PROVISIONS OF THE POLICY WHICH STATE FARM BELIEVES LIMIT OR PROVIDE COVERAGE FOR THE INSUREDS’ LOSS.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

ON OR ABOUT JUNE 22, 2024, WHILE THE POLICY WAS IN FULL FORCE AND EFFECT, THE SUBJECT PROPERTY SUSTAINED A COVERED LOSS TO THE PROPERTY. THIS RESULTED IN DAMAGE TO THE INSUREDS’ HOME. THE INSUREDS PROVIDED TIMELY NOTICE OF THE LOSS TO STATE FARM AND STATE FARM ASSIGNED CLAIM NUMBER 59-69V2-57H TO THE CLAIM. STATE FARM INSPECTED, ADJUSTED, AND IMPROPERLY DENIED THE CLAIM. STATE FARM WRONGFULLY DETERMINED AND WROTE IN ITS DENIAL LETTER DATED JULY 19, 2024 THAT “IT WAS DETERMINED THAT THE DAMAGE IN YOUR KITCHEN, WAS CAUSED BY CONTINUOUS AND REPEATED LEAKAGE OR SEEPAGE OF WATER OVER A PERIOD OF TIME FROM A COPPER DRAIN PIPE IN A BLOCK WALL BEHIND THE SINK RESULTING IN DETERIORATION, ROT AND MOLD. STATE FARM DENIED COVERAGE FOR THE LOSS AND MADE NO PAYMENT. THE INSUREDS RETAINED THEIR OWN PROFESSIONALS, WHO DOCUMENTED THE LOSS, PHOTOGRAPHED, AND PREPARED A DETAILED ESTIMATES, QUOTES, AND INVOICES THAT AMOUNT TO $119,796.39 TO RESTORE THE DAMAGE AND RETURN THE INSURED PROPERTY TO ITS PRELOSS CONDITION. THIS WAS PROVIDED TO STATE FARM, BUT STILL STATE FARM REFUSED TO PROPERLY INDEMNIFY THE INSURED. THE FOLLOWING IS ALLEGED UPON INFORMATION AND BELIEF. THESE ACTIONS DESCRIBED ABOVE, AND OTHERS THAT OCCURRED IN THIS CLAIM, AMOUNT TO A FAILURE TO ADJUST THE INSUREDS’ CLAIM IN GOOD FAITH. STATE FARM’S REFUSAL TO CONDUCT A REASONABLE INVESTIGATION BASED UPON AVAILABLE INFORMATION AND FAILURE TO PAY THE INSUREDS FOR THE DAMAGE AND COVERED LOSS UNDER THE POLICY ISSUED BY STATE FARM EXHIBITS BAD FAITH. FURTHER, STATE FARM FAILED TO COMPLY WITH ITS LOSS SETTLEMENT PROVISION. RATHER THAN ISSUING THE PROPER PAYMENT OR ATTEMPTING TO REACH AN AGREEMENT WITH ITS INSUREDS, STATE FARM DENIED THE CLAIM. UPON INFORMATION AND BELIEF, STATE FARM PERFORMS THE SUBJECT ACTIONS AS A BUSINESS PRACTICE, INCLUDING DELAYING THE CLAIM AND DENYING THE CLAIM IN AN ATTEMPT TO DISSUADE ITS INSUREDS FROM PURSUING THE CLAIM TO THE DETRIMENT OF ITS INSUREDS TO INCREASE FINANCIAL PROFITS. IN THE EVENT STATE FARM BELIEVES THIS CIVIL REMEDY NOTICE LACKS INFORMATION NECESSARY FOR STATE FARM TO CURE THE DEFECTS OUTLINED IN THIS NOTICE, OR THAT IT LACKS REQUIRED SPECIFICS IN ANY WAY, STATE FARM SHOULD CONTACT THE FILER OF THIS NOTICE DIRECTLY AND ALERT THEM TO THAT AS SOON AS POSSIBLE, PRIOR TO ANY FORMAL RESPONSE. THIS NOTICE IS FILED AND GIVEN TO STATE FARM TO PERFECT THE RIGHT TO PURSUE THE CIVIL REMEDY THAT SECTION 624.155 AUTHORIZES. TO CURE THE DEFECTS OUTLINED IN THIS CIVIL REMEDY NOTICE, STATE FARM MUST: (1). ADMIT FULL COVERAGE FOR THE INSUREDS’ LOSS; (2). PAY IN THE PROPER AMOUNT NECESSARY TO RESTORE THE PROPERTY TO ITS PRELOSS CONDITIONS, WHICH THE INSURED BELIEVES TO BE IN ACCORDANCE WITH THE ESTIMATE PREPARED BY THE INSUREDS’ PUBLIC ADJUSTER IN THE AMOUNT OF $119,796.39, FOR THE DURATION OF THE SIXTY-DAY CURE PERIOD; (3). PAY STATUTORY INTEREST ON THE AMOUNT OF UNPAID CONTRACT DAMAGES FROM THE DATE OF THE LOSS TO THE PRESENT TIME PURSUANT TO F.S. §627.70131, AND PAY REASONABLE ATTORNEYS FEES AND COSTS INCURRED. A COPY OF THIS FORM SUBMITTED TO THE FDFS HAS BEEN PROVIDED TO THE FOLLOWING PARTIES PROVIDING THEM NOTICE OF THE FILING OF THE CIVIL REMEDY NOTICE: STATE FARM FLORIDA INSURANCE COMPANY VIA EMAIL TO: statefarmfireclaims@statefarm.com ATTN: JOEL VARGAS
Comments
User Id Date Added Comment
lalfano@alfanokingsford.com 04-28-2025 Dear Mr. and Mrs. Mayback: This letter has been directed to you through your attorney as State Farm Florida Insurance Company’s (“State Farm”) formal response to the allegations set forth in the purported Civil Remedy Notice (“Notice”) of insurer violation dated March 6, 2025. This Notice was filed on your behalf by Attorney Matthew Mullinax, Esq. of Makris & Mullinax, P.A. and purports to comply with §624.155, Florida Statutes. (A copy of this Notice is attached as Exhibit A). In your purported Notice, there is an indication that State Farm did not handle your claim in good faith because State Farm denied your claim, it delayed your claim, it committed some unidentified form of unfair trade practice, it somehow misrepresented the insurance policy to you, and did not issue payment of benefits you believe are owed to you. State Farm denies each of these allegations, and as the facts below will demonstrate, your claim was properly investigated, and State Farm did not treat you unfairly in its adjustment of the claim. On June 25, 2024, you submitted the subject kitchen leak claim to State Farm with a reported date of loss of June 22, 2024. On June 28, 2024, State Farm Representative Antraneshi Martin spoke with you, at which time you advised that you found a leak beneath the kitchen sink. You further advised that a plumber had repaired the pipes and stated that the leak originated from a copper pipe. Ms. Martin advised that a claims handler would be assigned to inspect your property once you submitted the plumber’s report. Following this conversation, Ms. Martin received email correspondence from you attaching three pluming invoices for work performed by ServiceOne Air Conditioning & Plumbing. In the email, you advised that the plumber replaced the damaged pipes after the kitchen cabinets had been removed by a contractor. The email also attaches the plumber’s photographs. (Please see attached Exhibit B). The same day, State Farm received separate correspondence from Rob Avila of Entrusted Water, Mold & Fire Experts (“Entrusted”) attaching a Performance Authorization agreement executed by you on June 23, 2024, as well as a Certificate of Satisfaction & Completion of Mitigation executed by you on June 27, 2024. (Please see attached Exhibit C). The email also attaches the mitigation logs and mitigation invoice prepared by Entrusted totaling $4,924.79. Additionally, on June 28, 2024, State Farm sent correspondence to you advising you of your Duties After Loss and the Homeowner Claims Bill of Rights. (Please see attached Exhibit D and Exhibit E). On July 2, 2024, State Farm Representative Joel Vargas spoke with you and scheduled an inspection of your property to occur on July 8, 2024. On July 8, 2024, Mr. Vagas inspected your property with you and a contractor present. On July 9, 2024, State Farm received email correspondence from Mr. Avila attaching a post-mitigation rebuild estimate prepared by Entrusted totaling $33,073.26. (Please see attached Exhibit F). On July 15, 2024, Ms. Martin spoke with you and advised that State Farm was waiting to discuss the cause of loss with the plumber. Following this conversation, Ms. Martin received email correspondence from you attaching the plumber’s June 23, 2024, invoice. (Please see attached Exhibit G). On July 18, 2024, State Farm received email correspondence from Mr. Avila of Entrusted checking the status of the claim and requesting confirmation of the estimate and mitigation invoice provided by Entrusted. (Please see attached Exhibit H). On July 19, 2024, State Farm sent you its coverage determination explaining that the damage to the kitchen was caused by continuous and repeated leakage and seepage of water over a period of time from a copper drainpipe in a block wall behind the sink. State Farm further explained that this leakage resulted in deterioration, rot, and mold and that such damage is not covered by the subject policy. (Please see attached Exhibit I). The same day, State Farm sent correspondence advising you of your right to participate in the Florida Department of Financial Services mediation program. (Please see attached Exhibit J). On July 21, 2024, State Farm sent correspondence in response to the July 18, 2024, email from Entrusted advising that the coverage decision was sent to you on July 19, 2024. State Farm further advised that the contractor will have to discuss the claim status with you. (Please see attached Exhibit K). On March 6, 2025, State Farm received a Letter of Representation from Matthew Mullinax, Esq. of Makris & Mullinax, P.A. on your behalf. (Please see attached Exhibit L). The same day, Mr. Mullinax filed the subject Notice on your behalf. On March 11, 2025, Mr. Mullinax filed a Notice of Intent to Initiate Litigation (“NOIL”) in the amount of $121,352.00 on your behalf. (Please see attached Exhibit M). The NOIL attaches the Entrusted rebuild estimate totaling $33,073.26 and the Entrusted water mitigation invoice totaling $4,924.79, among other invoices for various kitchen repairs. On March 17, 2025, State Farm sent correspondence to Mr. Mullinax acknowledging his representation of you. (Please see attached Exhibit N). On March 24, 2025, State Farm sent correspondence to Mr. Mullinax responding to the NOIL and advising that it stands by its coverage determination. (Please see attached Exhibit O). On April 3, 2025, Mr. Mullinax filed a lawsuit against State Farm on your regarding the subject claim. As the above-referenced facts demonstrate, there is no support for your allegations against State Farm, and State Farm has properly handled this claim and treated you fairly in its adjustment. Florida Statute §624.155 requires specificity in Civil Remedy Notices. Talat Enterprises, Inc. v. Aetna Casualty and Surety Co., 753 So. 2d 1278 (Fla. 2000); Julien v. United Prop. & Cas. Inc. Co., 2021 Fla. App. LEXIS 3131 (Fla. 4th DCA 2021). Your Notice lacks any specific information in support of any of its allegations. For example, your Notice alleges that State Farm “inspected, adjusted, and improperly denied the claim,” and “wrongfully determined and wrote in its denial letter dated July 19, 2024 that ‘it was determined that the damage in your kitchen, was caused by continuous and repeated leakage or seepage of water over a period of time from a copper drain pipe in a block wall behind the sink resulting in deterioration, rot and mold. State Farm denied coverage for the loss and made no payment.” While you have simply recited State Farm’s coverage decision, your Notice fails to present any specific information to demonstrate that the coverage decision was wrongfully determined. State Farm properly adjusted your claim and determined that the reported loss is not covered under the subject policy. The July 19, 2024, letter outlines the relevant provisions of the subject policy as applied to the results of State Farm’s investigation. It is clear that these allegations are based solely on your disagreement with State Farm’s coverage decision rather than any supporting factual basis. Accordingly, your Notice fails to meet its statutory purpose of providing an insurer with the opportunity to resolve legitimate disputes. Lane v. Westfield Ins. Co., 862 So. 2d 774, 779 (Fla. 5th DCA 2003); Julien, 2021 Fla. App. LEXIS 3131. State Farm denies these unfounded allegations and all others contained in your Notice. Your Notice then alleges that “the insureds retained their own professionals, who documented the loss, photographed, and prepared a detailed estimates, quotes, and invoices that amount to $119,796.39 to restore the damage and return the insured property to its preloss condition. This was provided to State Farm, but still State Farm refused to properly indemnify the insured.” Your Notice fails to identify the referenced “professionals” or any specific documentation that demonstrates that your property suffered a covered loss. The estimates and invoices that you and your representatives have provided to State Farm detail numerous repairs to your kitchen but fail to describe a cause of loss as applied to the policy in favor of coverage. State Farm is in no way obligated to issue payment for damages that are specifically excluded from coverage under the policy. Given the lack of support for these allegations, your Notice again fails to meet its statutory purpose of providing an insurer with the opportunity to resolve legitimate disputes. Lane, 862 So. 2d 774; Julien, 2021 Fla. App. LEXIS 3131. Your Notice continues by alleging that “these actions described above, and others that occurred in this claim, amount to a failure to adjust the insureds’ claim in good faith. State Farm’s refusal to conduct a reasonable investigation based upon available information and failure to pay the insureds for the damage and covered loss under the policy issued by State Farm exhibits bad faith.” Your Notice provides no information or specific details of State Farm’s investigation to show that it was conducted unreasonably. You fail to describe any specific actions taken by State Farm during its adjustment of your claim that amount to bad faith conduct. As previously discussed, you have not provided State Farm with any evidence that your property suffered a covered loss. You further alleged that State Farm “failed to comply with its loss settlement provision. Rather than issuing the proper payment or attempting to reach an agreement with its insureds, State Farm denied the claim.” State Farm’s issued its coverage determination consistent with the cited policy exclusions. State Farm communicated its decision with you and does not owe payment for the claim. Despite the lack of factual support for the allegations contained in your Notice, you assert that “upon information and belief, State Farm performed the subject actions as a business practice, including delaying the claim and denying the claim in an attempt to dissuade its insureds from pursuing the claim to the detriment of its insureds to increase financial profits.” Yet, you do not provide any of the referenced “information” that you base these speculative allegations upon. Your Notice has failed to demonstrate that State Farm has engaged in any of the alleged wrongful conduct when adjusting your claim, let alone any other claim with such frequency as to constitute a general business practice. As has already been a problem with the Notice, it continues to fail to adhere to its statutory purpose of providing an insurer with the opportunity to resolve legitimate disputes. Lane, 862 So. 2d 774; Julien, 2021 Fla. App. LEXIS 3131. Furthermore, your Notice states that “in the event State Farm believes this Civil Remedy Notice lacks information necessary for State Farm to cure the defects outlined in this Notice, or that it lacks required specifics in any way, State Farm should contact the filer of this Notice directly and alert them to that as soon as possible prior to any formal response.” This is clearly an unlawful attempt to transfer your obligation of strict compliance under Florida Statute §624.155 onto State Farm. It is the obligation of you and your attorney alone to ensure that your Notice complies with its statutory requirements at the time that its is filed. No retroactive correction can validate your Notice in the event that it lacks the required specificity. Indeed, your Notice lacks any information in support of the allegations contained therein and thus it fails to adhere to its statutory purpose of providing an insurer with the opportunity to resolve legitimate disputes. Lane, 862 So. 2d 774; Julien, 2021 Fla. App. LEXIS 3131. Lastly, your Notice alleges that State Farm has violated several Florida Statutes without providing any factual support to demonstrate how State Farm engaged in such behaviors. For instance, your Notice alleges that State Farm violated Fla. Stat. § 624.155(1)(b)(1) by “Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests” and violated Fla. Stat. § 624.155(1)(b)(3) by “failing to promptly settle claims, when the obligation to settle a claim has become reasonably clear.” However, you have not identified any facts about this claim to show that State Farm should have or was obligated to settle this claim at any time. As previously stated, State Farm is in no way obligated to indemnify you for damages that are specifically excluded from coverage. Your Notice goes on to allege that State Farm has violated Fla. Stat. § 626.9541 (1)(i)(2) through “a material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy.” Yet, your Notice does not identify any specific instance or communication in which State Farm has made any misrepresentation during the adjustment of your claim. Furthermore, State Farm cannot have made any such misrepresentation to effectuate the settlement of this claim, as State Farm has not approached settlement. Your Notice alleges that State Farm has violated Fla. Stat. § 626.9541 (1)(i)(3)(a) by “failing to adopt and implement standards for the proper investigation of claims.” As previously discussed, you have failed to identify any conduct or standards exercised by State Farm during the investigation of your claim that would be considered improper. The facts above show that State Farm completed a prompt and proper investigation of your claim. Your Notice alleges that State Farm has violated Fla. Stat. § 626.9541 (1)(i)(3)(b) by “misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.” Yet your Notice fails to identify any specific facts or provisions of the policy that were supposedly misrepresented to you, nor do you identify any specific communications containing said misrepresentations. State Farm’s coverage determination letter clearly outlines the relevant policy provisions that State Farm based its decision upon. Your Notice alleges that State Farm has violated Fla. Stat. § 626.9541 (1)(i)(3)(c) by “failing to acknowledge and act promptly upon communications with respect to claims.” Yet your Notice does not identify any specific communications from you or your representatives that State Farm has failed to respond to. State Farm made timely responses to all communications and materials received on your behalf during the adjustment of your claim. Your Notice alleges that State Farm has violated Fla. Stat. § 626.9541 (1)(i)(3)(d) by “denying claims without conducting reasonable investigations based upon available information.” This is clearly untrue, and you fail to identify how State Farm’s investigation was unreasonable in any way. The above facts demonstrate that State Farm considered all available information when making its coverage determination. Your Notice alleges that State Farm has violated Fla. Stat. § 626.9541 (1)(i)(3)(e) by “failing to affirm or deny full or partial coverage of claims, and, as to partial coverage, the dollar amount or extent of coverage, or failing to provide a written statement that the claim is being investigated, upon the written request of the insured within 30 days after proof-of-loss statements have been completed.” Yet you fail to identify the specific action prescribed by the statute that State Farm failed to comply with. You have not submitted any proof of loss statements to State Farm for this claim. Your Notice alleges that State Farm has violated Fla. Stat. § 626.9541 (1)(i)(3)(f) by “failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement.” This is demonstrable false, as State Farm’s coverage determination letter clearly outlines the factual basis for its decision and identifies the specific policy provisions that apply to the loss. Your Notice alleges that State Farm has violated Fla. Stat. § 626.9541 (1)(i)(3)(g) by “failing to promptly notify the insured of any additional information necessary for the processing of a claim,” and violated Fla. Stat. § 626.9541 (1)(i)(3)(h) by “failing to clearly explain the nature of the requested information and the reasons why such information is necessary.” The language of the statute clearly indicates that there can be either a violation of § 626.9541 (1)(i)(3)(g) or § 626.9541 (1)(i)(3)(h), but not both, as these behaviors conflict with each other. Either way, your Notice fails to identify any information to demonstrate that State Farm has violated either statute. As the facts show, State Farm completed its investigation will all of the necessary information available and made no further requests from you. Your Notice alleges that State Farm has violated Fla. Stat. § 626.9541 (1)(i)(3)(j) by “amending or altering an insurance adjuster’s report without: . . .” Your Notice fails to describe any instance amounting to a violation of this statute. State Farm’s adjuster did not provide any such report, and you provide no evidence that such a report exists and was then altered in any way. Your Notice fails to provide any evidence demonstrating that State Farm violated any of the referenced statutes aside from a mere recitation of the statutory language and a number of factual inaccuracies. State Farm denies that it violated any statutory provisions in its handling of the claim. As has already been a problem with the Notice, it continues to fail to adhere to its statutory purpose of providing an insurer with the opportunity to resolve legitimate disputes. Lane, 862 So. 2d 774; Julien, 2021 Fla. App. LEXIS 3131. State Farm denies that this claim has been handled in bad faith, unfairly, or with delay. State Farm hereby denies each and every allegation against it as put forth in your Notice. State Farm has in the past, and continues at the present time, to make all efforts to promptly resolve this claim in a fair and reasonable fashion and in full accord with the insurance policy and Florida law.
Acknowledgement
* The submitter hereby states that this notice is given in order to perfect the rights of the person(s) damaged to pursue civil remedies authorized by Section 624.155, Florida Statutes.

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DFS-10-363
Rev. 10/14/2008