Civil Remedy Notice of Insurer Violations
Login

Filing Number:     810844
Filing Accepted:  3/12/2025
         Print Filing
Complainant
Last/Business Name *  
BAUMAN   First Name   ROBERT AND TINA
Street Address * 17 CRISTON COURT
City, State Zip * PALM COAST, FL 32137
Email Address * BOBBYBAUMAN34@GMAIL.COM
Complainant Type: * Insured
Insured
Last/Business Name*   BAUMAN   First Name   ROBERT AND TINA
Policy # * FPH5341618-03 Claim #* FPI252641
Attorney
Attorney is Applicable
Last Name* VALLEY First Name * JOSEPH Initial
Street Address* 2300 MAITLAND CENTER PKWY. STE 106
City, State Zip* MAITLAND , FLORIDA 32751
Email Address * JVALLEY@SERRANOCAGAN.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   FLORIDA PENINSULA INSURANCE COMPANY
NAIC Company Code 10132
 
Name of individual responsible for violation (if any):* TONYA WALKER, LEAH AFFUL
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)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
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)(i) Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b).
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

SECTION I – PROPERTY COVERAGE A. Coverage A – Dwelling (Entire Section) B. Coverage B – Other Structures (Entire Section) C. Coverage C – Personal Property (Entire Section) D. Coverage D – Loss of Use (Entire Section).
 
* 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 10/09/2024, ROBERT BAUMAN AND TINA BAUMAN, ("Insured"), sustained a covered direct physical loss to Insured's property due to a Hurricane. Insured reported the loss thereafter to FLORIDA PENINSULA INSURANCE COMPANY ("Insurer"). Prior to the date of loss, Insurer issued a policy of insurance, believed to be policy # FPH5341618-03 which afforded coverage for the aforementioned property for losses caused by the covered peril. The policy was in full force and effect on the date of loss. The Insured promptly notified Insurer of the loss, who then assigned the loss claim # FPI252641. Insurer was fully afforded any and all opportunity to inspect the loss and document the loss. To date, Insurer has paid $00.00 to Insured on this claim even after numerous attempts by the Insured to provide documentation of additional damages and compensation owed. Insured had no choice but to retain legal representation on or about 02/18/2025,, as the Insurer refused to pay the full amount due and owed to its Insured. Insurer has continually failed to negotiate this claim with Insured’s attorney and/or failed to provide a satisfactory settlement offer to resolve the subject claim. This has severely harmed the Insured's ability to remedy their losses and continue with repairs to the property. The only purpose for Insurer's refusal to negotiate the claim is to increase profits and harm their insured. This is either done intentionally as a pattern and practice of Insurer to deny coverage and harm their insureds, or Insurer has failed to properly train and supervise its adjusters to the harm and detriment of their insureds. This pattern and practice is done for only one reason, which again, is to maximize profits and harm their insureds. Insurer has violated the following statutory provisions: 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)(3)(a): Failing to adopt and implement standards for the proper investigation of claims. 626.9541(1)(i)(3)(c): Failing to acknowledge and act promptly upon communications with respect to claims; 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)(i): Unfair claim settlement practices, and any other applicable statutes to the factual allegations included herein. To remedy and/or cure this CRN, Insurer must immediately tender payment in the amount of $ 55,833.00 less any applicable deductible and prior payment to the Insured to complete the repairs for the Insured property. The payment shall be tendered to the Insured’s attorneys, Serrano Cagan & Cagan at 2110 Park Street, Jacksonville Florida, 32204.
Comments
User Id Date Added Comment
Jvalley@serranocagan.com 05-16-2025 Claimant hereby withdraws this Civil Remedy Notice against Florida Peninsula Insurance Company.
jbosch@qpwblaw.com 05-08-2025 VIA DFS WEBSITE Florida Department of Insurance Civil Remedy Section 200 East Gaines Street Tallahassee, Florida 32399 Complainants: Robert and Tina Bauman Claim No: FPI252641 (“subject claim”) Policy No: FPH5341618-03 (“policy”) Loss Location: 17 Criston Court, Palm Coast, FL 32137 (“property”) CRN Filing No: 810844 CRN Acceptance Date: 3/12/2025 RE: CIVIL REMEDY NOTICE - DFS FILING NUMBER 810844 Dear Sir or Madam: The undersigned counsel represents Florida Peninsula Insurance Company (“Florida Peninsula”) in regard to the alleged dispute as to the subject claim number listed above involving an alleged windstorm with a date of loss of on or October 9, 2024, made under the Policy of insurance Florida Peninsula issued to the Insureds listed above. This correspondence constitutes Florida Peninsula Insurance Company’s response to the Civil Remedy Notice of Insurer Violations (“Notice” or “CRN”) filed on behalf of Robert Bauman and Tina Bauman (referenced herein as “Insureds” or “Complainants”) regarding the claim listed above. Based on the below response, the Civil Remedy Notice should be rejected and returned by the Department of Financial Services as it is substantively defective and objectionable for the reasons stated herein, and, without waiving objections, as it completely misstates the facts surrounding this claim. ALLEGED STATUTORY VIOLATIONS 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. Florida Peninsula specifically denies the allegation that it has violated the above referenced statute. Florida Peninsula did not violate these provisions. The CRN does not include any facts to support this allegation. Based on the culmination of Florida Peninsula’s investigations of the claim, the Complainants’ covered damages fell below the Policy’s applicable hurricane deductible. Simply because the outcome of Florida Peninsula’s investigation revealed covered damages less than Complainants’ unjust demand for compensation, does not mean that Florida Peninsula has violated the above statute. 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. Florida Peninsula specifically denies the allegation that it has violated the above referenced statute. Florida Peninsula did not violate these provisions. The CRN does not include any facts to support this allegation. Florida Peninsula conducted a thorough investigation in good faith. Simply because the outcome of Florida Peninsula’s investigation revealed covered damages less than Complainants’ unjust demand for compensation, does not mean that Florida Peninsula has violated the above statute. 626.9541(1)(i)(3)(a): Failing to adopt and implement standards for the proper investigation of claims. Florida Peninsula specifically denies the Complainants’ allegation that it has violated the above referenced statute. The CRN does not include any facts to support this allegation. Florida Peninsula did not fail to adopt and implement standards for the proper investigation of the claim. 626.9541(1)(i)(3)(c): Failing to acknowledge and act promptly upon communications for the proper investigation of claims. Florida Peninsula specifically denies the Complainants’ allegation that it has violated the above referenced statute. The CRN does not include any facts to support this allegation. Florida Peninsula conducted a thorough investigation in good faith and promptly and continually communicated with the insureds and their representatives regarding the Claim. This allegation is without merit. 626.9541(1)(i)(3)(d): Denying claims without conducting reasonable investigations based upon available information. Florida Peninsula specifically denies the Complainants’ allegation that it has violated the above referenced statute. The CRN does not include any facts to support this allegation. Simply because the outcome of Florida Peninsula’s investigation revealed covered damages less than Complainants’ unjust demand for compensation, does not mean that Florida Peninsula has violated the above statute. 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. Florida Peninsula specifically denies the Complainants’ allegation that it has violated the above referenced statute. The CRN does not include any facts to support this allegation. Florida Peninsula conducted a thorough investigation in good faith and issued its coverage determination based on the Policy’s provisions, conditions, exclusions and endorsements. This allegation is without merit. 626.9541(1)(i)(3)(f): Failing to promptly provide a reasonable explanation in writing to the insured of the basis of the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement. Florida Peninsula specifically denies the Complainants’ allegation that it has violated the above referenced statute. The CRN does not include any facts to support this allegation. Florida Peninsula conducted thorough investigations in good faith and issued its coverage determination based on the Policy’s provisions, conditions, exclusions and endorsements. This Coverage Determination correspondence specifically referenced all claimed damages and conclusions regarding each, and enclosed additional information relating to the claim, as well as information relating to the Department of Financial Services mediation services. This allegation is without merit. 626.9541(1)(i)(3)(i): Failing to pay personal injury protection insurance claims within the time periods required by s. 627.736(4)(b). The referenced statute does not reflect the appropriate statutory language and is irrelevant to first party property insurance claims. In abundance of caution, Florida Peninsula specifically denies the allegation that it has violated the above referenced statute. In addition to the allegations specifically denied above, Florida Peninsula generally denies all allegations presented in this CRN, as Florida Peninsula has not violated any statute, Code or Rule. SPECIFICITY REQUIREMENTS Florida Statute requires that a CRN state the facts and circumstances giving rise to the alleged violations with specificity sufficient to allow an insurer to “cure” the alleged violations within the sixty-day statutory period. See Fla. Stat. § 624. 155(3)(b)(2). See also Lane v. Westfield Ins. Co., 862 So. 2d 774, 777 (Fla. 5th DCA 2003), Talat Enterprises, Inc. v. Aetna Cas. & Sur. Co., 753 So. 2d 1278, 1283 (Fla. 2000). However, here, the CRN is deficient and defective in that it fails to state with sufficient specificity the necessary facts in support of the Insureds’ contentions, including but not limited to, those that would be necessary for Florida Peninsula to “cure” the alleged violations. Further, the subject CRN provides what appears to be several boilerplate and conclusory statements, which fail to describe any accurate facts constituting violations of the statutes cited therein. Thus, because the allegations in the CRN are incomplete and incorrect, they fail to provide actual notice of the specific allegations and the actions that Florida Peninsula could undertake to cure any alleged violations. 316, Inc. v. Maryland Cas. Co., 625 F. Supp. 2d 1187, 1193 (N. D. Fla. 2008). Blanket references to policy provisions and statutes without specification deems the Civil Remedy Notice deficient. Julien v. United Property and Casualty Insurance Co., 311 So. 3d 875 (Fla. 4th DCA 2021). For the reasons set forth herein, Florida Peninsula hereby objects to the subject CRN and states it does not intend to waive, ratify or otherwise accept the deficiencies in the CRN, and reserves the right to contest the legal adequacy of the CRN hereinafter as appropriate. As to the content of the CRN here, it is important to note that said CRN is a nullity and should be rejected because the CRN fails to comply with the specific requirements mandated by Florida Statutes §624.155. Specifically, Fla. Stat. § 624.155(3)(b)(2) requires the Complainant to set forth with specificity, sufficient factual allegations to state a prima facie case of an insurer violation, so as to put the insurer on notice and be afforded the opportunity to cure the deficiency. However, the Insureds failed to do so in the subject CRN and instead only included conclusory statements, which lack even minimal specificity and/or lack the underlying factual basis to support them. The Insureds’ failure to describe any actual facts or circumstances to support the alleged statutory violations in the CRN precludes Florida Peninsula from evaluating what error, if any, allegedly occurred during the claim process. Furthermore, contrary to the requirement to “describe the facts and circumstances giving rise to the insurer’s violation as you understand them at this time,” the purpose of which is “to enable the insurer to investigate and resolve [the] claim,” the CRN itself only provides unsupported and incorrect allegations with no basis in fact or circumstances. Consequently, the CRN lacks the requisite minimal specificity and Florida Peninsula is unable to determine what specifically the Complainant is claiming was done by or on behalf of Florida Peninsula that constitutes the bad faith alleged. Due to the absence of specific and accurate information regarding the alleged acts or omissions by Florida Peninsula which allegedly give rise to any violation of the Civil Remedy Statute, Florida Peninsula is limited in its ability to set forth specific facts to address and/or refute these unsubstantiated assertions. Notwithstanding, Florida Peninsula explicitly denies violations of any applicable Florida Statute in the adjustment of the subject claim and realleges and re-asserts its specific denials to the alleged violations in the subject CRN as set forth above. Florida Peninsula maintains that it has acted and continues at all times to act in good faith during the investigation and adjustment of the Insured’s claim. Further, Florida Peninsula wishes to dispel even the inference of any statutory violation and reiterates below the various reasons which clearly show the proper handling of the subject claim by Florida Peninsula. Additionally, the CRN fails to state with specificity the facts relevant to any alleged policy violation. Julien v. United Property and Casualty Insurance Co., 311 So.3d 875 (Fla. 4th DCA 2021). The CRN merely refers to general language without any details as to how any provisions were actually violated. Thus, the CRN does not satisfy the requirements. BACKGROUND FACTS Aside from the fact that the allegations contained in the subject CRN lack specific facts, the tenor and inferences of statutory violations are wholly without merit, and Florida Peninsula denies each and every one. Below are some of the relevant facts regarding the subject claim that the Insureds failed to include in the CRN. On December 20, 2024, the Insureds contacted Florida Peninsula to report a claim for windstorm damage sustained as a result of Hurricane Milton. The Insureds reported that they found lifted and creased shingles on the east slope of the roof. Additionally, it was reported that the only room impacted was the living room. No further information regarding the alleged damage was provided at the time of the initial reporting of the claim. Immediately, that same day, Florida Peninsula sent correspondence to the Insureds acknowledging receipt of the claim. Upon receiving notice of the Insureds’ claim, Florida Peninsula retained an independent field adjuster to inspect and evaluate the Insured’s property and reported damages, which was conducted December 31, 2024. On January 6, 2025, Florida Peninsula issued its reservation of rights letter to the Insureds informing them of their responsibilities under the policy. In its letter, Florida Peninsula states: There is also a question whether coverage under your policy applies to this loss. Under the policy conditions we need to further investigate this matter to provide a timely response. The nature of the coverage question that exists is whether you have complied with your duties after a loss as noted in “Section I – Conditions” of your policy. Florida Peninsula also included with its letter, the Policy excerpt labeled “Your Duties After Loss.” On January 8, 2025, Florida Peninsula received correspondence from APC Roofing, including a signed contract, W-9 and third party authorization. Florida Peninsula issued its Coverage Determination by letter dated January 13, 2025, informing the Insureds that based on the estimate, the damage to the property was less than the policy’s deductible, therefore, no payment can be made under the claim. In its letter, Florida Peninsula explains: Our inspection of the exterior walls of your home revealed no obvious evidence of any damage or openings on the exterior walls of your home that might have been caused by windstorm or any other peril for which coverage is afforded under the terms of your insurance policy contract. The observed damages were found to be caused by wear and tear. Therefore, without a peril created opening, we are unable to extend coverage for interior water damage and the screens on the sliding glass doors. According to your homeowner’s policy, coverage does not extend to wear and tear, pre-existing damages, or issues related to maintenance. Florida Peninsula also included with its Coverage Determination Letter, an Estimate, Statement of Loss, and applicable Policy language. On January 17, 2025, Florida Peninsula received correspondence from APC Roofing, along with documents regarding the subject claim to which Florida Peninsula acknowledged on January 20, 2025. On February 16, 2025, Florida Peninsula issued its coverage determination informing the Insureds, and their representatives, that there is no coverage for the claim. In its letter, Florida Peninsula explains: Our investigation and supplemental review did not identify any additional damage beyond what was initially addressed. The supplemental estimate from APC Roofing LLC includes additional line items that are not covered or warranted under the policy. The photos provided do not show wind-damaged shingles, and the estimate referenced an incorrect shingle type. Coverage is limited to sudden and accidental damage caused by a covered peril. Additionally, the submitted estimate requests gutter replacement; however, no storm damage was identified. Florida Peninsula also included with its letter, the applicable Policy language. On March 12, 2025, Florida Peninsula received this Civil Remedy Notice. As you can see, Florida Peninsula conducted a good faith comprehensive and prompt investigation of this claim. Florida Peninsula consistently and promptly communicated with the Insureds and their representatives and conducted an inspection of the property. Florida Peninsula afforded coverage based on an inspection and thorough investigation of the claim. Florida Peninsula respectfully denies any wrongdoing in the adjustment and handling of the Subject Claim, and further denies any and all allegations that it violated any statutes. Instead, Florida Peninsula acted quickly and responsibly and in accordance with the terms and provisions of the applicable Policy of insurance as well as with F.S. §624.155 and §626.9541 and its sub-parts. INACCURACY OF ALLEGATIONS IN THE SUBJECT CRN The case specific facts related to Florida Peninsula’s handling of the subject claim provided above implicitly address many of the vague allegations contained within the Insureds’ CRN and further establish that Florida Peninsula undertook a thorough investigation in accordance with applicable statutory requirements and professional standards of care. It is important to note that the Insureds have not provided any factual support for any of the above allegations. Instead, the facts support that Florida Peninsula promptly contacted the Insureds, inspected the claim shortly after it was reported, and issued a coverage determination based on a thorough investigation. When additional information was provided, Florida Peninsula conducted additional investigations. The circumstances support that Florida Peninsula conducted a good faith, thorough, prompt investigation with the information provided. The Insureds are alleging bad faith in a scenario where Florida Peninsula conducted a comprehensive, prompt investigation in good faith. Furthermore, contrary to the requirement to “describe the facts and circumstances giving rise to the insurer’s violation as you understand them at this time”, the purpose of which is “to enable the insurer to investigate and resolve [the] claim”, the Civil Remedy Notice itself only provides completely false allegations with no basis in fact or circumstances. As clearly set forth above and contrary to the allegations set forth in the Notice, Florida Peninsula’s investigations and adjusting of its Insureds’ claim were prompt, thorough, and complete. When additional information was provided, the claim was reopened. Furthermore, the Insureds have included absolutely no facts or evidence to support any claims in the Notice. All of these baseless claims support Florida Peninsula’s position that the claim was properly adjusted, and the Insureds do not actually have any concrete facts to support a bad faith allegation. As mentioned, mere disagreement as to the amount of coverage does not equate to bad faith. The Civil Remedy Notice does not show how Florida Peninsula has failed to comply with the statutory provisions alleged to have been violated. Evidently, this Civil Remedy Notice was filed in bad faith, as it is being used as an improper mechanism designed solely for the purpose of intimidating Florida Peninsula into potentially overpaying the Insureds. For the aforementioned reasons, Florida Peninsula categorically denies that it has acted with bad faith in connection with this claim. CONCLUSION The purpose of a CRN is to provide the insurer an opportunity to “cure” the alleged wrongdoing. Talat Enterprises, Inc. v. Aetna Casualty and Surety Co. , 753 So. 2d 1278 (Fla. 2000). However, the CRN here does not serve this purpose because it does not provide any means as to how FPIC can “cure” the alleged defects. This failure to provide a proper opportunity to cure renders the CRN improper. Longpoint Condominium Associations v. Allstate Insurance Co. , 2005 WL 131580 (N. D. Fla. June 2, 2005). Moreover, the method for curing the violations alleged in a civil remedy notice are not determined by the insured. In Talat Enterprises, Inc. v. Aetna Casualty and Surety Co. , 753 So. 2d 1278 (Fla. 2000), the Florida Supreme Court accepted and quoted the reasoning of the court below in its opinion which stated in relevant part, as follows: Section 624. 155 does not impose on an insurer the obligation to pay whatever the insured demands. . . . Section 624. 155(2)(d) would have no effect or purpose under such an interpretation. The law does not support such an expansive and illogical reading of Fla. Stat. Ann. §624. 155(2)(d). . . . To cure an alleged violation and to avoid a civil action, an insurer must pay the claim . . . before the sixty days expire. Talat, 753 So2d at 1282 citing Talat Enterprises Inc. v. Aetna Cas. & Sur. Co., 952 F. Supp. 773, 777-778 (M. D. Fla. 1996). Here, Florida Peninsula properly afforded coverage for the subject claim as it investigated the loss within the statutory time frame. Florida Peninsula denies all of the allegations contained in the subject CRN, which is defective and improper, as Florida Peninsula has not violated any of the subject statutes. Florida Peninsula further states that the accusations made against it in the subject CRN are patently false. In closing, Florida Peninsula first believes that the Civil Remedy Notice should be rejected and returned by the Department of Financial Services due to its failure to comply with Florida Statute §624.155 and Florida Case law. Due to the lack of any factual and circumstantial basis to support the allegations therein, Florida Peninsula respectfully requests, through this response, that the DFS return and reject the CRN for lack of specificity pursuant to Florida Statutes. Regardless of the rejection, Florida Peninsula denies all allegations contained in the Civil Remedy Notice and submits there are no violations. While Florida Peninsula’s response herein is meant to address the allegations in the Insureds’ Notice, it is based upon the limited information provided in the Civil Remedy Notice and the information presented to date. If the Insured feels that Florida Peninsula is not in possession of all the facts, please inform the undersigned immediately. Please note that Florida Peninsula’s response is not necessarily exhaustive and does not preclude Florida Peninsula or anyone on Florida Peninsula’s behalf from asserting any other valid reason for seeking rejection and return of the Civil Remedy Notice. Also, this letter or any act or failure to act on the part of Florida Peninsula or any agent or representative of Florida Peninsula should not be construed as a waiver of any rights or defenses available to it by contract or at law, as all such rights and defenses are hereby specifically reserved. On behalf of Florida Peninsula, we trust that this response addresses the allegations in the Civil Remedy Notice of Insurer Violation. Should you have any questions regarding this matter or need anything further, please do not hesitate to contact the undersigned. Very Truly Yours, QUINTAIROS, PRIETO, WOOD & BOYER, P.A.
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.

Before submitting a Notice using this system, please verify that all text has been entered correctly and completely. Once the Notice has been submitted, the text cannot be changed or deleted.




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