The purpose of the proposed amendment is to incorporate all of the forms utilized by the Division of Funeral, Cemetery, and Consumer Services (and its predecessors) into one rule and to update the forms.

DEPARTMENT OF FINANCIAL SERVICES
Division of Funeral, Cemetery, and Consumer Services

RULE NO: RULE TITLE
69K-1.001: List of Approved Forms; Incorporation.
PURPOSE AND EFFECT: The purpose of the proposed amendment is to incorporate all of the forms utilized by the Division of Funeral, Cemetery, and Consumer Services (and its predecessors) into one rule and to update the forms.
SUBJECT AREA TO BE ADDRESSED: Forms utilized by the Division of Funeral, Cemetery, and Consumer Services.
SPECIFIC AUTHORITY: 497.101(8), 497.103(5)(b), 497.141(2), (12)(f), 497.142(10)(g), (12), 497.146, 497.147(4)(a), (d), (5), 497.263(2)(a), 497.264(2)(a), 497.266(2), 497.269, 497.270(2), 497.272(7), 497.283(2)(c), 497.287(2), 497.367(2), 497.370(1), 497.375(1), 497.380(4), 497.382(1), (2), 497.385(1)(a), (1)(g)1., (2)(f), (g), 497.453(1)(a), (4)(b), (5)(a), (b), (7)(a), (8), 497.454.(1), 497.456(13)(f), 497.461(4), (8), (12), (16), 497.462(2), (10), 497.464(3), 497.466(5)(c), (8)(a), 497.550(2), 497.551(3), 497.553(2), (6)(a), 497.554(2), 497.602(2)(a), 497.603(2), 497.604(2)(a), (6), 497.606(2)(a), (6), (9)(a), 497.608(2) FS.
LAW IMPLEMENTED: 497.101(8), 497.103(2)(c), 497.141(2), (12)(f), 497.142(10)(g), (12), 497.146, 497.147(4)(a), (d), (5), 497.263(2)(a), 497.264(2)(a), 497.266(2), 497.269, 497.270(2), 497.272(7), 497.283(2)(c), 497.287(2), 497.367(2), 497.370(1), 497.375(1), 497.380(4), 497.382(1), (2), 497.385(1)(a), (1)(g)1., (2)(f), (g), 497.453(1)(a), (4)(b), (5)(a), (b), (7)(a), (8), 497.454.(1), 497.456(13)(f), 497.461(4), (8), (12), (16), 497.462(2), (10), 497.464(3), 497.466(5)(c), (8)(a), 497.550(2), 497.551(3), 497.553(2), (6)(a), 497.554(2), 497.602(2)(a), 497.603(2), 497.604(2)(a), (6), 497.606(2)(a), (6), (9)(a), 497.608(2) FS.
IF REQUESTED IN WRITING AND NOT DEEMED UNNECESSARY BY THE AGENCY HEAD, A RULE DEVELOPMENT WORKSHOP WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:
TIME AND DATE: April 24, 2007, 2:00 p.m.
PLACE: Alexander Building, 2020 Capital Circle, S.E., Tallahassee, Florida
Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 5 days before the workshop/meeting by contacting Diana Evans, [phone]. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT, IF AVAILABLE, IS: Diana Evans, Executive Director, Board of Funeral, Cemetery, and Consumer Services, Alexander Building, 2020 Capital Circle S.E., Tallahassee, Florida 32399-0361, [phone]

THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS:

69K-1.001 List of Approved Forms; Incorporation by Reference.

The following forms used by the Board in its dealings with the public are listed as follows and are hereby adopted and incorporated by reference, and can be obtained from the Department Board office by writing to the Department of Financial Services, Division of Funeral, Cemetery, and Consumer Services, 200 East Gaines Street, Tallahassee, Florida 32399-0361, by logging on to the Department’s website at http://www.fldfs.com., or by telephoning [phone]:

(1) DFS-PNL-1COA-1, effective 9-28-03, entitled “Application for Preneed License,” Rev. 10-06.

(2) DFS-HistS, 7/01 effective 9-28-03, entitled “Historical Sketch,” Rev. 10-06.

(3) DFS-PNLBCOAB, – 12/00 effective 9-28-03, entitled “Application for Preneed License Branch Office License,” Rev. 10-06.

(4) DFS-PNLT1COAT1, 01/01 effective 9-28-03, entitled “Application for Transfer of a Preneed License,” Rev. 10-06.

(5) DFS-RTF-1, effective 9-28-03, entitled “Preneed Funeral Contract Regulatory Trust Fund Remittance,” Rev. 10-06.

(6) DFS-PNS-1, Rev. 04/94 effective 9-28-03, entitled “Registration of a “Preneed Sales Agent Application for Agent License and Initial Appointment,” Rev. 10-06.

(7) DFS-CEMN, 7/01 effective 9-28-03, entitled “Application to Organize a New Cemetery Company,” Rev. 10-06.

(8) DFS-F-32, 10/91 effective 9-28-03, entitled “Financial Statement,” Rev. 10-06.

(9) DFS-CEM, 1/96 REV 7/01 effective 9-28-03, entitled “Application to Transact Cemetery Business,” Rev. 10-06.

(10) DFS-F-35, 01/01 effective 9-28-03, entitled “Application for Authority to Acquire Control of an Existing Cemetery Company,” Rev. 10-06.

(11) DFS-BYLAW1, 6/99 effective 9-28-03, entitled “Pamphlet for Cemetery By-Law Approval,” Rev. 10-06.

(12) DFS-EW-1, 1/99 effective 9-28-03, entitled “Examination Workpapers,”– Rule 69K-6.0052, F.A.C.” Rev. 10-06.

(13) DFS-F-43, REV 9/99 effective 9-28-03, entitled “Performance Bond,” Mausoleums or Below-Ground Crypts.” Rev. 10-06.

(14) DFS-C-1, effective 9-28-03, entitled “Application to Use a Letter of Credit or Surety Bond,” Rev. 10-06.

(15) DFS-C-2, REV 9/99 effective 9-28-03, entitled “Surety Bond,” Rev. 10-06.

(16) DFS-C-3, 3/91 effective 9-28-03, entitled “Letter of Credit/Surety Bond Claim Form,” Rev. 10-06.

(17) DFS-TFR-1, 5/94 effective 9-28-03, entitled “Preneed Funeral Contract Consumer Protection Trust Fund Remittance,” Rev. 10-06.

(18) DFS-TFD-1, 6/01 effective 9-28-03, entitled “Preneed Funeral Contract Consumer Protection Trust Fund Proof of Claim and Disbursement Request,” Rev. 10-06.

(19) DFS-N1-1698, “Pre-Need Funeral & Cemetery Arrangements” Brochure, Eff. 10-06.

(20) DFS-N1-1701, “Board Appointment,” Eff. 10-06.

(21) DFS-N1-1702, “Cemetery Renewal,” Eff. 10-06.

(22) DFS-N1-1703, “Exempt Cemetery Renewal,” Eff. 10-06.

(23) DFS-N1-1704, “Change of Address or Contact Data – Individuals,” Eff. 10-06.

(24) DFS-N1-1705, Change of Address or Contact Data – Entities,” Eff. 10-06.

(25) DFS-N1-1706, “Application for Embalmer License by Internship and Examination,” Eff. 10-06.

(26) DFS-N1-1707, “Application for Embalmer License by Endorsement,” Eff. 10-06.

(27) DFS-N1-1708, “Application for Embalmer Intern License,” Rev. 10-06.

(28) DFS-N1-1709, “Other Licensing Examinations,” Eff. 10-06.

(29) DFS-N1-1710, “Endorsement Licenses – Continued,” Eff. 10-06.

(30) DFS-N1-1711, “Application to Purchase Florida Laws and Rules Examination Study Guide,”

(31) DFS-N1-1712, “Application to Re-Take Florida Law & Rules Exam,” Eff. 10-06.

(32) DFS-N1-1713, “Miscellaneous Applications,” Eff. 10-06.

(33) DFS-N1-1714, “Certification of High School Graduation,” Eff. 10-06.

(34) DFS-N1-1715, “Adverse Licensing Action History Form,” Eff. 10-06.

(35) DFS-N1-1716, “Criminal History Form,” Eff. 10-06.

(36) DFS-N1-1717, “Other Licenses Form,” Eff. 10-06.

(37) DFS-N1-1718, “Business Entity – List of Principals,” Eff. 10-06.

(38) DFS-N1-1719, “Mortuary Science Course Information Form,” Eff. 10-06.

(39) DFS-N1-1720, “Application for Funeral Director License by Internship and Examination,” Eff. 10-06.

(40) DFS-N1-1721, “Application for Funeral Director License by Endorsement,” Eff. 10-06.

(41) DFS-N1-1722, “Application for Funeral Director Intern License,” Eff. 10-06.

(42) DFS-N1-1723, “Application for Combination Funeral Director & Embalmer License by Endorsement,” Eff. 10-06.

(43) DFS-N1-1724, “Application for Combination Funeral Director & Embalmer License by Internship & Exam,” Eff. 10-06.

(44) DFS-N1-1725, “Application to Reactivate Inactive or Delinquent Embalmer License,” Eff. 10-06.

(45) DFS-N1-1726, “Application to Reactivate an Inactive or Delinquent Funeral Director License,” Eff. 10-06.

(46) DFS-N1-1727, “Application to Reactivate an Inactive or Delinquent Funeral Director/Embalmer License,” Eff. 10-06.

(47) DFS-N1-1728, “Application for Inactive Status,” Eff. 10-06.

(48) DFS-N1-1729, “Purchase Order Brochure,” Eff. 10-06.

(49) DFS-N1-1730, “Trustee’s Report, Preconstruction Trust Fund,” Eff. 10-06.

(50) DFS-N1-1731, “Trustee’s Report, Care & Maintenance Trust Fund,” Eff. 10-06.

(51) DFS-N1-1732, “Application for Concurrent Intern License,” Eff. 10-06.

(52) DFS-N1-1733, “Application to Extend Embalmer Apprenticeship,” Eff. 10-06.

(53) DFS-N1-1734, “Notice of Termination/Change of Supervisor,” Eff. 10-06.

(54) DFS-N1-1735, “Examination Questionnaire – Cemetery,” Eff. 10-06.

(55) DFS-N1-1736, “Inspection Form – Removal Service,” Eff. 10-06.

(56) DFS-N1-1737, “Inspection Form – Refrigeration Facility,” Eff. 10-06.

(57) DFS-N1-1738, “Inspection Form – Monument Establishment,” Eff. 10-06.

(58) DFS-N1-1739, “Inspection Form – Funeral Establishment,” Eff. 10-06.

(59) DFS-N1-1740, “Inspection Form – Direct Disposal Establishment,” Eff. 10-06.

(60) DFS-N1-1741, “Inspection Form – Cinerator Facility,” Eff. 10-06.

(61) DFS-N1-1742, “Certification of Licensure in Good Standing,” Rev. 10-06.

(62) DFS-N1-1743, “Change of Funeral Director/Direct Disposer in Charge,” Rev. 10-06.

(63) DFS-N1-1744, “Application for Direct Disposer License,” Rev. 10-06.

(64) DFS-N1-1745, “Inspection Form – Centralized Embalming Facility,” Eff. 10-06.

(65) DFS-N1-1746, “Application for Retired Professionals,” Eff. 10-06.

(66) DFS-N1-1747, “Supervisor’s Quarterly Report of Apprentice or Intern Training,” Rev. 10-06.

(67) DFS-N1-1748, “Application for Funeral Establishment License,” Rev. 10-06.

(68) DFS-N1-1749, “Registration as Training Agency,” Rev. 10-06.

(69) DFS-N1-1750, “Application for Cinerator Facility License,” Rev. 10-06.

(70) DFS-N1-1751, “Funeral Establishment/Report of Cases Embalmed or Bodies Handled,” Rev. 10-06.

(71) DFS-N1-1752, “Direct Disposal Establishment/Report of Cases Embalmed or Bodies Handled,” Rev. 10-06.

(72) DFS-N1-1753, “Cinerator Facility/Report of Cases Embalmed or Bodies Handled,” Rev. 10-06.

(73) DFS-N1-1754, “Centralized Embalming Facility/Report of Cases Embalmed or Bodies Handled,” Rev. 10-06.

(74) DFS-N1-1755, “Application for Embalmer Apprentice License,” Rev. 10-06.

(75) DFS-N1-1756, “Application for Centralized Embalming Facility License,” Rev. 10-06.

(76) DFS-N1-1757, “Application for Direct Disposal Establishment License,” Rev. 10-06.

(77) DFS-N1-1758, “Application for Refrigeration Facility License,” Rev. 10-06.

(78) DFS-N1-1759, “Application for Removal Service License,” Rev. 10-06.

(79) DFS-N1-1760, “Application for Approved Continuing Education Provider Status,” Rev. 10-06.

(80) DFS-N1-1761, “Application for Continuing Education Course Approval,” Rev. 10-06.

(81) DFS-N1-1762, “Monument Establishment Sales Agent Application for Agent License,” Eff. 10-06.

(82) DFS-N1-1763, “Monument Sales Agent Renewal,” Eff. 10-06.

(83) DFS-N1-1764, “Change of Name & Request for Revised License Certificate – Entities,” Eff. 10-06.

(84) DFS-N1-1765, “Change of Name & Request for Revised License Certificate – Individuals,” Eff. 10-06.

(85) DFS-N1-1766, “Request for Duplicate License,” Eff. 10-06.

(86) DFS-N1-1767, “Inspection Form – Cemetery,” Eff. 10-06.

(87) DFS-N1-1768, “Provisional or Temporary License, Application for Initial License,” Eff. 10-06.

(88) DFS-N1-1769, “Provisional or Temporary License, Application for Renewal,” Eff. 10-06.

(89) DFS-N1-1770, “Election of Procedures for Removal of Cremated Remains and Poscremation Processing,” Eff. 10-06.

(90) DFS-N1-1771, “Broker of Burial Rights Renewal,” Eff. 10-06.

(91) DFS-N1-1772, “Monument Establishment Renewal,” Eff. 10-06.

(92) DFS-N1-1773, “PNL Examination,” Eff. 10-06.

(93) DFS-N1-1774, “Preneed Sales Agent – Application for Appointment,” Eff. 10-06.

(94) FD-258, “U.S. Department of Justice, Federal Bureau of Investigation, Fingerprint Cards,” Rev. 5-11-99.

(95) DFS-C-MON1, “Application for Monument Establishment License,” Rev. 10-06.

(96) DFS-EC-1, “Report of Identification for an Exempt Cemetery,” Rev. 10-06.

(97) DFS-PNL-R1, “Preneed License Renewal Application,” Rev. 10-06.

(98) DFS-PNL-R2, “Preneed License Annual Financial Statement,” Rev.10-06.

(99) DFS-PNL-R3, “Preneed License Annual Renewal Statement,” Rev. 10-06.

(100) DFS-C-BBRI, “Broker of Burial Rights License Application,” Rev. 10-06.

(101) DFS-PNLBR “Application for Preneed Branch Office Renewal License,” Eff.10-06.

Specific Authority 497.101(8), 497.103(5)(b), 497.141(2), (12)(f), 497.142(10)(g), (12), 497.146, 497.147(4)(a), (d), (5), 497.260, 497.263(2)(a), 497.264(2)(a), 497.266(2), 497.269, 497.270(2), 497.272(7), 497.276, 497.281, 497.283(2)(c), 497.287(2), 497.367(2), 497.370(1), 497.375(1), 497.380(4), 497.382(1), (2), 497.385(1)(a), (1)(g)1., (2)(f), (g), 497.453(1)(a), (4)(b), (5)(a), (b), (7)(a), (8), 497.454.(1), 497.456(13)(f), 497.458, 497.459, 497.460, 497.461(4), (8), (12), (16), 497.462(2), (10), 497.463, 497.464(3), 497.466(5)(c), (8)(a), 497.550(2), 497.551(3), 497.553(2), (6)(a), 497.554(2), 497.602(2)(a), 497.603(2), 497.604(2)(a), (6), 497.606(2)(a), (6), (9)(a), 497.608(2) FS. Law Implemented 497.101(8), 497.103(2)(c), 497.141(2), (12)(f), 497.142(10)(g), (12), 497.146, 497.147(4)(a), (d), (5), 497.263(2)(a), 497.264(2)(a), 497.265, 497.266(2), 497.268, 497.269, 497.270(2), 497.272(7), 497.283(2)(c), 497.287(2), 497.367(2), 497.370(1), 497.375(1), 497.380(4), 497.382(1), (2), 497.385(1)(a), (1)(g)1., (2)(f), (g), 497.452, 497.453(1)(a), (4)(b), (5)(a), (b), (7)(a), (8), 497.454.(1), 497.456(13)(f), 497.461(4), (8), (12), (16), 497.462(2), (10), 497.464(3), 497.466(5)(c), (8)(a), 497.550(2), 497.551(3), 497.553(2), (6)(a), 497.554(2), 497.602(2)(a), 497.603(2), 497.604(2)(a), (6), 497.606(2)(a), (6), (9)(a), 497.608(2)  FS. History–New 9-28-03, Formerly 3F-5.010, 69K-5.010, Amended _________.