STATE OF FLORIDA OFFICE OF THE ATIORNEY GENERAL

DEPARTMENT OF LEGAL AFFAIRS

IN THE INVESTIGATION OF:

SJ Creative Enterprises, LLC; Promonote, LLC, d/b/a RoUabind and Promotional Notebook; and Jaeobo Feldman,

Respondents

--------------------------------------------------------~/

Case No. L14-3-1083

ASSURANCE OF VOLUNTARY COMPLIANCE

1. PURSUANT to the provisions of Chapter 501, Part ll of the Florida Statutes,

Florida's Deceptive and Unfair Trade Practices Act, the Office Of The Attorney General,

Department Of Legal Affairs (hereinafter referred to as the "Department"), caused an

investigation to be made into certain acts and practices of SJ Creative Enterprises, LLC;

Promonote, LLC, d/b/a Rollabind and Promotional Notebook; and Jacobo Feldman (collectively

hereinafter, ''Respondents").

2. SJ Creative Enterprises, LLC ("SJ Creative") is an active Florida limited liability

corporation with a principal place of business at 6800 E. Rogers Circle, Boca Raton, Florida.

3. Promonote, LLC, d/b/a Rollabind and Promotional Notebook (''Promonote'') is an

inactive Florida limited liability corporation with a principal place of business at 6600 W. Rogers

Circle, Suite 6, Boca Raton, Florida.

4. Jacobo Feldman ("Feldman") is an individual residing at 5809 NW 21 Way Boca

Raton, FL 33496, and is the sole manager and director of SJ Creative and Promonote.

5. Respondents are prepared to enter into this Assurance of Voluntary Compliance

(hereafter referred to as the "A VC") without an admission that Respondents violated Florida's

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Deceptive and Unfair Trade Practices Act ("FDUTP A'') or any other law and solely for the

purpose of resolution of this matter with the Department.

6. Pursuant to Section 501.207(6), Florida Statutes, the Department agrees to accept

this A VC in termination of its investigation as to Respondents solely as to the acts and practices

that were the subject of the investigation.

7. Stipulated Facts. The Department and Respondents hereby agree and stipulate to

the following:

a. During the time frame beginning at least October 2011 through the

present, Respondents engaged in the business of selling notebook, promotional and

organizational office products to consumers in the State of Florida and elsewhere.

b. The Department has investigated allegations that Respondents violated

FDUTPA by failing to deliver products in the time, manner and amount that they were

sold to consumers, and by failing to provide refunds or satisfactory resolutions to

consumer complaints.

8. This A VC is based upon the stipulated facts set forth herein. The Department

shall not be estopped from taking further action in this matter should the facts described herein

be shown to be incorrect in any material way or should this A VC not be complied with in full by

Respondents. The parties agree that this A VC has been entered into based on the truthfulness of

the information provided by Respondents.

9. Definitions. "Clear and Conspicuous" (including "Clearly and Conspicuously'')

means that a statement is made in a manner readily noticeable and understandable to the persons

to whom it is directed. To determine whether a statement is Clear and Conspicuous, factors to

consider include:

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a whether it is of sufficient prominence in tenns of sound and speed, font,

size, placement, color, contrast, and duration of appearance, as compared with

accompanying statements, claims, terms, or representations, so that it is readily

noticeable, understandable, and likely to be heard or understood by a reasonable person ;

and if written or conveyed electronically, the tenns are not buried on the back or bottom,

or in unrelated infonnation or placed on a portion of the page that a reasonable person

would not think contained significant infonnation;

b. whether it is located sufficiently near any other statement that it clarifies,

modifies, or explains, or that clarifies, modifies, or explains it;

c. whether it is presented to the person(s) to whom it is directed in a coherent

and meaningful sequence with respect to other terms, representations claims or

statements being conveyed;

d. whether it contradicts, or renders confusing or ambiguous, any other

statement, or appears to be inconsistent with any other statement;

e. whether, if it is oral, it is at an understandable pace, tone and volume as

the sales offer, or, if not oral, it appears for a duration sufficient to allow viewers to have

a reasonable opportunity to notice or read, and is free of distractions that compete for the

attention of the consumer;

f. whether it is presented in such a way as to be free of distractions,

including but not limited to sound, graphics, text or other offers that compete for the

attention of the consumer; and

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g. whether, in advertising on the Internet, it is made on the same page as any

other term, statement, claim or representation that it modifies, and either above the fold

or Clearly and Conspicuously referenced or linked to a location below the fold.

10. Respondents agree and stipulate that they will cease, desist and are hereby barred,

directly as well as indirectly through representatives, agents, employees, successors, assigns,

independent contractors or any other person who acts under, by, through, or on behalf of

Respondents, from engaging in unfair and deceptive trade practices in the marketing, selling,

advertising, offering, or providing of notebook and organizational supplies to consumers in the

State of Florida.

11. Respondents, including their representatives, agents, employees, successors,

assigns, independent contractors or any other person who acts under, by, through, or on behalf of

Respondents, directly or indirectly, or through any corporate or other device, shall:

a. Comply with the Florida Deceptive and Unfair Trade Practices Act, Chapter 501, Part 11, Florida Statutes;

b. Not make any false or misleading representations in any communications or advertising to consumers;

c. Maintain sufficient inventory on hand to fulfill all orders when placed, or -otherwise provide Clear and Conspicuous disclosures about available product inventory including out-of-stock and/or back-ordered items;

d. Provide Clear and Conspicuous disclosures about product shipment/fulfillment dates, and fulfill all orders in whole within the timeframes promised;

e. For any product that goes unexpectedly out of stock, notify the consumer within 48 hours of order placement and provide the consumer an opportunity to wait for shipment or obtain a full and immediate refund;

f. Refrain from charging consumer's credit cards until tlteir entire orders are shipped;

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g. Notwithstanding the above, provide complete refunds within 48 hours for any and all orders that cannot be fulfilled within the promised timeframe, or cannot be fulfilled in whole;

h. Refrain from misrepresenting the terms or conditions of product orders; and

i. Clearly and Conspicuously disclose any and all terms reasonably necessary to infonn consumers of special conditions pertaining to their orders.

12. Respondents shall preserve and retain all relevant business and financial records

relating to the acts and practices at issue in this A VC and other infonnation reasonably sufficient

to establish compliance with the provisions of this A VC for two (2) years from the date of this

A VC, and shall provide reasonable access to such documents and information to the Department

upon request.

13. Respondents shall make the terms and conditions of this A VC known to any

managers, members, officers, directors, employees, agents, independent contractors or anyone

else acting for or on behalf of Respondents. The obligations imposed by this A VC are

continuing in nature and shall apply to Respondents' successors and assigns as well as any and

all new officers, employees, agents, representatives or any other persons who become engaged in

the business or activities of Respondents.

14. Respondents shall not affect any change in the form of doing business or the

organizational identity of any of the existing business entities or create any new business entities

as a method of avoiding the obligations and tenns and conditions set forth in this A VC.

15. Subject to Respondents' full, complete and timely compliance with the terms of

this A VC, the Department is waiving pursuant to this settlement and in consideration of the

Respondents' perfonnance hereunder the civil penalties that would otherwise be due for the acts

and practices at issue under Sections 501.2075 or 501.2077, Florida Statutes, of up to $15,000

per violation in consideration of the parties' entry into this A VC. The total civil penalty liability

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that would otherwise be due, but for Respondents' full and complete compliance with this A VC,

is stipulated to be at least $330,000.00.

16. It is hereby agreed by the parties that any failure to comply with the terms and

conditions of this A VC by Respondents is by statute prima facie evidence of a violation of

Chapter 501, Part IT, Florida Statutes, and will subject Respondents to any and all civil penalties

and sanctions authorized by law, including attorneys' fees and costs. In the event that a court of

competent jurisdiction makes a determination that a violation of any condition of this A VC bas

occurred, then Respondents shall be liable for a consent judgment against Respondents in the

amount of $330,000.00 (Three Hundred Thirty Thousand Dollars) in civil penalties, as well as

attorney's fees and costs and any other legal or equitable relief as the court may determine

appropriate.

17. The Department's agreement to this AVC is expressly premised upon the

truthfulness, accuracy and completeness of Respondent Jacobo Feldman's sworn fmancial

statement submitted to the Department, signed under penalty of perjury on April28, 2015. This

sworn financial statement includes material information upon which the Department relied in

negotiating and agreeing to this A VC. If the Department learns that Respondent Jacobo

Feldman's financial statement failed to disclose any material asset or materially misstated the

value of any asset, or made any other material misstatement or omission, such disclosure(s) or

non-disclosure(s) will be deemed to be a failure to comply with the terms and conditions of this

AVC and Respondents shall be liable for a consent judgment as described in paragraph 16 above.

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18. The original AVC bearing the notarized signatures of Respondents and the

payrnent(s) due hereunder will be delivered to the attention of Assistant Attorney General Sarah

Shullman, Office of the Attorney General, Consumer Protection Division, 1515 N. Flagler Drive,

Suite 900, West Palm Beach, FL 33401.

19. Upon the expiration of91 days following the latter of full execution of this AVC,

provided the Respondents have fully and completely performed all obligations owing to date and

no voluntary or involuntary petition for bankruptcy or other declaration of insolvency has been

filed as to any of the Respondents, the Department shall close its civil investigation into the acts

and practices of Respondents at issue herein, provided that such closure shall be without

prejudice to any other remaining investigation(s) that may otherwise exist as to Respondents or

any other entities.

20. The effective date of this A VC shall be the date of its execution and delivery by

the Department. Acceptance by the Department shall be established by the signature of the

Bureau Chief. The receipt by the Department of any monies pursuant to the A VC does not

constitute acceptance by the Department, and any monies received shall be returned to

Respondent if this AVC is not accepted and fully executed by the Department.

21. It is further agreed that facsimile copies of signatures and notary seals may be

accepted as original for the purposes of establishing the existence of this agreement, and this

AVC may be executed in counterparts the compilation ofwhich shall constitute the full and final

agreement.

22. Notice to any of the parties to this A VC as may be required shall made by

certified mail and email at the addresses set forth below unless any party notifies the other parties

in writing of another address to which notices should be provided.

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To Res.pondents:

Mark B. Goldstein, Esq. Mark B. Goldstein, P.A. 2700 N. Military Trail, Suite 130 Boca Raton, Florida 33431

To the Department:

Sarah L. Shullrnan Assistant Attorney General Office of the Attorney General Consumer Protection Division 1515 N. Flagler Drive, Suite 900 West Palm Beach, FL 33401

23. Nothing in this A VC is to be construed as a waiver of any private rights of any

person or release of any private rights, causes of action, or remedies of any person against

Respondents or any other person or entity.

24. It is a condition of each of the Department's obligations under this AVC that the

Respondents have fully and timely performed all of Respondents' obligations previously due

under this A VC.

25. Notwithstanding any other provision of this AVC, nothing herein shall be

construed to impair, compromise or affect any right of any government agency other than the

Office of the Attorney General for the State of Florida.

26. This AVC is the final, complete, and exclusive statement of the parties'

agreement on the matters contained in this A VC, and it supersedes all previous negotiations and

agreements. Other than any representation expressly stated in this A VC, the parties have not

made any representations or warranties to each other, and neither party's decision to enter into

this AVC is based upon any statements by the other party outside of those in this A VC.

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27. It is further agreed that the parties jointly participated in the negotiation of the

tenn.s of this A VC. No provision of this A VC shall be construed for or against any party on the

grounds that one party had more control over establishing the tenns of this A VC than another.

28. By my signature, I hereby affinn that I have authority to execute this A VC on

behalf of the party indicated and, to the extent I am acting in a representative capacity, I am

acting within the scope of my authority as corporate representative, and that by my signature I

am binding the party/parties indicated to the tenns and conditions of this AVC.

SIGNATURES TO FOLLOW

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SJ CREATIVE ENTERPRISES. LLC PROMONOTE. LLC. D/B/A ROLLABIND AND PROMOTIONAL NOTEBOOK

Agreed to and signed this l~fh day of fi-{Jilt L , 2015, by the below-stated person who

stated and affirmed as follows:

BY MY SIGNATURE I hereby affirm that I am acting in my capacity and within my

authority as the Manager, Owner and President of SJ CREATIVE ENTERPRISES, LLC; and

PROMONOTE, LLC, d/b/a ROLLABIND and PROMOTIONAL NOTEBOOK, and that by my

signature I am binding SJ CREATIVE ENTERPRISES, LLC; and PROMONOTE, LLC, d/b/a

ROLLABIND and PROMOTIONAL NOTEBOOK to the terms and conditions of this A VC.

By:

STATE OF FLORIDA ) COUNTY OF PALM BEACH )

BEFORE ME, this J fi), day of {J) ~( L , 2015, an officer duly authorized to take acknowledgments in the State of Florida, personally appeared Jacobo Feldman, who acknowledged before me that he executed the foregoing instrument for the urposes therein stated.

{print, type r stamp commiSSIOned name ofNotary Public)

Personally known __ or Produced Identification F/.I)L (check one) Type of Identification Produced:

J)L ~ Frt~s·tF~o· V?• 31' · 0

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JACOBO FELDMAN

BY MY SIGNATURE I hereby affirm that I am acting in my individual capacity, and

that by my signature I am binding myself, individually, to the terms and conditions of this A VC.

SIGNED this c) ~7f day of &'?v• L. ,2015.

JACOBO.~~~ STATE OF FLORIDA ) COUNTY OF PALM BEACH )

BEFORE ME, this J' Th day of !A~~~ L , 2015, an officer duly authorized to take acknowledgments in the State of Florida, personally appeared Jacobo Feldman, who acknowledged before me that he executed the foregoing instrument for the urposes therein stated.

Personally known __ or Produced Identification Ff. bL( check one) Type of Identification Produced; JL~F~lS·VJO·V'·~l,-6

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FOR THE OFFICE OF THE ATTORNEY GENERAL

PJ? 1/f( _Lt. _. '/ Signed this.£::__ day of......,_.Pf-rtF-'-·-......:>' 2015

L

Assistant Attorn General Office of the rney General Florida Bar No. 0888451 1515 North Flagler Drive, Suite 900 West Palm Beach, FL 33401 Telephone No.: (561) 837~5000 Facsimile No.: (561) 837-5109 Electronic mail: sarah.shullman@myfloridalegal.com

Accepted this~~ _day of Vl/~." \

'2015

South Florida Bureau Chief, Consumer Protection Division Office of the Attorney General 1515 North Flagler Drive, Suite 900 West Palm Beach, FL 33401

Page 12 ofl2 Initials J (-

BACKGROUND INFORMATION

Item 1. Information About You

Your Full Name _j~ t ~ ~£\.3 ~f.\ .J Social Security No. S q "-\ 2 S ~ ~ \) 0 Place ofBirth ~ f,c'LO ~'-" d Date ofBirthCS • \J\& -~1 Drivers License No.f'\ ~S-'\ 1a -'\\' ~1~.,

Current Address S\~ l\ MrJ L\ W'· t;:J ~~~ ~",...) ~?,~={,.From (Date) \ '\(\ "{

Rent or Own? ()w J Telephone No.~\ "'-'<::li~ ~ '1.. Facsimile No. - ---------

E-Mail Address ..)Pt~~ . <=' Ql.. 'l,Q \\ f\~ \ ..J ~ c \B4, Internet Home Page W ~....J . <la \\ ~\.J!) -~

Previous Addresses for past five years:

Address. ____ .....;S=-..:~et...!...t\1-...3-~~-------- Rent or Own? ___ From/Until, _____ _

Address. _________________ Rent or Own? ___ From/Until. ______ _

Identify any other name(s) and/or social security number(s) you have used, and the time period(s) during which they

were used, _________________________________ _

Item 2. Information About Your Spouse or Live-In. Companion

Spouse/Companion's Name ......:=:i)::.,....;._~.;....._~.;:...,3Q_<.....:::....l!l€.. ______ ___ Social Security No. - ---- ---

Place ofBirth ________________ Date ofBirth ___________ _

Identify any other name(s) and/or social security number(s) your spouse/companion has used, and the time period(s)

during which they were used----------------------------

Address (if different from yours) - --------------------------

From (Date)----------Rent or Own? ____ Telephone No .. _________ _

Employer's Name and Address----------------- ----------

Job Title---------Years in Present Job _ _ __ Annual Gross Salary/Wages$. _____ _

Item 3. Information About Your Previous Spouse

Previous Spouse's Name & Address------------------------- -

- -------- - ---Social Security No. _______ Date of Birth _____ _

Item 4. Contact Information

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Name & Address of Nearest Living Relative or Friend---------------------

------------------------ Telephone No.---------

Information About Dependents Who Live With You

~>Name ______ i-J __ \~f\ ________ Date of Birth ___________ _

Relationship---------------- Social Security No.-----------

~>Name __________________ DateofBirth ____________ _

Relationship---------------- Social Security No.-----------

~>Name ___________________ DMeofBirth _______________ __

Relationship----------------- Social Security No.-----------

Information About Dependents Who Do Not Live With You

~>Name&Addre~---------~--\~~------------------------------------------Date of Birth _ _ _ ____ Relationship - - ------- Social Security No. ___ _ ___ _

~>NameAddr~s _____________________________________ __

Date of Birth _ _ ___ ___ Relationship------- - Social Security No., _ _____ _

~>Name&Address _______ _____ ______ _ _ _______________ _ _

D&e of Birth------- Relationship - ----- -- Social Security No. _ ____ _ _

Employment Information

Provide the following infonnation for this year-to-date and for each of the previous five full years, for each company of which you were a director, officer, employee, agent, contractor, participant or consultant at any time during that period. "Income" includes, but is not limited to, any salary, commissions, draws, consulting fees, loans, loan payments, dividends, royalties or other benefits for which you did not pay (e.g., health insurance premiums, automobile lease or loan payments) received by you or anyone else on your behalf.

~>Company Name & Address ~ ~ C:.Q..tp,"' vJ i. t ,J ~~ Q_ t ~ ~ ~ \...\., C:., . 2~~s t-AN f'-<:f· -.,~c c~"' .... ttiC &-.....sL,~~U\ ~IJ R "S')"'\1_!,

Dates Employed: From (Month/Year) 0\ -\\ · 1-C \ ..._\ To (Month/Year) C"-\ • "1~ · \ '::;)

Positions Held with Beginning and Ending Dates ___ c.;;..(...;_-_~,;__'_t_\~Q_-=,.__ _ ____ _____ _

Item 7. continued

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Income Received: This year-to-date: $. _ _ ______ _ $. ______ _ _

20 __ : $. _________ _ $. ______ _ _

$. __ ~------------ $. _____________ __

•Company Name & Address __________ ~_._\...:......:::o_-=------------------------------Dates Employed: From (Month/Year) --------- - To (Month/Year)-----------

Positions Held with Beginning and Ending Dates------------------------ ---

Income Received: This year-to-date: $. _________ _ $ _ __________ _

20__ $ _______ _ $ ______ _ _

$ _________ _ $. ________ _

•Company Name & Address ____ _ ..:..fi_\_.,,-CQrL...!-_________ _________ _

Dates Employed: From (Month/Year)_·-----------To (Month/Year)-----------

Positions Held with Beginning and Ending Dates - ----- - ------ - ---- - ---

Income Received: This year-to-date: $. _ _ ______ _ $ __________ _

20 __ : $. _______ _ $. _ _ _ _____ _

$ ___________ __ $. ____ ______ __

ItemS. Pending Lawsuits Filed by You or Yo11r Spouse

List all pending lawsuits that have been filed by you or your spouse in court or before an administrative agency. (List lawsuits that resulted in final judgments or settlements in Items 16 and 25).

Opposing Party's Name & Address --------~--\..:__Pt..:__ ______________________ _ Court' s Name & Address--------~---------------------

Docket No.-- -----Relief Requested---- ---- Nature of Lawsuit--- -----

______________ smtus ____ ____ _ ________ _____ _

Item 9. Pending Lawsuits Filed Against You or Your Spouse

List all pending lawsuits that have been tiled against you or your spouse in court or before an administrative agency. (List

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lawsuits that resulted in final judgments or settlements in Items 16 and 25. Attach additional sheets if necessary.)

Opposing Party's Name & Address---------------------------

Court's Name & Address------------------------------

Docket No.-------Relief Requested ________ Nature ofLawsuit --------

------- __________ Smtus ______________________ _

Item 10. Safe Deposit Boxes

List all safe deposit boxes, located within the United States or elsewhere, held by you, your spouse, or any of your dependents, or held by others for the benefit of you, your spouse, or any of your dependents. On a separate page, describe the contents of each box.

Owner's Name Name & Address of Depository Institution Box No.

Item 11. Business Interests

List all businesses for which you, your spouse, or your dependents are an officer or director.

~>Business' Name & Address-------------- - - ---------------

Business Format (e.g., corporation)-----------Description of Business---------

---------------------- Position(s) Held, and By Whom-------------- --

~>Business' Name & Address_-=------ - - ---- -----------------

Business Format (e.g., corporation)----~------Description of Business----- ----

------- ---------- Position(s) Held, and By Whom--- -------------

~>Business' Name & Address ___________ _ _______ _________ __:___

Business Format (e.g., corporation)---------- - Description of Business---------

------------ Position(s) Held, and By Whom------------- ---

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FINANCIAL INFORMATION: ASSETS AND LIABILITIES

REMINDER: "Assets" and "Liabilities" include ALL assets and liabilities, located within the United States or elsewhere, whether held individually or jointly.

Item 12. Cash, Bank, and Money Market Accounts

List cash and all bank and money market accounts, including but not limited to, checking accounts, savings accounts, and certificates of deposit, held by you, your spouse, or your dependents, or held by others for the benefit of you, your spouse, or your dependents. The term "cash" includes currency and uncashed checks.

Cash on Hand $. ________________ Cash Held For Your Benefit $. __________ _

Name on Account Name & Address of Financial Institution Account No. Current Balance

------- --------------------------------------$-----

-------------- -----------------------------------------$ ___ _

---------- -~------------------------------- ------------ $ _____ _

------------- ----------- --------- ---------------------$ _ ____ __

------$ \"-\ '\ \W

Item 13. U.S. Government Securities FJ \ ~ List all U.S. Government securities, including but not limited to, savings bonds, treasury bills, and treasury notes, held by you, your spouse, or your dependents, or held by others for the benefit of you, your spouse, or your dependents.

Name on Account T:xpe of Obligation Security Amount Maturity Date

----------------------- --------- --------$ _ ____________ _

-----------------------------------------$ ________________ _ _

----------------------------------------------$ __________________ _ _

Item 14. Publicly Traded Securities and Loans Secured by Them J.i \ ~ Page 6 Initials~~ _____:: __ _

List all publicly traded securities, including but not limited to, stocks, stock options, registered and bearer bonds, state and municipal bonds, and mutual funds, held by you, your spouse, or your dependents, or held by others for the benefit of you, your spouse, or your dependents.

~>Issuer _____________ Type of Security ________ No. of Units Owned _ _ _ _

Name on Security - ------ Current Fair Market Value$ ____ Loan(s) Against Security$. ____ _

Broker House, Address----------------------Broker Account No.-----

~>Issuer _____________ Type of Security ___ _____ No. of Units Owned _ _ _

Name on Security------- Current Fair Market Value$. ____ Loan(s) Against Security $ ___ _

Broker House, Address------- ------- -----Broker Account No. _ _ __ _

Item 15. Other Business Interests

List all other business interests, including but not limited to, non-public corporations, subchapter-S corporations, limited liability corporations ("LLCs"), general or limited partnership interests, joint ventures, sole proprietorships, and oil and mineral leases, held by you, your spouse, or your dependents, or held by others for the benefit of you, your spouse, or your dependents.

~>Business Format Business' Name & Address ------------------ --------------------- -------- - - -------------- --Ownership% ____ _

Owner (e.g., selt: spouse) -------------Current Fair Market Value$ _ _ _____ _

~>Business Format _ _____ _ _____ Business' Name & Address------- - ------ ---

------ ---------------- - -------- - --- Ownership% ____ _

Owner (e.g., self: spouse)----'--------------Current Fair Market Value$ _______ _

Item 16. Monetary Judgments or Settlements Owed to You, Your Spouse, or Your Dependents ~ \ Q._

List all monetary judgments or settlements owed to you, your spouse, or your dependents.

•Opposing Party's Name & Address------------------------------

Court' s Name & Address------- ---------------- Docket No. _____ _

Nature ofLawsuit _______________ Date of Judgment _____ _ Amount$ _ ___ _

~>Opposing Party's Name & Address---------------- ----------

Court's Name & Address--------------- --------Docket No. _ ____ _

Nature of Lawsuit Date of Judgment Amount $ _____ _ Item 17. Other Amounts Owed to You, Your Spouse, or Your De_pe_ n_d_e_n_ts __ 1J---'I\.- ~

Page 7 Initials ~-=....o.r ____

List all other amounts owed to you, your spouse, or your dependents.

Debtor's Name, Address, & Telephone No.-------------------------

Original Amount Owed$ _____ Current Amount Owed $ _____ Monthly Payment$ ____ _

Item 18. Life Insurance Policies

List all life insurance policies held by you, your spouse, or your dependents.

•Insurance Company's Name, Address, & Telephone No.--------------------

Insured _____ _ _ _ __ Beneficiary ----------Face Value$. ________ _

Policy No. _______ Loans Against Policy$ _______ Surrender Value$ _____ __ _

•Insurance Company's Name, Address, & Telephone No.--------------------

Insured----------Beneficiary----------Face Value$ ________ _

Policy No. _______ Loans Against Policy$ _______ Surrender Value$ _______ _

Item 19. Deferred Income Arrangements

List all deferred income arrangements, including but not limited to, deferred annuities, pensions plans, profit-sharing plans, 40l(k) plans, IRAs, Keoghs, and other retirement accounts, held by you, your spouse, or your dependents, or held by others for the benefit of you, your spouse, or your dependents.

•Name on Account----------Type of Plan ________ Date Established ___ _

Trustee or Administrator's Name, Address & Telephone No.--------------------

Account No.--------- Surrender Value$. _______ _

•Name on Account----------Type of Plan _ _ ___ ___ Date Established ___ _

Trustee or Administrator's Name, Address & Telephone No. - -------------- - - ---

Account No. Surrender Value$ --------Item 20. Personal Property

List all personal property, by category, whe~er held for personal use or for investment, including but not limited to,

Page 8 Initials -~--!£: __ _

furniture and household goods of value, computer equipment, electronics, coins, stamps, artwork, gemstones, jewelry, bullion, other collectibles, copyrights, patents, and other intellectual property, held by you, your spouse, or your dependents, or held by others for the benefit of you; your spouse, or your dependents.

Prwertv Category (e.g .. artwork. jewelry)

J\~

Name of Owner Pronertv Location

Item 21. Cars, Trucks, Motorcycles, Boats, Airplanes, and Other Vehicles

$

$

$

$

$

$

d~Yi~iDQn Current ~ Value

$

$

$

$

$

$

List all cars, trucks, motorcycles, boats, airplanes, and other vehicles owned or operated by you, your spouse, or your

dependents, or held by others for the benefit of you, your spouse, or your dependents. Attach additional sheets if

necessary.

~Vehicle Typ~ P E.<? Make ~ t ~ ~ Model (_~ \'-. \'\ ~ Year~\ '\ Registered Owner's Nam&t ~ ~~ a.~(:) Y\ ~Registration State & No. __ f_L _______ _ Address of Vehicle's Location S\ ~ ~ tVv.J ~' ~ ~a \A ~ ...J k. ~ ~"-\ ~ \o

Purchase Price$ t~ ~ \o \. ""' Current Value $ ~ ~ ~<:)\) AccounfJLoan No. \' '-\!{ ~ l ~ Lender's Name and Address C~ \~\.J::.IL. ~' -J ~..,) 'C, ~\...­

Original Loan Amount $L~~ '-t \~J Current Loan Balance $L\c:,.~ \ "(J r ?.,~; Monthly Payment $ ~ -

~vehicle Type _______ Make --------Model _________ Year __ _

Registered Owner's Name----------Registration State & No.-----------

Address of Vehicle's Location----------------------- -----

Purchase Price $ ______ Current Value $ ____ _ _ Accounf1Loan No.------~---

Lender's Name and Address-----------------------------

Original Loan Amount $. ______ Current Loan Balance$. ______ Monthly Payment$. ____ _

Item 21. Continued

~vehicle Type _______ Make ________ Model _______ .,....__Year __ _

Page: 9 Initials J F

Registered Owner's Name _ _________ Registration State & No.------------

Address of Vehicle's Location ---------------------------------------------------------Purchase Price $ ______ Current Value$ ______ Account/Loan No.----------------

Lender's Name and Address -----------------------------------------------Original Loan Amount $ ___ ___ Current Loan Balance$ _______ Monthly Payment$. ____ _

Item 22. Real Property

List all real estate held by you, your spouse, or your dependents, or held by others for the benefit of you, your spouse, or your dependents.

~Type ofProperty ~~~~t c~~ (~~~) Property's Location~'\~~ N-N L\ ~ ~Q~ ~R :::;::::::j ~ ~ ~

Narne(s) on Title and Ownership Percentages ____ \.;;:.,~ __ ..:__"'_\..:........o::~ ____________________________ _

Acquisition Date \1::\ (\ ~ r Purchase PriceS~~\. ~::l Current Value$~~ ~-~ -

Basis ofValuation f"'t:U'l~' Loan or Account No.~~ \\ 'L'i':\ ~ Lender'sNameandAddress\tJ~\...'l £9-t_~., \a\\ ~~~ (ln ~ '-.. ~ t ,..:, ,..._) \ "---\~~

Current Balance On First Mortgage $ ~ 1 \' ~~ Monthly Payment $ <"'3 ~~ -

Other Loan(s) (describe) ________________________ Current Bala!tce S ______ _

Monthly Payment$. _________ Rental Unit? ___ ____ Monthly Rent Received$ _ _ __ _

~Type ofProperty ________________ Property's Location._ _ __________ ___ _

Name(s) on Title and Ownership Percentages. ___________________________________ _

Acquisition Date. _ _____ Purchase Price$ ___ _____ Current Value$ ___________ _

Basis of Valuation'--------------------------- Loan or Account No._·------------------

Lender's Name and Address ________________________________________________ _

Current Balance On First Mortgage $ _____ _ _ _ Monthly Payment$ ___________ __

Other Loan(s) (describe) _ ________________ Current Balance$. ______ _ _ _

Monthly Payment$. _ _______ Rental Unit? ___ ____ Monthly Rent Received$. ____ _

Item 23. Credit Cards

List each credit card held by you, your spouse, or your dependents. Also list any other credit cards that you, your spouse, or your dependents use.

Page 10 Initials ) k

Name of Credit Card (e.~ .. Visa. MasterCard. Department Store)

Item 24. Taxes Payable

AS.:£QYnt No.

~~~

~~

Name(~) Qn Account

~~~~~ o/ ./ $

$

$

$

s

Current MinimY!J), Halance Monthlx fam~nt

\Lo\o $ -1.~ '\\S

,-$ 2~

$

$

$

$

List all taxes, such as income taxes or real estate taxes, owed by you, your spouse, or your dependants.

T~~Qfiax AmountOw~g Year Incurred

\~'\.a $ ~-~~ ~,~

'~"'~ . $ \ "''~ ~ '<A\. 1_

\ ~'-'...C $ \~~~ «..o \\ $

u~m25. Judgments or Settlements Owed

List all judgments or settlements owed by you, your spouse, or your dependents.

Opposing Party's Name & Address~· ------------------------

Court's Name & Address. ___________________ Docket No.'------

Nature ofLawsuit:..,._ _______ ______ _ Date. _____ Amount$ ____ _

Page 11 Initials J l-

Item 26. Other Loans and Liabilities

List all other loans or liabilities in your, your spouse's, or your dependents' names.

~>Name&AddressofLender/Creditor ...,""\i~f,_J~ ,. ~C) ~<:l~ C\~ YJ\'-\C..E~ . ~~l.<tl.. , QA ' I \ ~':\1 ':)

NatureofLiabili~~Ql ..... r:l-~~.J' L\)P'I-) Name(s)onLiability S b 1"\t, \':)

Date of Liability 0'-.a. 4 \"'-\ .. <l \.o Amount Borrowed$\~ ~4<l - Current Balance $ ~ ~ \o ~ ";) -

Payment Amount $ '}) ~ 'S - Frequency of Payment~{ ~\ ~ ~,Jf'\ ~ .,Jr; ~ ~~ \ \.a

~>Name & Address of Lender/Creditor __ ................................................................................................................................................................................................................................................ .......... Nature ofLiability ________________ Name(s) on Liability _________ _

Date of Liability _________ Amount Borrowed $ ___ _____ Current Balance $ ______ _

Payment Amount $ __________ Frequency of Payment'---------

OTHER FINANCIAL INFORMATION

Item 27. Tax Returns

List all federal tax returns that were filed during the last three years by or on behalf of you, your spouse, or your dependents. Provide a copy of each signed tax return that was filed during the last three years.

TaxY~!!:! Namefsl on Return Refund Expected

~,~ \ ~~~ $

<t...~ 'f)_ \ ~'-\ -~ $

q_~ \\ \~~~ $

Item 28. Applications for Credit ~\Ot List all applications for bank loans or other extensions of credit that you, your spouse, or your dependents have submitted within the last two years. Provide a copy of each application, including all attachments.

Name(s) on Application Name & Address of Lender

Item 2~. Trusts and Escrows

Page 12 Initials -=~=-~-----

List all funds or other assets that are being held in trust or escrow by any person or entity for you, your spouse, or your dependents. Also list all funds or other assets that are being held in trust or escrow by you, your spouse, or your dependents, for any person or entity. Provide copies of all executed trust documents.

Trustee or Escrow Agent's Name & Address

Date Established

Grantor Beneficiaries Present Market Value of Assets

----------------------------------$. _____ _

-----------------------------------$. _____ _

----------------------------------$ _____ _

------- ------------------------------$ _____ _ ------------------------- ------------------$ _____ _

Item30. Transfers of Assets

List each person to whom you have transferred, in the aggregate, more than $2,500 in funds or other assets during the previous three years by loan, gift, sale, or other transfer. For each such person, state the total amount transferred during that period.

Transferee's Name. Address. & Relationship Proj>ertv Transferred

Aggregate Value

Transfer Date

JYpe ofTransfer (e.~. Loan. Gift)

----------------------------$ ____________________ _

------------------------------$----~-----------------

-------------------------------------$ _______________________ __

----------------------------$ ____________________ __

------------------------------$ ____________________ _

---------------------------------$ ____________________________ __

---------------------------------------$ _____________________ __

Page 13 Initials~\----=-='---

Item 31. Interests and Estates.

List all equitable or future interests, life estates, and rights or powers exercisable for the benefit of the individual held by you, your spouse, or your dependents, or held by others for the benefit of you, your spouse, or your dependents.

Item 32. Estate, Trust, Death Benefit Plan

Name of Owner or Estate Value of Interest

List all contingent and noncontingent interests in estate of a decedent, death benefit plan, life insurance policy, or trust held by you, your spouse, or your dependents, or held by others for the benefit of you, your spouse, or your dependents.

Item 33. Other Claims

Name of Owner, Decedent or Holder

Estimated Value of Interest

List all other contingent and unliquidated claims of every nature, including tax refunds, counterclaims, and rights to setoff claims held by you, your spouse, or your dependents, or held by others for the benefit of you, your spouse, or your dependents. Give estimated value of each.

Page 14 Initials .J ~

Type of Claim

Item 34. Party to a Lawsuit

Estimated or Claimed

Value

List all lawsuits to which you are a party in your individual or representative capacity.

Case Number or Other Identizyin~ Details

Opposing Party's Name & Address _ _ _ \N~-=C._~_\..--'i=--~~--t;-~------------Court'sName & Address -~-f\_l-"-~--~-~--~-_0...;;;;· _~-~-..,.?\_.._,,_~...__,.,!!....,Q.~§?A~. '--------

Docket No~ 'l~\ j (_~ ReliefRequested Nature ofLawsuit ~fl! t.\....~ ~ C\ 1'\1.~ ''A:-t:i..~ f\0 ·---- ---

Status Q ~~~ ..SS. ----------------------------'

Opposing Party's Name & Address------------------------------------------------

Court's Name & Address-----:-------------------------------------------------

Docket No. ____ __ ____,_ReliefRequested. _______________ Nature of Lawsuit--------------

-----------------------sm~----------------------------------------

Opposing Party's Name & Address-----------------------------------------------

Court's Name & Address--------------------------------------------

Docket No. ____________ .ReliefRequested'-------------- Nature of Lawsuit------------

----------------------------sm~ ____________________ ______________ __

Page 15 Initialj (-------

SUMMARY FINANCIAL SCDEDULES

Item3S. Combined Balance Sbeet for Yo~ Your Spouse, and Your Dependents

ASSETS LIABILITIES Cashon Hand s'Z<J.J- Credit Cards

s\~~'-(Item 12) (Item 23)

Cash in Financial Institutions s\ ~ '\ ~

Motor Vehicles • Liens 'L ~<\. \'il (Item 12) (Item21) s \c, .

U.S. Government Securities Real Property - Encumbrances sG> ~~~~ (Item 13) $ (Item22)

Publicly Traded Securities Loans Against Publicly Traded Securities (Item 14) $ (Item 14) $

Other Business Interests Taxes Payable $~~~~'\ (Item 15) $ (Item24)

Judgments or Settlements Owed Judgments or Settlements Owed to You (Item 16) $ (Item 25) $

Other Amounts Owed to You Other Loans and Liabilities ..,~

(Item 17) $ (Item26) $q~\a~~

Summder Value of Life Insurance (Item 18) $ Other Liabilities (Itemize)

Deferred Income Arrangements (Item 19) $ $

Personal Property (Item20) $ s Motor Vehicles (Item21) $ $

Real Property (Item 22) $ $

Other Assets (Itemize) $

$ $

$ $

$ $

$ $

Total Assets s?"\"\- Total Liabilities ;-:\~1 ·~~~~

Page 16 Initials ~ ~

Item 36. Combined Average Monthly Income and Expenses for You, Your Spouse, and Your Dependents for the Last 6 Months

Provide the average monthly income and expenses for you, your spouse, and your dependents for the last 6 months. Do not include credit card payments separately; rather, include credit card expenditures in the appropriate categories.

INCOME EXPENSES

Salary - After Taxes $ Mortgage Payments for Residence(s) s~n..K"-~~~

Fees, Commissions, and Royalties s Property Taxes for Residence(s) $

Rental Property Expenses, Including Interest $ Mortgage Payments, Taxes, and Insurance $

Car or Other Vehicle Lease or Loan ,...,..1 ~":) -Dividends and Capital Gains $ Payments s

Gross Rental Income $ Food Expenses s'-~-

Profits from Sole Proprietorships s Clothing Expenses $ \ ~<:)-

Distributions from Partnerships, $ 2...\ ~ -S-Corporations, and LLCs $ Utilities

Distributions from Trusts and o.o Estates $ Medical Expenses, Including Insurance $ \ ~"'-\.

Distributions from Deferred Income Arrangements $ Other Insurance Premiwns $

Social Security Payments sO...\~q_~ Other Transportation Expenses s\~~-

Alimony/Child Support Received $ Other Household Expenses $

Gambling Income s Other Exoenses Qtemize)

Qther Income (Itemize) '-~~~ (i~@J\i $~

r- ~f'\\L) \\t\.:~ sS~·- $

$ $

s $ ·

c-,.o s\~t.~:.,:) Total Income s\'\\G - Total Expenses

Page 17 Initialsjfr-

Your New Benefit Amount _.

BENEFICIARY'S NAME: JACOBO FELDMAN

Your Social Security benefits will increase by 1. 7 percent in 2015 because of a rise in the cost of living. You can use this letter when you need proof of your benefit amount to receive food,

rent, or energy assistance; bank loans; or for other business. Keep this letter with your important financial records.

How Much Will I Get And When? • Your monthly amount (before deductions) is $910.90. • The amount we deduct for Medicare medical insurance is $104.90.

____ @y'!u ~~-I!CJ!.~ye_M~~~ a!__()_f_~~fO, ~5)J~'---- ·----~----·---~- ... ·~ ____ .. ______ . or if someone else pays your premium, we show $0.00.)

• The amount we deduct for your Medicare prescription drug plan is $0.00. (Ifyou did not elect withholding as ofNov. 1, 2014, we show $0.00.)

• The amount we deduct for voluntary Federal tax withholding is $0.00. (If you did not elect voluntary tax withholding as of Nov. 20,2014, we show $0~'00.)

• After we take any other deductions, you will receive $806.00 on or about Jan. 14, 2015.

If you disagree with any of these amounts, you must write to us within 60 days from the date you receive this letter. ·We would be happy to review the amounts.

You may receive your benefits through direct deposit, a Direct Express® card, or an Electronic Transfer Accowtt If you still receive a paper check and want to switch to an electronic payment, please visit the Department of the Treasury's Go Direct website at www.godirect.org.

What If I Have Questions? Please visit our website at www.socitdsecurity.gw for more information and a variety of online services. You also can calll-800-'nl-1213 and speak 1D a representative :from 7 am. until7 p.m., Monday through Friday. Recorded infonnation and services are available 24 homs a day. Our lines are busiest early in the week, early in the month, as well as during the week between Christmas and New Year's Day; it is best to call at othet timeS. If you are deaf ot hard ofhearing, callOUI' TIY riunlber, 1-800-325-0778. Hyou are outside the United States, you can contact any US. embassy or consu1ate office. Please have your Social Security claim mnnber available when you call or visit and include it on any letter you send 1D Social Securi1y. If you are inside the United States and need assistance of any kind, you can visit your local office.

SUITE400 621 NW 53 ST BOCA RATON FL

I " i

024588

JACOBO FELDMAN 5809 NW 21ST WAY BOCA RATON, Fl33496-3457

ACCOUNT INFORMATION Acrourit Number 17483ll

Account Status Current

Statement Date 03/16f.l015 Payment D~ Date 0313012015

. Payment Amount· $552;85 Payments Made 8 ·

Maturity Date 098012020

Past Due Amot.~nt $0.00 ··

Ptil'\dpal $26,514.60 Atcrued Interest $150.98

Unpaid Fees & Charges $.00

. Estimated Pay~ $26,665;58 . . ·:. ~

••••Pin•n••ln•••h••m•llll••n••nn•ll••l•llll•l••• hll••l . TOTAL AMOUNT DUE

$ .. _- B ..

. 552.85 j ;313012015 *CJalanee induc;lingprincipal. ac(llJed interest. and

unpaid ~ and dlarjles as of the Statement Oate.

No valid work phone number, please update online.

Description Date Amount

Payment Made 02/28J2015 $-552.85

. ~-- ;··;~: .... ·- .. ~ .. _~·-,,-~--" . ,--·.-· : ... :,.. : .

,~ !-~;$~~J~;~~W~~~:.m. -;·_ /-~~\··~~;y:.g~,~·~6~~·~ii~~~;::~~;l;~~5 .. _'t%·r":';,, ., .. _.,

,· ·_---,-~ -~\:_.·.:::"~:::>:~ -: ·: ::::::~!(; . .'?;::t_ .. ~ --~:: ::-~"1 -- . >::::•_.-::·

~\ .-) MoheyGrarn·orWestemUnion~ ·: , Uf:_.·,/· '.}:;{;i.;t1:-·!' ~~··;~~~~ fqr .adqition~l ~~j~;;qpdonl'~'~_.:,i .. t)'2····.,

. . ~ . '· •'' , , ·. :· ·-::. ·;-. -,._._; _ .··,., , ·. • . ·'. :j;; ,c<·._,. ~ -, , ·, <;::·:·- __ ::." ·_: :-:

::-;: -~ ::·- ·!_::: .·_~ ._:;:·::~~g;.~~~~ ~:~._ ~;:·~:- _ .. · :::~-~ ::::::~::::~;~;~-:t·+t: .:~;~/\f:;:::~; :._~--~:{:-_ :-~-:~:·:-·:· '··~:·: ~--~~--~-·-·;;~ .-;;;~-~}:::-;;·::· ~~~·;:·-'·t?. :.~~ >.:::-::;~·:;:~;:: ~-:::~.-:· '

Questions? Go to MyAccount.ChryslerCapital.com or call Toll-Free 1-855-563-5635.

· With Chrysler you're behind th~-"' 'nti~.eL Manage your a~count (;mline:

» Pay your biUs online , Get payment history ~< Decrease probability of ~ail fraud ~n~'~••n.rn.ao"" ?) Find answers to your frequently :asked q· u~,tioJ'I$

----------·--·--~---'-··----·'-··---· · ·--·-···--··-- ... . ,·-

ATTACHMENTS

Item 37. Documents Attached to this Financial Statement List

all documents that are being submitted with this financial statement

Item No. Document Relates To

Description of Document

I am submitting this financial statement with the understanding that it may affect action by the Office of the Attorney General for the State of Florida I have used my best efforts to obtain the information requested in this statement. The responses I have provided to the items above are true and contain all the requested facts and information of which I have notice or knowledge. I have provided all requested documents in my custody, possession, or control. I know of the penalties for false statements under 18 U.S.C. § 1001, 18 U.S.C. § 1621, and 18 U.S.C. § 1623 (five years imprisonment and/or fines). I certifY under penalty of petjiuy under the laws of the United States that the foregoing is true and correct.

Executed on:

(Date) Signature

Page 18 Initials~...:..·.;_.(-__