demand for hearing ttjmwater, wa98so'i ~a)< filed … · 2019-12-31 · s.my secutity...
TRANSCRIPT
St!l!I:! Qf We~'11ngton Ofrlo& ar tha ln~Yr.ance. Commlaaloner Heafln95 Unit PO Box 402!:HI Demand for Hearing Oly«if)ia WA S6504-025S l.iOOO Capito! Boulevard TtJmwater, WA98SO'I {360) 725-7002 ~A)< {360) 664-2782 [email protected],9(w FILED
Pl~ase type l)t print In Ink. Attach a c.;>PY of the Order or c.orrespondence in dispute and all documents supijfl~lpf>Vj:f~r <lwian<l. 0 • ll, 1 , This Demand for Hearing can be mailed, faxed, hand-delivered or emailed to the Hearings Unit at the addre\!s a~li>'\11:!. L ·1 A 1' '-'
For OIC Demands, pleafle provide contact information for all other Interested parties and their representatives.
• Requesting Party (roquired infarm•6on)
---·-·--- ........ Orf ICE OF
Name/Business Name 01ccaserotaerR18: " John Glen Gay/Newca$tle lnsuranceLLC 17-0039 Street Address City, State, Z~
950519th Ave SE #116 Everett,WA 8208 Telephone Number Fax Number (206)999-5154 Contact Person Telephone Number Emall Address Glen Gay (206)999-5154 qlenaavai:iencv(Q)qmail.com
II Authorized RepresentaUve/Attorney for Requesting Party '' Last Name First M.I.
Business Name
Street Address I City, State, Zip
Telephone Number l'ax Number I Email Address
D SubJect Matter of Demand for Hearing 0 Revocatl1;:1n or O~nlal <if License [] Revoceition or Denial Certlflcate of Authority or ~eglstrauon D Cease and Desist Order E1 Imposition of Fine/Consent Order OOther _______________________ ~
• Additional Parties/Representatives (for more parties and/or mpresenratlv••, pl•••• attach additional page•)
Lest Name Fir,it M.I.
Business Name
Street Address \ City, State, Zip
Telephone Number Fax Number I Email Address
d Issues rmd Argument!! a. Issues - Briefly describe each Issue er area of dispute that you wish us to consider. Attach additional pages it necessary.
I feel the statement from Mike Perkins was grossly Incorrect and then made any other statemenw my wife or I made to appear as If we were dishonest. The majority of Mr Perkins statement$ were Lies. The Investigator seemed to not listen to us and totally belierved Mr Perkins. Premera released me for "Mixing Policyholders funds with Producer funds. This was done through an entirely different company totally unrelated to Health Insurance Agency. Mr Perkins stated, he was supposed to get 50% of the transaction funds. Mr perklns stated I cancelled his Health and Commercial insurance policie$. I acknowledged writing a check for $550.00 All monev order$ were written without oermission. Wrom1. Mike oave us oermission as he was
REV (6/16)
b. Arguments - faplain why each Issue or area of dlspuie listed above should be decided In your favor. Atlaoh additlonal pages If neces$ary, To the extant known, cite applicable rules, statutes, ot cases in support of your arguments. Enaloi?>e copies of documents concerning your arguments including documento the Department previously requested fro1~ you that you have not yet provided,
In order to have owed Mr Perl~lns any money there would have been a signed agreement. Mr Perkins has never signed an agreemnet , which if he had we would still be doing buasiness as there Is a 5 year commitment. The transactions shares differ by account as agreed. Mr perkins , Initially In 2013 did not want any share of the transaction. In 2015, we offered some compensation as times had changed in the industry. He suggested we use his money to facilitate the payments. An agent cannot cancel insurance policies , only the insured can ovancel said policies. Both the Health and Commercial POLICIES WERE CANCELLED DUE TO NON PAYMENT. i CONTACTED THE wslcb TO SEE IF I COULD GET HELP FORCING HIM TO PAY FOR HIS COMMERCIAL INSURANCE. hE HAD NOT PAID FOR THREE MONTHS AND I HAD FOUND OUT HE WAS WORKING WITH ANOTHER BROKER TO GET A NEW POLICY STARTED AND CHEATING MY vENDOR OUT OF THREI:: MONTHS OF PAYMENTS. On any insurance contract there is a question of; Have you ever been cancelled for non payment. Mr Perkins lied on his other application in order to avoid paying for three months. I paid back some $2500 in unearned commissions for his cancelled accounts. Obviously I would not cancel his accounts to pay back money.
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dirsnature
Eltl1er the Requesting Party or the Attorney/Representative can sign this Demand for Hearing. However, If ths Representative Is submitting the. Demand, co111act information for the Requesting Party !I!!!§!; be provided under Section 1 above and the Attorney/Representative's contact information must be provtdeci In Section 2.
;,:N~ms (please print or type)
. ,11,,uthOrli<ed Representative:
Sign11ture
Name (please print or type)
,. ' .
.. .
REV (S/1B)
03/28/2017 Date
Owner Title
Date
Tiiie
., .... , , I· Cash Cow Vending LLC
9505 19th Ave SE #116 Eve.-ett, WA 98208
Phone: ( 425)225-6866 [email protected]
'rilis agreement made this day of ____ ---"--___ 20_, between C3.$h Cow Vending LLC (Hereafter referred to as Owner) and -'----~--"'"-----------------(hereafter refeaed to as Customer),
dq.ihg.busme:js' at __ .-'" c..,··------------~---.':: ·. · . ,· · ·:. · ... >. .' · · (Location). In Considera1fon of the agreements and promises contained herein,
llri<fother good i:ui.4 'Valuable corisiileration, the receipt of which is hereby acknowledged, the parties do hereby agree as follows: · · ·
I. Own~~irgrees to ~uill in Custome('s place of business at location, the following ATM Hyosung l800SE, Halo, or GenMega. Cashless ATM, etc. ()lquipment):. . .
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2 .. awrier sfuul h~ve the right to rotate or change the type of equipment at the location in order to mmdmize . income..' OWµer shall have the right to increase .of decrea$e the number of units of eci.uipment at location; however in no event shall the number be less than one •.
;:\. Equipment shall, at all times, be and remain the sole pr6perty of owner, customex shall not place or permit s.my secutity interest, chai:t~l mortgage, pledge agreement or lie.n of any kind o:r description on Equipment.
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. 4.. Qusto~er shlill J;lrdmptiy notify Owner of any ~eeded tepfilrs or maintenance to Equipment and, upon such ii:otific~tion, Owner shall repair such Equipment or replace it with similar unit as soon as reasonably possible.
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5 .. Owner will supply all cash needed to op~ate at ~eak efficiency. Owner will pay the Merchant $.50 per@ <500;$.75 per>7.501!ind $1.00 per>lOOO ttansaqtion$. ' . · . · Transaction fees will be an agreed amount per transaction.· Set at . Merchant wi.11 sign w-9 forni for proper payments: ;paid by the i5•h of the folloWing month.
6. The tetins of th«.'! ~~etnent shall be foi:' ( 60) mo~~ COllln).encing , 20 . , and ending · · ·· · ·. 20 . · ., and shall be automatically renewed on an annual basis a£ter the htltial ()0 :l\J.ontilli acoorcllng to the same t<:>nns and conditions contained herein, wtless either patty shall give written notice of illtentiori not to .reil.<:>v1; by certified mail at least 60 days before the expiration of the original t<:>nll or.original term a8 extended, provided, however, Owner may texminate this agreement when this Iiq\Jipi:nent eanis less .than $ ____:._ : in any 3 O day period, Furthex, ownex may unilaterally terminate . thi~ agreement with l 0 days written notice upon the sale or transfer of Customer's business.
7. <:iust~iner at~~ o~ei $ee that Equi~:ment will/at ~ltlmes, be located or plaoed in a conspicuous.place at Locatioll, readjl.y ac¢e$sible for operatio.ll by Customer's patrons,
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8. Custoine;. shall not pemut any ATM machii:te not supplied by owi1er, to be placed, used 01' furnished at . ' ' . ' ' ' ' ' ' ' .
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. 9. Any CJ:ianges to this agreement inu8t be ilj .writing, slfirioo bYboth parties.
lo:. If a party bre~h~s the tcims of this 'agreement; the; ~~n-breaehing p!lrty will be entitloo to recover atton:1ey fees and costs, in addition to all of the remedies otherwfse afforded by law.
' . ·OWNER: ",' .CUSTOMER: . \, '
cA.s:B: cow VENDIN'G LLC :•
,•, ..
· BY: ·_.· -----'---.'.-----"-'-----'-----'-- ·BY:-------~------~ (Authorized Agent) · (Authorized Agent)
NAME:';__;___..;..,_ ________ _ NAME: --'-------~-----(Print Name) (Print Name)
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· · : Request fo~taxpayer · ldf;intification · Nuinlier .and Certification
on thi#t llna; do not leave thllli !ina blank.
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Give Fonn to the requester. Do not send to the IRS.
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1 List acccurtt nilmbar(!i) 111)f$ (optf~ ' ' . . ' ' ·. '
· i;:nrer yoUr TIN In the approprlatG l'..ioX. Tua i!N pro\lided muBt match th& ri.ame given on line i to avoid backup withh0ldln$1; For lnt1iViduals1 thl!i!- i.S gen!ltt'eJly ypUt aocl3l' $it11;:1,uity nUinbe'r (SSN). However, fQr a l'el;:lklent ~len,' sole pr-O~rietor, or disregarded eriUty1 ai;ie the Part I ln5truot11211s: on p~e 3. For othef entitles,·lt 11;1 'your employer ldeihtifidatfon hYmber {E!N). If yOy do not have a nurn~r. see HQW to get a TIN 6li poge3. . . . . . . . · . · .
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•, . . . . .. · Certification
l'Jn.dkr ~enaltlois 9f po~uoy, 1 certify thot: . . . . 1: ·Tue ~ui'nbi'i~ tihown on thjs form ilil my CorTiiit'~p~yef Jder;tlfililatlon numbef-(or ! ~m watuns for a nul'l'lber to be i~ued to ma); and
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no Jonge:r subject to backup wlthhc:ildlngi and
ci.: l:am a U.:s·. citt.z~n or·oUJ~ O.s. person cdeftneld beto"-1;- and 4. Tu~ FATC/\ oodo(•) on\ered·on this 1b11t1 ·01 ~Y) i~dloallng that I am ""empi from FAlCA reporting io oorreot .
. :~iitii~~n in~~~~.Xot.i m\,JSt cross out ltem,2 ab~ve if y~u h"-~ ~~ iiotlf'l~d by the IRS thftt you are ourrently eybJe9t to backup Withholding · ~~uae.you he~ fa lied to recportiul lnt.et'e!ll: ehd dlOJlderids on·yt1ur tax rptl,lm, For real estat$ transaotlotl$, Item 2 does nct·'G\!;lpty~ 'For mortgage interest pOOd1 ~cqulsltion of .fil>andonmenfof secul'tlc;I propt!lrly, i:::anoallatior'I of debt, contributions to an fndlv'idl.Jlitl ret1remeht ari:angEtrYumt (IRA), &nd · genaraily, payme~ othertha11 rnteroot 1;111d dtvklliVlrJS:, yau are not required to 1;1.Jg:n th~ certfflcatlon, but you rnust provide yo~r ti¢rNm TIN. $ee the ll'li;;trlJCtlons on page 3. · . · · · · · · · · · . · . · .
Sign 1 •1gn.,.root .' · ·, .. Her~ . u.s. j:>6r.10n.,. · Date ti--
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infoimlltl0n fell.Atn with the 11'1$ tnust 1>*ln }'Ollf ~CHJ'oot ta;t~Vl3l' Identification nwnber (TIN}' Whlcti l'rlay be yOur·sooiaJ seeuf%' number (SSN), lnQividual tax~r ldel')tifloot1011, liumber (lnN}, adopt!Ol'l ~payer li;te:ritifioatlQO J'tumbar (A1lN), or imtployer ltlwitiHcatlon number(EIN}, to.report .:in an lrifor'«laticn rirtw'n the 4!nount ~i:f *a ~ou, or other .amoutrl rePQ~0 on ~ Information mt um. e<Bmpfe!J ¢f i~tlori .· raturii~'!J'!i!:luda. bl,lt t\rt m'tt Umlfi:d lb, the 1ollcwlng! . · : · . ·.
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, ·~·Fa~ 1 oo~M1sc ~-Wlous typ~ ot inoome, pnzim, · ~warde. ·or gro~ p'rQWe(i~) . ~I FOOri '1i:Jse.-B (stock' <>r mub.ial wna .:sales anCi ~fl 61:11ar t:r'Wl~Or\IJ. bY 'efak8ra) .. :. '.: .· :. · · . ~; .:·. :· · ..... • ~orM 109~-S (pt'o~a·from !'tell ai:itatetnineacrt!O!'i:;) : . , ~ ForrO 109g.:i( (rriefci'iarrt Car~ ~ 'tti lrd pai'cy ~BtwtirK tianim~iQ'na). · : · .. ·... ' ' . ' ,. ' .. : .
• Form 1099·0 (CMceled debt)
• t<:lITTl 1DaM (acquisition or aba.ndonment Of'1oomed prop arty}
·. tJsa f'cil'tt'! W~9 only if y0u are a u.s. ~n ~l'loludlng ~ ~identa.ll~rl}, to ··. P19vida yol,l)' etirreat TIN, . · ff y6u do ~ f'eium FQrm W....9 to tll" raquas~r Wilh 12 TIN, ~ might tie .subjact to ~ukup Wfti'/hr;i/ding. $e:<; What !s txfelrup wlthhi>lding? on J;'IM.0 2,
By signing the flll!!(l•<mt form, YQu: · 1. Certify that lha TIN y¢ll are glvltl~ i~ oorreot (or vou sr~ W-'il:lllQ for S. l'tl.lmbar
to~i~uiOCt),
.. 2. Oartlfy ihat you snei not aubj~ to bacl(l.IP Withholding, or 3. Claim exemption f'rtml backup WlthhQJdlng !f yt.11 llfflo a LI.$. W10mpt payw. If
appl~t;l-1~, you are "'to cartll'yln~ that es~ U.S. paraoo, your Bllooabll'.I ahara Of My pertrierthip Income from Q IJ,S. trade or bU:!.1nB88 I~ tlOt subjeQt to the wlthhold!rig t<tic on fo/~l.Qn parln«e' ¢1era cf el'fettively conn&ttad.l!ieome, eni;t
. 4. Oertlfyfuat PAT¢AOOd~(~) erdl!lrad on th'rs form ·Qf any) Indicating that you~ · ~$mpt from itm· PA TOA rtporl:lng, f$' ¢0ITEKlt. $lilt What 1R /ii\ WA rapbrlin!017 ofi P~. 2 fr.ir.fu~llerln(Ql'lnatton. '
. ;/·;:. ' ,,. .... ;: Cat. NQ, '{02S1X Foml W,9 (Rev. 12'1014)
STATE OF WASHINGTON OFFICE OF THE INSURANCE COMMISSIONER
In The Maller of
JOHNG.GAY,
and
NEWCASTLE INSURANCE LLC,
Licensees.
To: JOHN G. GAY NEWCASTLE INSURANCE LLC 9505 19th Avenue SE #116 Everett WA 98208 [email protected]
ORDER NO. 17-0038
WAOICNO. 161484 NPN 5770243
W AOIC NO. 770596 FEIN 20-3006506
ORDER REVOKING LICENSES
IT IS ORDERED At'iD YOU ARE HEREBY NOTIFIED that your Washington Seate
insurance producer licenses are REVOKED, effective April 4, 2017, pursuant to RCW 48.17.530.
BASIS:
I. John Glen Gay ("'Mr. Gay'') is a licensed insurance producer, \V AOIC No. 161484,
and is the owner of Newcastle Insurance LLC ("Newcastle") a Washington domiciled corporation,
dba J. Glen Gay Agency, \V AO!C No. 770596.
2. Donna K. Stephenson ("Ms. Stephenson"") is a licensed insurance producer, WAO!C#
200363, and is the spouse of Mr. Gay. Ms. Stephenson is listed as the designated responsible licensed
person (DRLP) for Newcastl. Ms. Stephenson's affiliation with Newcastle expiml October I. 2016.
3. On July 13, 2016, Premera Blue Cross ("Premera") notified the Office of the
Insurance Commissioner ("Insurance Commissioner") that Newcastle had been terminated for
cause by Premera on June 30, 2016. Premcra indicated that it had investigated a complaint from a
ORDER REVOKING LICENSE ORDER NO. 17-0038
LA· 1390938- I
S1a1e of Washington Office of the lnsurnnce Commissioner PO Box 40255 . Ol)inpia, WA 98504-0255
member ("Mr. Perkins") who alleged, and it was confinned, that Mr. Gay had sold him an
individual policy, but that the bills went to and premium payments were made by Mr. Gay. Mr.
Perkins called Premera to complain because the bills were no longer being paid by Mr. Gay and
the policy had been terminated by Premera for nonpayment. Section B.3 of Premera's producer
agreement states that the mixing of policyholder funds with producer funds vio !ates the agreement.
Premera tenninated Mr. Gay's agency for a violation of section B.3 of the Producer Agreement.
4. The Insurance Commissioner's investigation found that Mr. Gay had contacted
Mr. Perkins around the second quarter of 2013, soliciting him for non-insurance business. Mr.
Perkins owns several medical/recreational marijuana businesses and Mr. Gay offered him his Cash
Cow Services (A TM business), where Mr. Perkins was supposed to receive 50% of the earned
income.
5. Mr. Perkins was interviewed by the Insurance Commissioner's investigator and
provided a signed declaration stating that he was never paid for the ATM business he had with
Mr. Gay and Ms. Stephenson, but instead Mr. Gay and Ms. Stephenson paid for his individual
medical insurance for seven months. However, after Mr. Perkins decided to use a different ATM
company, Mr. Gay and Ms. Stephenson cancelled both his medical and commercial insurance
policie? and reported Mr. Perkins to the Washington State Liquor and Cannabis Board for
operating without the required commercial liability insurance.
6. In Mr. Gay's written response to the Insurance Commissioner's investigator, he
stated he had been falsely accused and had his words manipulated by the Premera VP to
intentionally take his business that is worth $5,000 per month. He denied making premium
payments on the individual medical insurance policy that he sold to Mr. Perkins and said as an
agent and the owner of Newcastle, he was not aware of the accusations.
7. During an audio recorded interview with the Insurance Commissioner's
investigator, Mr. Gay acknowledged that he wrote a check $550.50 check to pay for Mr. Perkins'
medical insurance policy but said that his spouse, Ms. Stephenson, was responsible for handling
six money orders that paid for Mr. Perkins' policy. In Mr. Pcrkins's declaration he stated that he
never gave Mr. Gay or Ms. Stephenson permission to sign his signature on the check or the money
orders. Mr. Gay told the Insurance Commissioner's investigator there was no written contract
regarding the ATM business with Mr. Perkins and that he paid Mr. Perkins in cash each month.
Mr. Gay also said he did not maintain any records of the monthly earnings for Mr. Perkins. ORDER REVOKING LICENSE 2 S1a1eof\Vashing1on ORDER NO. 17·0038 Office of the Insurance Commissioner
PO Box 40255 LA- 1390938- l Olympia. WA 98504-0255
8. The Insurance Commissioner's investigation revealed that Ms. Stephenson was
involved in making monthly premium payments with money orders for Mr. Perkins six times, from
March 2015 to September 2015, totaling S2,469.08. Additionally, Ms. Stephenson forged Mr.
Perkins' signarure on the money orders without his consent.
9. During the audio recorded interview with the Insurance Commissioner's
investigator, Ms. Stephenson reviewed the copies of the six money orders and said she did prepare
and sign Mr. Perkins' name on them. According to Ms. Stephenson, Mr. Perkins asked for a
$60,000 loan from Mr. Gay and Ms. Stephenson to pay back taxes he owed from his marijuana
business. When Mr. Gay and Ms. Stephenson decided not to loan Mr. Perkins this amount, Mr.
Perkins told them to remove their ATMs out of his business locations. After the ATMs were
removed from Mr. Perkins· business and since there was no more monthly income generated, Mr.
Gay and Ms. Stephenson decided not to pay Mr. Perkins' monthly medical insurance premiums,
which resulted in cancellation of his policy. Ms. Stephenson also stated that they were business
partners for approximately a year and half and that she kept records of the monthly income that
Mr. Perkins made during these period. Ms. Stephenson agreed to provide copies of these records
to the Insurance Commissioner's investigator.
I 0. Eventually, copies of monthly income statements from Kahuna A TM Resolutions
were provided to the Insurance Commissioner. Mr. Gay provided six out of seventeen monthly
statements. The six monthly statements showed that the total income from the A TM business that
should have been paid to Mr. Perkins for those six months was $15,507.00.
I l. RCW 48.l 7.530(l)(b) allows the Insurance Commissioner to place on probation,
suspend, revoke, or refuse to issue or renew an insurance producer's license for violating any
insurance laws, or violating any rule, subpoena, or order of the Insurance Commissioner or of
another state's insurance commissioner.
12. RCW 48.17.530( l)(d) allows the Insurance Commissioner to place on probation,
suspend, revoke, or refuse to issue or renew an insurance producer's license for improperly
withholding, misappropriating, or converting any monies or properties received in the course of
doing insurance business. By paying for Mr. Perkins' individual health insurance premiums via a
check for S550.50 10 Premera, Mr. Gay violated RCW 48. l 7.530(l)(d).
13. RCW 48.17.530(1 )(h) allows the Insurance Commissioner to place on probation,
suspend, revoke, or refuse to issue or renew an insurance producer's license for using fraudulent, ORDER REVOKING LICENSE 3 Stnteof\Vnshington ORDER NO. 17·0038 Oflice of the Insurance Conunissioner
PO Box 40255 LA - 1390938· I Olympia, \VA 98504·0255
coercive, or dishonest practices, or demonstrating incompetence, untrustworthiness, or financial
irresponsibility in this state .or elsewhere. By mixing producer and policyholder funds, and by
paying for Mr. Perkins' individual health insurance premiums by writing a check for $550.50 to
Premera, Mr. Gay violated RCW 48. l 7.530(1)(h).
14. RCW 48. I 7.530(2) allows the Insurance Commissioner to suspend or revoke the
license of a business entity if the Commissioner finds that an individual licensee's violation was
known or should have been known by one or more of the partners, officers, managers acting on
behalf of the partnership or corporation, and the violation was neither reported to the
Commissioner nor corrective action taken. By paying for Mr. Perkins' individual health insurance
premiums by writing a check for $550.50 to Premera, and by acknowledging that his spouse, Ms.
Stephenson, was responsible for handling six money orders that paid for Mr. Perkins' policy, and
by not reporting these incidents, and by not taking corrective action, Mr. Gay violated RCW
48. I 7.530(2).
15. RCW 48.30.140(1) provides no insurance producer shall, as an inducement to
insurance, or after insurance has been effected, directly or indirectly, offer, promise, allow, give,
set off, or pay to the insured or to any employee of the insured, any rebate, discount, abatement,
or reduction of premium or any part thereof named in any insurance contract, or any commission
thereon, or earnings, profits, dividends, or other benefit, or any other valuable consideration or
inducement whatsoever which is not expressly provided for in the policy. By not paying Mr.
Perkins his share of the ATM business, but instead by paying for Mr. Perkins' individual medical
insurance for seven months, Mr. Gay violated RCW 48.30.140(1 ).
16. RCW 48. I 7.560 provides after hearing or upon stipulation by the licensee or
insurance education provider, and in addition to or in lieu of the suspension, revocation, or refusal
to renew any such license or insurance education provider approval, the Insurance Commissioner
may levy a fine upon the licensee or insurance education provider in an amount not more than one
thousand dollars.
l 7. By mixing producer and policyholder funds, paying for a consumer's individual
health insurance premiums, and by acknowledging that his spouse was responsible for handling
six money orders that paid for the consumer's policy, and by not reporting these incidents or taking
corrective action, Mr. Gay violated RCW 48.17.530(1 )(d), RCW 48. l 7.530(1 )(h), 48.17.530(2),
and RCW 48.30. I 40( l ), justi.fying the imposition of a fine under RCW 48.17 .560. ORDER REVOKING LICENSE 4 State of Washington ORDER NO. l 7-0038 Office of the Insurance Commissioner
PO Box 40255 LA. 1390938- l Olympia, IV A 98504-0255
IT IS FURTHER ORDERED that you return· your insurance producer license certificates
to the Insurance Commissioner on or before the effective date of the revocation of your license, as
required by RCW 48.17.530(4). Return your license to:
Licensing Manager Office of the Insurance Commissioner P. 0. Box 40255 Olympia, WA 98504-0255
ENTERED at Tumwater, Washington, this /?f. l day of_~f!J..,,.,4! ... ·c.i.C..,,J,.1---~-' 2017.
MIKE KREIDLER Insurance Commissioner By and ough his designee
R ENSEN Ins e Enforcernent Specialist Legal Affairs Division
ORDER REVOKING LICENSE ORDER NO. 17·0038
LA· 1390938- I
' 5 Sime of Washington Office oflhe Insurance Commissioner PO Box 40255 Olympia, \VA 98504-0255
NOTICE OF YOUR RIGHT TO A HEARING
If you are aggrieved by this Order Revoking License, you may demand a hearing in
accordance with RCW 48.04.010, WAC 284-02-070, and WAC 10-08·110. Generally a hearing
demand must be in writing and received within ninety (90) days after the date of this Order
Revoking License, which is the day it was mailed to you, or you will waive your right to a
hearing.
If the /11rnra11ce Co111111issio11er receives your demand for a hearing before the effective
date fisted 011 the order revoking your license, the revocation will be a11to111atically stayed
(postponed) and your license will remain i1,1 effect pending tlze hearing.
You may fill out a demand for hearing form online at the following location: www.insurance.wa.gov/laws-rules/administrative-hearings/how-to-file/
Alternatively, if you choose to file by mail, your demand for hearing must briefly state
how you are hanned by this decision and why you disagree with it, along with contact
information (phone number, mailing address, e-mail address, etc.) for yourself and any
representative that appears on your behalf. The demand may be sent to the following address:
Hearings Unit Office of the Insurance Commissioner PO Box 40255 Olympia, WA 98504-0255
You will be notified of the time and place of your hearing. If you have questions about
filing a demand for hearing or the hearing process, please telephone the Hearings Unit at (360)
725-7002, or send an email to [email protected].
ORDER REVOKING LICENSE ORDER NO. l7-0038
LA - 1390938- I
6 Stnle of Washington Office of the Insurance Con1n1issioner PO Box 40255 Olympia, WA 98504-0255
CERTIFICATE OF MAILING
The undersigned certifies under the penalty of perjury under the laws of the state of
Washington that I am now and at all times herein mentioned, a citizen of the United States, a
resident of the state of Washington, over the age of eighteen years, not a party to or interested in
the above-entitled action, and competent to be a witness herein.
On the date given below I caused to be served the foregoing Order Revoking License on
the following individual by email and by depositing in the U.S. mail via state Consolidated Mail
Service with proper postage affixed:
JOHNG.GAY NEWCASTLE INSURANCE LLC 9505 19th Avenue SE #116 Everett \VA 98208 [email protected]
Dated this --=-' t_-JL ___ day of _,,_fiJ-'--'-·o--r __ cL_-=----·• 20 ! 7, in Tumwater, Washington.
Secretary Senior Legal Affairs Division
ORDER REVOKING LICENSE ORDER NO. 17-0038
LA - 1390938- I
7 State of Washington Office of the Insurance Commissioner PO Box 40255 Ol)mpia. WA 98504-0255