Fla. Admin. Code R. 69K-1.001

Current through Reg. 50, No. 253; December 31, 2024

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

The following forms are hereby adopted and incorporated by reference and can be obtained from the Department 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.myfloridacfo.com/Division/funeralcemetery/, or by telephoning (850)413-3039:

(1) DFS-PNL-1, "Application for Preneed License," Rev. 08/16

http://www.flrules.org/Gateway/reference.asp?No=Ref-09968.

(2) DFS-HistS, "Historical Sketch," Rev. 08/16

http://www.flrules.org/Gateway/reference.asp?No=Ref-09966.

(3) DFS-PNLB, "Application for Preneed Branch Office License," Rev. 08/16

http://www.flrules.org/Gateway/reference.asp?No=Ref-09967.

(4) DFS-PNLT1, "Application for Transfer of a Preneed License," Rev. 08/16

http://www.flrules.org/Gateway/reference.asp?No=Ref-09965.

(5) DFS-PNS-1, "Preneed Sales Agent Application for Agent License and Initial Appointment," Rev. 10-06.

(6) DFS-CEMN, "Application to Organize a New Cemetery Company," Rev. 10-06.

(7) DFS-F-32, "Financial Statement," Rev. 10-06.

(8) DFS-CEM, "Application to Transact Cemetery Business," Rev. 10-06.

(9) DFS-F-35, "Application for Authority to Acquire Control of an Existing Cemetery Company," Rev. 10-06.

(10) DFS-F-43, "Performance Bond," Rev. 10-06.

(11) DFS-C-3, "Surety Bond Claim Form," Rev. 11/18.

http://www.flrules.org/Gateway/reference.asp?No=Ref-11117

(12) DFS-TFD-1, "Preneed Funeral Contract Consumer Protection Trust Fund Proof of Claim and Disbursement Request," Rev. 10-06.

(13) DFS-N1-1702, "Cemetery Renewal," Eff. 10-06.

(14) DFS-N1-1703, "Exempt Cemetery Renewal," Eff. 10-06.

(15) DFS-N1-1704, "Change of Address or Contact Data - Individuals," Eff. 10-06.

(16) DFS-N1-1705, "Change of Address or Contact Data - Entities," Eff. 10-06.

(17) DFS-N1-1706, "Application for Embalmer License by Internship and Examination," Eff. 10-06.

(18) DFS-N1-1707, "Application for Embalmer License by Endorsement," Eff. 10-06.

(19) DFS-N1-1708, "Application for Embalmer Intern License," Rev. 08/16

http://www.flrules.org/Gateway/reference.asp?No=Ref-09960.

(20) DFS-N1-1709, "Other Licensing Examinations," Eff. 10-06.

(21) DFS-N1-1710, "Endorsement Licenses - Continued," Eff. 10-06.

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

(23) DFS-N1-1713, "Miscellaneous Applications," Eff. 10-06.

(24) DFS-N1-1714, "Certification of High School Graduation," Eff. 10-06.

(25) DFS-N1-1715, "Adverse Licensing Action History Form," Eff. 10-06.

(26) DFS-N1-1716, "Criminal History Form," Eff. 10-06.

(27) DFS-N1-1717, "Other Licenses Form," Eff. 10-06.

(28) DFS-N1-1718, "Business Entity - List of Principals," Eff. 10-06.

(29) DFS-N1-1719, "Mortuary Science Course Information Form," Eff. 10-06.

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

(31) DFS-N1-1721, "Application for Funeral Director License by Endorsement," Eff. 10-06.

(32) DFS-N1-1722, "Application for Funeral Director Intern License," Rev. 08/16

http://www.flrules.org/Gateway/reference.asp?No=Ref-09964.

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

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

(35) DFS-N1-1725, "Application to Reactivate Inactive or Delinquent Embalmer License," Eff. 10-06.

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

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

(38) DFS-N1-1728, "Application for Inactive Status," Eff. 10-06.

(39) DFS-N1-1729, "Purchase Order Brochure," Eff. 10-06.

(40) DFS-N1-1730, "Trustee's Report, Preconstruction Trust Fund," Eff. 10-06.

(41) DFS-N1-1731, "Trustee's Report, Care & Maintenance Trust Fund," Eff. 10-06.

(42) DFS-N1-1732, "Application for Concurrent Funeral Director and Embalmer Intern License," Effective 02/23, https://www.flrules.org/Gateway/reference.asp?No=Ref-15122.

(43) DFS-N1-1734, "Notice of Termination/Change of Supervisor," Eff. 10-06.

(44) DFS-N1-1742, "Certification of Licensure in Good Standing," Rev. 10-06.

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

(46) DFS-N1-1744, "Application for Direct Disposer License," Rev. 10-06.

(47) DFS-N1-1746, "Application for Retired Professionals," Eff. 10-06.

(48) DFS-N1-1747, "Supervisor's Quarterly Report of Apprentice or Intern Training," Rev. 08/16

http://www.flrules.org/Gateway/reference.asp?No=Ref-09982.

(49) DFS-N1-1748, "Application for Funeral Establishment License," Effective 02/23, https://www.flrules.org/Gateway/reference.asp?No=Ref-15123.

(50) DFS-N1-1749, "Registration as Training Agency," Rev. 08/12

http://www.flrules.org/Gateway/reference.asp?No=Ref-09981.

(51) DFS-N1-1750, "Application for Cinerator Facility License," Rev. 10-06.

(52) DFS-N1-1751, "Funeral Establishment/Monthly Report of Cases Embalmed or Bodies Handled," Rev. 10-06.

(53) DFS-N1-1752, "Direct Disposal Establishment/Monthly Report of Cases Embalmed or Bodies Handled," Rev. 10-06.

(54) DFS-N1-1753, "Cinerator Facility/Monthly Report of Cases Embalmed or Bodies Handled," Rev. 10-06.

(55) DFS-N1-1754, "Centralized Embalming Facility/Monthly Report of Cases Embalmed or Bodies Handled," Rev. 10-06.

(56) DFS-N1-1756, "Application for Centralized Embalming Facility License," Effective 02/23

https://www.flrules.org/Gateway/reference.asp?No=Ref-15124.

(57) DFS-N1-1757, "Application for Direct Disposal Establishment License," Effective 02/23

https://www.flrules.org/Gateway/reference.asp?No=Ref-15125.

(58) DFS-N1-1758, "Application for Refrigeration Facility License," Rev. 10-06.

(59) DFS-N1-1759, "Application for Removal Service License," Rev. 10-06.

(60) DFS-N1-1760, "Application for Approved Continuing Education Provider Status," Rev. 10-06.

(61) DFS-N1-1761, "Application for Continuing Education Course Approval," Rev. 10-06.

(62) DFS-N1-1762, "Monument Establishment Sales Agent Application for Agent License," Eff. 10-06.

(63) DFS-N1-1763, "Monument Sales Agent Renewal," Eff. 10-06.

(64) DFS-N1-1764, "Change of Name & Request for Revised License Certificate - Entities," Eff. 10-06.

(65) DFS-N1-1765, "Change of Name & Request for Revised License Certificate - Individuals," Eff. 10-06.

(66) DFS-N1-1766, "Request for Duplicate License," Eff. 10-06.

(67) DFS-N1-1768, "Provisional or Temporary License, Application for Initial License," Eff. 10-06.

(68) DFS-N1-1769, "Provisional or Temporary License, Application for Renewal," Eff. 10-06.

(69) DFS-N1-1770, "Election of Procedures for Removal of Cremated Remains and Postcremation Processing," Eff. 10-06.

(70) DFS-N1-1771, "Broker of Burial Rights Renewal," Eff. 10-06.

(71) DFS-N1-1772, "Monument Establishment Renewal," Eff. 10-06.

(72) DFS-N1-1774, "Preneed Sales Agent - Application for Appointment," Eff. 10-06.

(73) DFS-C-MON1, "Application for Monument Establishment License," Effective 02/23

https://www.flrules.org/Gateway/reference.asp?No=Ref-15126.

(74) DFS-EC-1, "Report of Identification for an Exempt Cemetery," Rev. 08/16

http://www.flrules.org/Gateway/reference.asp?No=Ref-09980.

(75) DFS-PNL-R, "Cover Sheet and General Instructions for Preneed License and Branch Annual Renewal Packet," Eff. 08/16 http://www.flrules.org/Gateway/reference.asp?No=Ref-09963.

(76) DFS- PNL-R1, "Invoice - Renewal of Preneed License," Rev. 08/16

http://www.flrules.org/Gateway/reference.asp?No=Ref-09971.

(77) DFS- PNL-R2, "Financial Statement Instructions," Rev. 08/16

http://www.flrules.org/Gateway/reference.asp?No=Ref-09962.

(78) DFS-PNL-R2A, "Balance Sheet of Preneed Licensee," Rev. 08/16

http://www.flrules.org/Gateway/reference.asp?No=Ref-09978.

(79) DFS-PNL-R2B, "Income Statement," Rev. 08/16

http://www.flrules.org/Gateway/reference.asp?No=Ref-09977.

(80) DFS- PNL-R3A, "Statement of Preneed Sales Under Each Individual Trust, Surety Bond, or Insurer," Rev. 08/16 http://www.flrules.org/Gateway/reference.asp?No=Ref-09976.

(81) DFS-PNL-R3B, "Summary of Preneed Activity," Eff. 08/16

http://www.flrules.org/Gateway/reference.asp?No=Ref-09975.

(82) DFS-PNL-R4, "Annual PNL Financial Statement and Renewal Statement Certification and Application for Renewal," Eff. 08/16 http://www.flrules.org/Gateway/reference.asp?No=Ref-09974.

(83) DFS-PNL-R5, "Notice of Non-Renewal of Preneed License," Eff. 08/16

http://www.flrules.org/Gateway/reference.asp?No=Ref-09973.

(84) DFS-PNL-R6, "Net Worth Alternatives Form," Eff. 08/16

http://www.flrules.org/Gateway/reference.asp?No=Ref-09972.

(85) DFS-C-BBRI, "Broker of Burial Rights License Application," Rev. 10-06.

(86) DFS-PNLBR "Application for Preneed Branch Office Renewal License," Eff.10-06.

(87) DFS-N1-2001, "Notice of Change in Location of Funeral Establishment," Eff. 10/09.

(88) DFS-N1-2002, "Notice of Change in Location of Cinerator Facility," Eff. 10/09.

(89) DFS-N1-2003, "Notice of Change in Location of Direct Disposal Establishment," Eff. 10/09.

(90) DFS-N1-2036, "Application to Renew Funeral Director Internship to Continue Course of Study," Rev. 08/16 http://www.flrules.org/Gateway/reference.asp?No=Ref-09969.

(91) DFS-N1-2037, "Application to Renew Internship Due to Illness, Hardship, or Awaiting Results," Rev. 08/16 http://www.flrules.org/Gateway/reference.asp?No=Ref-09979.

(92) DFS-N1-2038, "Application to Take the Florida Law & Rules Exam," Rev. 08/16

http://www.flrules.org/Gateway/reference.asp?No=Ref-09984.

(93) DFS-N1-2039, "Certification for General Supervision of Intern," Rev. 08/16

http://www.flrules.org/Gateway/reference.asp?No=Ref-09983.

(94) DFS-N1-2040, "Report of Suspension of Intern's Conditions of Internship," Rev. 08/16

http://www.flrules.org/Gateway/reference.asp?No=Ref-09970.

(95) DFS-N1-2041, "Application for Approval of a Course of Study under section 497.373(1)(d)2., F.S.," Eff. 1/12.

(96) DFS-N1-2183, "Preneed Trust Fund, Annual Trustee Report," Eff. 03/19

http://www.flrules.org/Gateway/reference.asp?No=Ref-11118.

Fla. Admin. Code Ann. R. 69K-1.001

Rulemaking Authority 497.103, 497.141, 497.142, 497.146, 497.147, 497.152, 497.263, 497.264, 497.266, 497.269, 497.270, 497.272, 497.281, 497.283, 497.287, 497.368, 497.369, 497.370, 497.373, 497.374, 497.375, 497.376, 497.380, 497.382, 497.385, 497.453, 497.454, 497.456, 497.458, 497.462, 497.464, 497.466, 497.550, 497.551, 497.553, 497.554, 497.602, 497.603, 497.604, 497.606, 497.608 FS. Law Implemented 497.103, 497.140, 497.141, 497.142, 497.143, 497.146, 497.147, 497.263, 497.264, 497.266, 497.269, 497.270, 497.272, 497.281, 497.283, 497.287, 497.365, 497.368, 497.369, 497.370, 497.373, 497.374, 497.375, 497.376, 497.377, 497.378, 497.379, 497.380, 497.382, 497.385, 497.453, 497.454, 497.456, 497.458, 497.462, 497.464, 497.466, 497.550, 497.551, 497.553, 497.554, 497.602, 497.603, 497.604, 497.606, 497.608 FS.

New 9-28-03, Formerly 3F-5.010, 69K-5.010, Amended 1-24-08, 4-18-10, 6-17-10, 7-22-12, Amended by Florida Register Volume 44, Number 239, December 11, 2018 effective 12/27/2018, Amended by Florida Register Volume 45, Number 186, September 24, 2019 effective 10/6/2019, Amended by Florida Register Volume 49, Number 025, February 7, 2023 effective 2/20/2023.

New 9-28-03, Formerly 3F-5.010, 69K-5.010, Amended 1-24-08, 4-18-10, 6-17-10, 7-22-12, 12-27-18, 10-6-19, 2-20-23.