Homesite Homeowners Insurance Program

Homesite HOME INSURANCE

Underwritten by
HOMESITE INDEMNITY COMPANY
P.O. Box 5300 Tel.: 1-800-466-3748 Fax: 1-877-273-2984
Binghamton, NY 13902-9953
66259007 00 RP 18 20230218 NNNNNNNN 0000343 0001
February 21, 2023
LONNIE LUPARDUS
829 CREEKSIDE DR
GARDNER, KS 66030-8408

11111111111111111111111+11111111111111111'111411"111111111

IMPORTANT NOTICE REGARDING THE STATUS OF YOUR POLICY

Dear Lonnie Lupardus,

After conducting a review of your policy, we have determined we are unable to renew your insurance for the
upcoming term. Unfortunately, your policy no longer meets our underwriting guidelines. We've listed the specific
reason(s) in the attached form.

Important notes:

• Please be assured this does not affect your policy in the current term. This notice is regarding the
upcoming term, for which we will not be able to renew your policy.

• Your coverage will continue through Effective Date of Notice, the last day of your current term.

• We sent you this information in advance to allow you sufficient time to obtain coverage elsewhere.

If you have questions, please call Customer Service at 1-800-466-3748, 8 a.m. - 9 p.m. EST Monday - Friday and
from 9 a.m. - 6 p.m. EST Saturday.

We thank you for insuring your home with us and apologize for any inconvenience.

Sincerely,

Customer Care Department

Homesite Homeowners Insurance Program

@E[IW[E

HHI9 49 CW 0213
i By
FEB 2 3 2023

a
Clerk of the District Court, Johnson County Kansas
2/23/2023 13:19:29 MJ
 NOTICE OF CANCELLATION, NONRENEWAL OR DECLINATION OF INSURANCE
(Kansas
NAME AND HOMESITE INDEMNITY COMPANY KIND OF POLICY:
ADDRESS P.O. Box 5300 Renters Insurance
OF INSURANCE Binghamton NY 13902-9953 POLICY/APPLICATION/BINDER NO.: 38838914 (H)
COMPANY
EFFECTIVE DATE OF NOTICE:
04/26/2023 12:01 AM
(DATE) (HOUR-STANDARD TIME AT THE ADDRESS OF THE INSURED)
DATE OF MAILING: February 21, 2023
NAME AND . Lonnie Lupardus NAME AND ADDRESS OF AGENT/BROKER:
ADDRESS 829 CREEKSIDE DRIVE
OF INSURED GARDNER KS 66030

ADDlicable item marked "X"

Cancellation I I You are hereby notified in accordance with the terms and conditions of the above mentioned policy, and in accordance with law, that
your insurance will cease at and from the hour and date mentioned above.
Reason for cancellation: Nonpayment of premium.
See the "Important Notices" section for other information that may apply.
I I You are hereby notified in accordance with the terms and conditions of the above mentioned policy, and in accordance with law, that your
insurance cease at and from the hour and date mentioned above.
See the "Important Notices" section for other information that may apply.
Premium I I Enclosed is $ being the amount of return premium at pro rata for the unexpired term of the policy.
Adjustment I I Unearned premium will be returned separately not more than 10 days from the date of this notice.
Unearned premium will be returned in accordance with Kansas law and the terms of the policy.
A bill for the premium earned to the time of cancellation will be forwarded in due course.
Other:
Nonrenewal X You are hereby notified in accordance with the terms and conditions of the above mentioned policy, and in accordance with law, that the
above mentioned policy will expire effective at and from the hour and date mentioned above and the policy will NOT be renewed.
See the "Important Notices" section for other information that may apply.
Declination of I I Your written application or written request for the kind of insurance mentioned above has been dedined for the following reason(s):
Insurance See the "Important Notices" section below for other information that may apply.
Important I 1 FINANCIAL SECURITY REQUIRED BY THE KANSAS AUTOMOBILE INJURY REPARATIONS ACT FOR EVERY MOTOR VEHICLE
Notices COVERED BY THE POLICY EXPIRES ON THE ABOVE MENTIONED DATE. FINANCIAL SECURITY FOR EVERY MOTOR VEHICLE
COVERED BY THE ABOVE MENTIONED POLICY IS REQUIRED TO BE MAINTAINED CONTINUOUSLY THROUGHOUT THE MOTOR
VEHICLE REGISTRATION PERIOD. THE OPERATION OF ANY SUCH MOTOR VEHICLE WITHOUT MAINTAINING CONTINUOUS
FINANCIAL SECURITY THEREFOR IS A CLASS B MISDEMEANOR AND SHALL BE SUBJECT TO A FINE OF NOT LESS THAN $300
AND NOT MORE THAN $1000. THE REGISTRATION FOR ANY SUCH MOTOR VEHICLE FOR WHICH CONTINUOUS FINANCIAL
SECURITY IS NOT PROVIDED IS SUBJECT TO SUSPENSION AND THE DRIVER'S LICENSE OF THE OWNER THEREOF IS
SUBJECT TO SUSPENSION.
X Reason(s) for cancellation, nonrenewal or declination (reason(s) stated only if this item is marked):
NONRENEWAL: Any policy where an insured's behavior is intended to injure, threaten, or financially harm the Company or any of its
employees, or any behavior indicating that trust and confidence required for the continuation of an insurance relationship no longer exists.
INSURED LOCATION: 829 CREEKSIDE DRIVE GARDNER KS 66030

Right to Request Reason(s): If the detailed reason for cancellation, nonrenewal or dedination of your policy is not included on this notice,
you have the right to request specific information from the insurer at the address listed above as follows:
I I If this cancellation or nonrenewal notice pertains to a policy of personal automobile insurance and the reasons are not included on this
notice, you have the right to request a specific explanation of why this insurer cancelled or did not renew your policy. Within 10 days
after receiving a written request, this company will furnish the reason for the cancellation or nonrenewal in writing.
rl If this notice pertains to an adverse underwriting decision on a personal lines policy insurance and the reasons are not induded on
this notice, you have the right to request a specific explanation of why this insurer cancelled or failed to renew your policy or denied
your application for a policy. Within 21 days of receiving a written request, the company will furnish the specific reason(s) for the
adverse underwriting decision in writing if not furnished with this notice. Your written request must be received within 60 business days
from the date of the mailing of this notice.

OWE-11
rfE8 232023
By eiCZ
Clerk of the District Court, Johnson County Kansas
(E)GU 8892r (Ed. 7-13) Wolters Kluwer Financial Services I Uniform FormsTM INSURED'S COPY 2/23/2023 13:19:29 MJPage 1 of 2
(c) 2013 Wolters Kluwer Financial Services
 NOTICE OF CANCELLATION, NONRENEWAL OR DECLINATION OF INSURANCE
(K
NAME AND . HOMESITE INDEMNITY COMPANY KIND OF POLICY:
ADDRESS P.O. Box 5300 Renters Insurance
OF INSURANCE Binghamton NY 13902-9953 POLICY/APPLICATION/BINDER NO: 38838914 (H)
COMPANY
EFFECTIVE DATE OF NOTICE:
04/26/2023 12:01 AM
(DATE) (HOUR-STANDARD TIME AT THE ADDRESS OF THE INSURED)
DATE OF MAILING: February 21, 2023
NAME AND Lonnie Lupardus NAME AND ADDRESS OF AGENT/BROKER:
ADDRESS 829 CREEKSIDE DRIVE
OF INSURED GARDNER KS 66030

Important Automobile Insurance Plan Information: If this cancellation or nonrenewal pertains to automobile insurance (other than insurance issued
Notices under the Automobile Insurance Plan), you are possibly eligible for automobile insurance through another insurer or under the Kansas
(cont'd) Automobile Insurance Plan. Please contact your agent or broker for more information. This information is being provided pursuant to
Section 40-278 of the Kansas Insurance Code.
Appeal to Automobile Insurance Plan Governing Committee: As your policy was one obtained through the Kansas Automobile
Insurance Plan, you are hereby advised, regarding the above notification of cancellation, that you have the right of appeal to the Governing
Committee of the Plan, P.O. Box 8789, Topeka, Kansas 66608.
Kansas All-Industry Placement Facility (FAIR Plan): You have been notified herewith that this Company will no longer be carrying your
insurance. If you wish to replace your policy you should make an effort to obtain insurance through another company in the voluntary
market. If you have difficulty in procuring replacement coverage in the voluntary market you possibly may obtain insurance through the
Kansas All-Industry Placement Facility. For further information please contact your agent or the Kansas FAIR Plan at 1115 SW Wanamaker
Road, Topeka, Kansas 66604-3808.
Consumer Report: In compliance with the Fair Credit Reporting Act (Public Law 91-508) and the Consumer Credit Reform Act of 1996,
you are hereby informed that the action taken above is being taken partly because of information contained in a consumer report from the
following consumer reporting agency: (Name) (Phone Number)
(Address)
Please see additional information for a disclosure of your rights under this federal law.

Additional Information regarding your rights under the Consumer Credit Reform Act
Pursuant to the Consumer Credit Reform Act of 1996, you are informed that:
The consumer reporting agency identified on this form did not make any decisions regarding the stated insurance policy. Therefore, the consumer
reporting agency would not be able to provide you with the specific reasons why the insurance company is taking the present action.
You have the right to obtain within 60 days of the receipt of this notice a free copy of your credit report from the consumer reporting agency which has
been identified on this form.
You have the right to dispute inaccurate information by contacting the consumer reporting agency directly. Once you have directly notified the consumer
reporting agency of your dispute, the agency must, within a reasonable period of time reinvestigate and record the current status of the disputed
information. If after reinvestigation, such information is found to be inaccurate or unverifiable, such information must be promptly deleted from your
records. If the reinvestigation does not resolve the dispute, you may file a brief statement setting forth the nature of the dispute with the consumer
reporting agency. Your filed statement will then be included or summarized in any subsequent consumer report containing the information in question.
For complete information regarding the Federal Consumer Credit Protection Law please refer to The Code of the Laws of the United States of
America, Title 15, Chapter 41, Subchapter III, (15 U.S.C. 1681 et seq.).

AUTHORIZED REPRESENTATIVE

Clerk of the District Court, Johnson County Kansas

(E)GU 8892r (Ed. 7-13) Wolters Kluwer Financial Services I Uniform FormsTM INSURED'S COPY 2/23/2023 13:19:29 MJPage 2 of 2
(c) 2013 Wolters Kluwer Financial Services
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