SAMPLE SUBRO INITIATIVE

                                                                                                     October 14, 2004

ROBERT JONES                                                             CLIENT #:           M0113
JONES INSURANCE GROUP                                         LOSS DATE:       1/1/98

111 W 6^TH AVENUE                                                CLAIM/ACCT:    000000123
ANYWHERE, CO 80021                                  REFERENCE:      SUE JOHNSON

We have developed the following information:

SUBJECT:     JOHN M. SMITH

ADDRESS:    543 SKIPTOWN AVENUE
                      ALLENTOWN, PA 20202
                      (211) 222-9988

COUNTY:    LINCOLN

GENDER:     MALE

DATE OF BIRTH:  1/13/65

SOCIAL SECURITY NUMBER:  111-22-3232

DRIVER’S LICENSE:    26-343-4497

REAL ESTATE OWNERSHIP:  YES, ABOVE ADDRESS

LEGAL DESCRIPTION:  LOT 21A, MAP 4

AREA WEALTH RATING:  UPPER-MIDDLE

PURCHASE DATE:  6/15/92

ASSESSED VALUE:  $97,000.00

EMPLOYER:  WOODS CONSTRUCTION

                        326 N. PINE, SUITE #1246

                        ALLENTOWN, PA 20202

                        (211) 675-1553

POSITION:  CARPENTER

DOH:  7/1/97

WAGE:  $45,000.00

Per your subro-initiative request insurance coverage was identified with Everson Insurance Group in Allentown, policy number 233-33-233.

This investigation was conducted in compliance with the Fair Credit Reporting Act and the Gramm-Leach-Bliley Act.

FEE:     $0.00                 CASE#: 2005010560-07 (Please refer to case # when remitting)