DEPARTMENT OF INSURANCE

Affiliations

Name	George, Derrick E	DOIID	302321	NAIC NPN	3367856

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	5/23/2007	8/31/2010
Inactive	Non Resident	Agent	Property	5/23/2007	8/31/2010
Inactive	Non Resident	Agent	Health	5/31/2001	10/31/2004
Inactive	Non Resident	Agent	Casualty	5/23/2007	8/31/2010
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	21st Century Centennial Insurance Company	301840	Agent - Casualty	12/13/2007	8/31/2010
Inactive	21st Century Centennial Insurance Company	301840	Agent - Property	12/13/2007	8/31/2010
Inactive	AIU Insurance Company	300729	Agent - Casualty	12/13/2007	8/31/2010
Inactive	AIU Insurance Company	300729	Agent - Property	12/13/2007	8/31/2010
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	6/17/2002	10/31/2004
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	6/17/2002	10/31/2004
Inactive	American General Life and Accident Insurance Company	301362	Agent - Health	4/7/1998	11/4/1999
Inactive	American General Life and Accident Insurance Company	301362	Agent - Life	4/7/1998	11/4/1999
Inactive	American Home Assurance Company	300246	Agent - Casualty	12/13/2007	8/31/2010
Inactive	American Home Assurance Company	300246	Agent - Property	12/13/2007	8/31/2010
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	11/26/2001	10/31/2004
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	11/26/2001	10/31/2004
Inactive	Bankers United Life Assurance Company	300296	Agent - Health	3/9/2001	12/31/2001
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	5/24/2004	10/31/2004
Inactive	Empire Fire and Marine Insurance Company	300666	Agent - Casualty	4/9/2008	5/19/2010
Inactive	Empire Fire and Marine Insurance Company	300666	Agent - Property	4/9/2008	5/19/2010
Inactive	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	8/7/2002	4/18/2004
Inactive	Fidelity and Deposit Company of Maryland	300976	Agent - Casualty	4/14/2008	5/24/2010
Inactive	Fidelity and Deposit Company of Maryland	300976	Agent - Property	4/14/2008	5/24/2010
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	4/7/2009	8/31/2010
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	4/7/2009	8/31/2010
Inactive	Granite State Insurance Company	300818	Agent - Casualty	12/13/2007	8/31/2010
Inactive	Granite State Insurance Company	300818	Agent - Property	12/13/2007	8/31/2010
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	2/2/2000	9/27/2000
Inactive	Humana Insurance Company	300118	Agent - Health	2/2/2000	9/27/2000
Inactive	Life Investors Insurance Company of America	301793	Agent - Health	12/31/2001	9/8/2003
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Life	4/17/2010	5/13/2010
Inactive	Peoples Benefit Life Insurance Company	301895	Agent - Life	1/23/1997	11/3/2000
Inactive	Praetorian Insurance Company	301021	Agent - Casualty	10/5/2009	5/19/2010
Inactive	Praetorian Insurance Company	301021	Agent - Property	10/5/2009	5/19/2010
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	6/11/2007	8/31/2010
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	6/11/2007	8/31/2010
Inactive	Stillwater Insurance Company	567181	Agent - Casualty	7/10/2007	6/1/2010
Inactive	Stillwater Insurance Company	567181	Agent - Property	7/10/2007	6/1/2010
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Life	7/19/2007	11/23/2009
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Life	7/19/2007	11/23/2009
Inactive	Transamerica Assurance Company	300893	Agent - Life	5/31/2001	10/1/2004
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	5/14/2004	10/31/2004
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	11/15/1995	3/4/1998
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	11/15/1995	3/4/1998
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Life	4/13/2004	10/31/2004
Inactive	Western National Life Insurance Company	300461	Agent - Life	7/19/2007	8/31/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Balboa Insurance Services Inc.	516610	Agent - Property	9/21/2009	5/4/2010
Inactive	Balboa Insurance Services Inc.	516610	Agent - Casualty	9/21/2009	5/4/2010
Inactive	Banc of America Insurance Services, Inc.	400875	Agent - Life	7/19/2007	8/10/2010
Inactive	Banc of America Insurance Services, Inc.	400875	Agent - Property	6/11/2007	8/10/2010
Inactive	Banc of America Insurance Services, Inc.	400875	Agent - Casualty	6/11/2007	8/10/2010