DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Cupka, Thomas W	DOIID	306914	NAIC NPN	1963026

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	3/28/2008	7/31/2010
Inactive	Non Resident	Agent	Health	12/3/1998	4/6/2000
Inactive	Non Resident	Agent	Life	12/3/1998	4/6/2000
Inactive	Non Resident	Agent	Casualty	3/28/2008	7/31/2010
* 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	Lincoln National Life Insurance Company (The)	301382	Agent - Health	12/3/1998	4/6/2000
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	12/3/1998	4/6/2000
Inactive	National Casualty Company	301483	Agent - Casualty	7/8/2008	4/21/2010
Inactive	National Casualty Company	301483	Agent - Property	7/8/2008	4/21/2010
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Casualty	6/17/2009	4/27/2010
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Property	6/17/2009	4/27/2010
Inactive	Scottsdale Indemnity Company	300232	Agent - Casualty	7/8/2008	4/21/2010
Inactive	Scottsdale Indemnity Company	300232	Agent - Property	7/8/2008	4/21/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	K & K Insurance Group Inc	513466	Agent - Casualty	9/3/2008	4/27/2010
Inactive	K & K Insurance Group Inc	513466	Agent - Property	9/3/2008	4/27/2010