DEPARTMENT OF INSURANCE

Affiliations

Name	Bozio, Roman	DOIID	307643	NAIC NPN	577509

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Life	4/3/1995	4/1/2017
Inactive	Resident	Agent	Health	9/18/2006	4/1/2017
* 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	American Memorial Life Insurance Company	301445	Agent - Life	4/13/1999	1/10/2013
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Life	5/14/2014	5/21/2016
Inactive	Athene Annuity and Life Company	301893	Agent - Life	6/11/2012	4/1/2017
Inactive	ELCO Mutual Life and Annuity	300503	Agent - Life	3/10/2014	4/1/2017
Inactive	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	12/27/2013	4/1/2017
Inactive	Forethought Life Insurance Company	301407	Agent - Life	5/26/1995	7/18/2000
Inactive	Guaranty Income Life Insurance Company	552451	Agent - Health	5/20/2015	4/1/2017
Inactive	Guaranty Income Life Insurance Company	552451	Agent - Life	5/20/2015	4/1/2017
Inactive	MassMutual Ascend Life Insurance Company	300320	Agent - Life	5/9/2012	6/11/2014
Inactive	Midland National Life Insurance Company	300923	Agent - Health	11/15/2006	7/6/2016
Inactive	Midland National Life Insurance Company	300923	Agent - Life	11/15/2006	7/6/2016
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	11/16/2006	7/26/2010
Inactive	National Guardian Life Insurance Company	300596	Agent - Life	5/23/2012	5/9/2017
Inactive	National Western Life Insurance Company	301515	Agent - Life	8/7/2006	3/7/2007
Inactive	North American Company for Life and Health Insurance	300291	Agent - Life	6/4/2015	7/6/2016
Inactive	Shenandoah Life Insurance Company	300130	Agent - Life	8/10/2006	5/3/2007
Inactive	State Life Insurance Company	301497	Agent - Health	10/31/2013	4/5/2017
Inactive	State Life Insurance Company	301497	Agent - Life	10/31/2013	4/5/2017
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	7/5/2013	4/9/2015
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	7/5/2013	4/9/2015
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	7/5/2013	4/9/2015
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	7/5/2013	4/9/2015
Inactive	United World Life Insurance Company	300532	Agent - Health	11/16/2006	7/26/2010
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	12/12/2008	7/26/2010
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	12/12/2008	7/26/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Sentinel Security Plans Inc.	398097	Agent - Life	6/29/2004	4/1/2017