DEPARTMENT OF INSURANCE

Affiliations

Name	Chapman, William Jefferson	DOIID	316122	NAIC NPN	1723617

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Health	5/31/2001	7/31/2009
Inactive	Resident	Agent	Life	5/31/2001	7/31/2009
Inactive	Resident	Agent	Property	8/22/2006	7/31/2009
* 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	Allianz Life Insurance Company of North America	301791	Agent - Health	11/3/2003	5/23/2007
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	11/3/2003	5/23/2007
Inactive	American Investors Life Insurance Company, Inc.	301358	Agent - Life	3/27/2007	6/2/2009
Inactive	Bankers Life and Casualty Company	300701	Agent - Health	12/11/2000	9/19/2002
Inactive	Bankers Life and Casualty Company	300701	Agent - Life	12/11/2000	9/19/2002
Inactive	Columbian Life Insurance Company	300810	Agent - Life	6/5/2006	5/11/2007
Inactive	Combined Insurance Company of America	301472	Agent - Health	4/16/2007	10/22/2007
Inactive	Combined Insurance Company of America	301472	Agent - Life	4/16/2007	10/22/2007
Inactive	EMC National Life Company	300388	Agent - Health	10/3/2003	1/24/2006
Inactive	EMC National Life Company	300388	Agent - Life	10/3/2003	1/24/2006
Inactive	Everly Life Insurance Company	561641	Agent - Life	6/20/2006	10/7/2008
Inactive	Independent Mutual Fire Insurance Company	300851	Agent - Property	8/22/2006	4/13/2007
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Life	10/1/2003	5/4/2007
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	1/2/2004	5/16/2007
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	1/2/2004	5/16/2007
Inactive	Life Investors Insurance Company of America	301793	Agent - Health	2/26/1996	10/22/1996
Inactive	Loyal American Life Insurance Company	301172	Agent - Health	10/10/2003	12/8/2006
Inactive	Loyal American Life Insurance Company	301172	Agent - Life	10/10/2003	12/8/2006
Inactive	Midland National Life Insurance Company	300923	Agent - Health	10/6/2003	5/11/2007
Inactive	Midland National Life Insurance Company	300923	Agent - Life	10/6/2003	5/11/2007
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	3/3/2006	5/22/2007
Inactive	Settlers Life Insurance Company	300189	Agent - Life	10/6/2003	7/1/2006
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	10/23/2003	5/9/2007
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Life	10/23/2003	5/9/2007
Inactive	Sterling Life Insurance Company	301947	Agent - Health	6/11/2007	6/3/2008
Inactive	Sterling Life Insurance Company	301947	Agent - Life	6/11/2007	6/3/2008
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	1/4/2006	4/13/2007
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	1/4/2006	4/13/2007
Inactive	United Teacher Associates Insurance Company	300747	Agent - Health	10/10/2003	12/6/2006
Inactive	United Teacher Associates Insurance Company	300747	Agent - Life	10/10/2003	12/6/2006
Inactive	United World Life Insurance Company	300532	Agent - Health	3/3/2006	5/22/2007
Inactive	West Coast Life Insurance Company	301607	Agent - Life	10/6/2003	12/28/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Select Insurance Agency, Inc.	503760	Agent - Health	1/16/2004	3/31/2008
Inactive	Select Insurance Agency, Inc.	503760	Agent - Life	1/16/2004	3/31/2008