DEPARTMENT OF INSURANCE

Affiliations

Name	Henson, Forrest	DOIID	319142	NAIC NPN	7167383

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Health	6/17/1987	5/10/2006
Inactive	Resident	Agent	Life	6/17/1987	5/10/2006
* 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	Bankers Fidelity Life Insurance Company	300193	Agent - Health	2/27/1995	5/10/2006
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Life	2/27/1995	5/10/2006
Inactive	Berkley Life and Health Insurance Company	301421	Agent - Life	5/27/1992	12/18/1997
Inactive	Citizens Security Life Insurance Company	301257	Agent - Health	10/27/1992	5/10/2006
Inactive	Citizens Security Life Insurance Company	301257	Agent - Life	10/27/1992	5/10/2006
Inactive	Conseco Health Insurance Company	301725	Agent - Health	4/25/2001	10/14/2003
Inactive	Conseco Health Insurance Company	301725	Agent - Life	4/25/2001	10/14/2003
Inactive	Freedom Life Insurance Company of America	300074	Agent - Health	4/8/1994	3/31/1997
Inactive	Freedom Life Insurance Company of America	300074	Agent - Life	4/8/1994	3/31/1997
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Health	6/17/1987	12/31/1998
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Life	6/17/1987	12/31/1998
Inactive	Jackson National Life Insurance Company	300486	Agent - Life	6/13/1990	12/31/2002
Inactive	LifeSecure Insurance Company	301629	Agent - Health	6/27/1996	10/6/1997
Inactive	LifeSecure Insurance Company	301629	Agent - Life	6/27/1996	10/6/1997
Inactive	National States Insurance Company	300579	Agent - Health	4/30/1998	12/1/2000
Inactive	National States Insurance Company	300579	Agent - Life	4/30/1998	12/1/2000
Inactive	Senior Health Insurance Company of Pennsylvania	300251	Agent - Health	7/3/1990	7/18/2003
Inactive	Senior Health Insurance Company of Pennsylvania	300251	Agent - Life	7/3/1990	7/18/2003
Inactive	Settlers Life Insurance Company	300189	Agent - Health	9/30/1993	9/25/2000
Inactive	Settlers Life Insurance Company	300189	Agent - Life	4/14/2005	5/10/2006
Inactive	Southwestern Life Insurance Company	301343	Agent - Health	12/11/1997	10/5/2000
Inactive	Southwestern Life Insurance Company	301343	Agent - Life	12/11/1997	10/5/2000
Inactive	United American Insurance Company	300910	Agent - Health	6/16/1989	5/10/2006
Inactive	United American Insurance Company	300910	Agent - Life	6/16/1989	5/10/2006

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Grimsley Insurance Agency Inc.	399862	Agent - Life	1/12/2005	5/10/2006
Inactive	Grimsley Insurance Agency Inc.	399862	Agent - Health	1/12/2005	5/10/2006