DEPARTMENT OF INSURANCE

Affiliations

Name	Wise, Forrest Willard	DOIID	320709	NAIC NPN	7168104

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Property	8/15/2000	11/30/2007
Inactive	Resident	Agent	Life	2/21/1997	11/30/2007
Inactive	Resident	Agent	Health	11/6/1997	11/30/2007
Inactive	Resident	Agent	Casualty	8/15/2000	11/30/2007
Inactive	Resident	Agent	General Lines	5/31/2000	8/15/2000
* 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	4/11/2002	12/28/2006
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	2/26/2002	12/28/2006
Inactive	American Alternative Insurance Corporation	301697	Agent - Casualty	10/4/2001	11/28/2007
Inactive	American Alternative Insurance Corporation	301697	Agent - Property	10/4/2001	8/4/2006
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	3/26/2001	8/9/2002
Inactive	Consolidated Insurance Company	300943	Agent - Property	3/26/2001	8/9/2002
Inactive	Continental General Insurance Company	300691	Agent - Health	11/6/1997	2/8/2002
Inactive	First Colony Life Insurance Company	301179	Agent - Health	7/15/2004	1/1/2007
Inactive	First Colony Life Insurance Company	301179	Agent - Life	7/15/2004	1/1/2007
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	10/22/2003	11/30/2007
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	10/22/2003	11/30/2007
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Health	1/1/2007	11/30/2007
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	1/1/2007	11/30/2007
Inactive	Grange Indemnity Insurance Company	300793	Agent - Casualty	3/1/2001	11/30/2007
Inactive	Grange Indemnity Insurance Company	300793	Agent - Property	3/1/2001	11/30/2007
Inactive	Grange Insurance Company	300234	Agent - Casualty	3/1/2001	11/30/2007
Inactive	Grange Insurance Company	300234	Agent - Property	3/1/2001	11/30/2007
Inactive	Grange Life Insurance Company	300128	Agent - Health	2/1/2001	11/30/2007
Inactive	Grange Life Insurance Company	300128	Agent - Life	2/1/2001	11/30/2007
Inactive	Hartford Casualty Insurance Company	301332	Agent - Casualty	7/20/2001	11/13/2003
Inactive	Hartford Casualty Insurance Company	301332	Agent - Property	7/20/2001	11/13/2003
Inactive	Hartford Fire Insurance Company	300628	Agent - Casualty	12/29/2005	2/2/2006
Inactive	Hartford Fire Insurance Company	300628	Agent - Property	12/29/2005	2/2/2006
Inactive	Indiana Insurance Company	301909	Agent - Casualty	3/26/2001	8/9/2002
Inactive	Indiana Insurance Company	301909	Agent - Property	3/26/2001	8/9/2002
Inactive	Medical Protective Company (The)	301207	Agent - Casualty	8/27/2001	1/23/2008
Inactive	Medical Protective Company (The)	301207	Agent - Property	8/27/2001	1/23/2008
Inactive	Meridian Mutual Insurance Company	301303	Agent - Casualty	4/30/2001	6/1/2001
Inactive	Meridian Mutual Insurance Company	301303	Agent - Property	4/30/2001	6/1/2001
Inactive	Meridian Security Insurance Company	300423	Agent - Casualty	4/27/2001	3/10/2004
Inactive	Meridian Security Insurance Company	300423	Agent - Property	4/27/2001	3/10/2004
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Casualty	3/11/2002	11/30/2007
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Property	3/11/2002	11/30/2007
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	3/26/2001	8/9/2002
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	3/26/2001	8/9/2002
Inactive	Peerless Insurance Company	301910	Agent - Casualty	3/26/2001	8/9/2002
Inactive	Peerless Insurance Company	301910	Agent - Property	3/26/2001	8/9/2002
Inactive	Protective Life Insurance Company	300638	Agent - Life	1/1/2007	11/30/2007
Inactive	Reliance Insurance Company	300785	Agent - Casualty	8/15/2000	6/5/2001
Inactive	Reliance Insurance Company	300785	Agent - General Lines	5/31/2000	8/15/2000
Inactive	Reliance Insurance Company	300785	Agent - Property	8/15/2000	6/5/2001
Inactive	Reliance National Indemnity Company	301939	Agent - General Lines	5/31/2000	8/15/2000
Inactive	Reliance National Insurance Company	301675	Agent - General Lines	5/31/2000	8/15/2000
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Casualty	5/17/2001	3/15/2004
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Property	5/17/2001	3/15/2004
Inactive	Time Insurance Company	300683	Agent - Health	4/24/2001	11/30/2007
Inactive	Time Insurance Company	300683	Agent - Life	4/24/2001	11/30/2007
Inactive	Trustgard Insurance Company	300104	Agent - Casualty	8/15/2000	11/30/2007
Inactive	Trustgard Insurance Company	300104	Agent - Property	3/1/2001	11/30/2007
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Life	4/2/2003	10/4/2007
Inactive	United Pacific Insurance Company	300538	Agent - General Lines	5/31/2000	8/15/2000
Inactive	West Coast Life Insurance Company	301607	Agent - Life	9/7/2006	11/30/2007
Inactive	Woodmen of the World Life Insurance Society	301446	Agent - Life	2/21/1997	7/25/2000
Inactive		300277	Agent - Life	1/9/2003	1/1/2007

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Houk Insurance Agency Inc.	400613	Agent - Life	11/8/2004	11/30/2007
Inactive	Houk Insurance Agency Inc.	400613	Agent - Health	11/8/2004	11/30/2007
Inactive	Houk Insurance Agency Inc.	400613	Agent - Property	11/8/2004	11/30/2007
Inactive	Houk Insurance Agency Inc.	400613	Agent - Casualty	11/8/2004	11/30/2007
Inactive	Neace Lukens, Inc.	398909	Agent - Property	8/15/2000	4/9/2002
Inactive	Neace Lukens, Inc.	398909	Agent - Casualty	8/15/2000	4/9/2002
Inactive	Nunn Insurance, Inc.	526339	Agent - Life	10/30/2001	11/3/2004
Inactive	Nunn Insurance, Inc.	526339	Agent - Health	10/30/2001	11/3/2004
Inactive	Nunn Insurance, Inc.	526339	Agent - Property	5/29/2001	11/3/2004
Inactive	Nunn Insurance, Inc.	526339	Agent - Casualty	5/29/2001	11/3/2004