DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Jaffe, Robert S	DOIID	321122	NAIC NPN	7168289

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	3/22/1988	4/1/2009
Inactive	Resident	Agent	Health	12/5/1988	4/1/2009
Inactive	Resident	Agent	Health Maintenance Organization	2/4/1988	7/14/1997
* 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	First Colony Life Insurance Company	301179	Agent - Life	3/22/1988	12/20/2006
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	2/4/1988	7/14/1997
Inactive	Manhattan National Life Insurance Company	301011	Agent - Health	6/24/1994	3/31/1997
Inactive	Manhattan National Life Insurance Company	301011	Agent - Life	6/24/1994	3/31/1997
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	12/5/1988	12/13/2005
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	12/5/1988	12/13/2005
Inactive	Transamerica Assurance Company	300893	Agent - Health	1/26/1993	1/26/1993
Inactive	Transamerica Assurance Company	300893	Agent - Life	1/26/1993	1/26/1993
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Health	12/18/1992	3/31/1997
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Life	12/18/1992	3/31/1997

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Gordon & Brown Insurance Agency, Inc.	400377	Agent - Life	8/19/1993	9/11/2000
Inactive	Gordon & Brown Insurance Agency, Inc.	400377	Agent - Health	8/19/1993	9/11/2000