DEPARTMENT OF INSURANCE

Affiliations

Name	Church, Anita M	DOIID	322120	NAIC NPN	244489

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	12/30/2009	3/1/2011
Inactive	Non Resident	Agent	Health	12/30/2009	3/1/2011
Inactive	Non Resident	Agent	General Lines	4/7/1999	8/15/2000
Inactive	Non Resident	Agent	Personal Lines	12/30/2009	3/1/2011
Inactive	Non Resident	Agent	Property	8/15/2000	2/28/2009
Inactive	Non Resident	Agent	Casualty	8/15/2000	2/28/2009
* 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	ACE American Insurance Company	300625	Agent - Casualty	3/14/2006	2/12/2009
Inactive	ACE American Insurance Company	300625	Agent - Property	3/14/2006	2/12/2009
Inactive	Central States Health and Life Company of Omaha	301874	Agent - Health	2/10/2003	8/15/2005
Inactive	Central States Health and Life Company of Omaha	301874	Agent - Life	2/10/2003	8/15/2005
Inactive	Central States Indemnity Company of Omaha	300285	Agent - Casualty	2/10/2003	8/15/2005
Inactive	Central States Indemnity Company of Omaha	300285	Agent - Property	2/10/2003	8/15/2005
Inactive	Continental Casualty Company	301019	Agent - Health	6/10/2003	12/15/2004
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	1/24/2006	5/26/2008
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	1/24/2006	5/26/2008
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	9/19/2006	2/28/2009
Inactive	Sears Life Insurance Company	300218	Agent - Health	8/1/2002	1/12/2004
Inactive	Sears Life Insurance Company	300218	Agent - Life	8/1/2002	1/12/2004
Inactive	Stonebridge Life Insurance Company	301614	Agent - Health	3/22/1999	1/28/2003
Inactive	Stonebridge Life Insurance Company	301614	Agent - Life	3/22/1999	1/28/2003
Inactive	Transamerica Casualty Insurance Company	300311	Agent - Casualty	8/15/2000	1/28/2003
Inactive	Transamerica Casualty Insurance Company	300311	Agent - General Lines	4/7/1999	8/15/2000
Inactive	Transamerica Casualty Insurance Company	300311	Agent - Property	8/15/2000	1/28/2003
Inactive	Wilcac Life Insurance Company	301573	Agent - Health	6/10/2003	12/15/2004
Inactive	Wilcac Life Insurance Company	301573	Agent - Life	6/10/2003	12/15/2004
Inactive	Work First Casualty Company	300561	Agent - Health	7/17/2000	10/3/2003

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	PCCW Teleservices (US) , Inc.	533374	Agent - Life	2/15/2007	5/26/2008
Inactive	PCCW Teleservices (US) , Inc.	533374	Agent - Health	2/15/2007	1/26/2009
Inactive	PCCW Teleservices (US) , Inc.	533374	Agent - Property	2/15/2007	1/26/2009
Inactive	PCCW Teleservices (US) , Inc.	533374	Agent - Casualty	2/15/2007	2/12/2009