DEPARTMENT OF INSURANCE

Affiliations

Name	Montgomery, Charles Richard	DOIID	333992	NAIC NPN	2386264

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Life	12/9/2011	10/1/2013
Inactive	Resident	Agent	Health	12/9/2011	10/1/2013
* 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	All American Life Insurance Company	300702	Agent - Health	10/16/1997	7/10/1998
Inactive	All American Life Insurance Company	300702	Agent - Life	10/16/1997	7/10/1998
Inactive	American Continental Insurance Company	643130	Agent - Health	11/7/2007	5/12/2011
Inactive	American Continental Insurance Company	643130	Agent - Life	11/7/2007	5/12/2011
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	1/2/2013	11/20/2013
Inactive	Anthem Life Insurance Company	301209	Agent - Health	3/30/2011	9/30/2011
Inactive	Anthem Life Insurance Company	301209	Agent - Life	3/30/2011	9/30/2011
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Health	1/22/2004	5/24/2004
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Life	1/22/2004	5/24/2004
Inactive	Colorado Bankers Life Insurance Company	301845	Agent - Health	2/15/2005	11/24/2009
Inactive	Colorado Bankers Life Insurance Company	301845	Agent - Life	2/15/2005	11/24/2009
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	12/15/2011	10/1/2013
Inactive	CompBenefits Insurance Company	301864	Agent - Health	11/6/2009	9/30/2011
Inactive	CompBenefits Insurance Company	301864	Agent - Life	11/6/2009	9/30/2011
Inactive	Connecticut General Life Insurance Company	301333	Agent - Health	1/10/2012	8/8/2013
Inactive	Connecticut General Life Insurance Company	301333	Agent - Life	1/10/2012	8/8/2013
Inactive	Conseco Health Insurance Company	301725	Agent - Health	4/9/2007	11/4/2009
Inactive	Conseco Health Insurance Company	301725	Agent - Life	4/9/2007	11/4/2009
Inactive	Conseco Insurance Company	301202	Agent - Health	4/9/2007	10/21/2009
Inactive	Conseco Insurance Company	301202	Agent - Life	4/9/2007	10/21/2009
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	12/15/2011	10/1/2013
Inactive	Essence Healthcare, Inc.	657425	Agent - Health	1/19/2010	3/31/2011
Inactive	Family Life Insurance Company	300356	Agent - Health	6/30/2009	12/28/2010
Inactive	Gerber Life Insurance Company	300529	Agent - Health	1/17/2012	12/26/2012
Inactive	Gerber Life Insurance Company	300529	Agent - Life	1/17/2012	12/26/2012
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/10/2012	10/1/2013
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	12/15/2011	10/1/2013
Inactive	Humana Insurance Company	301104	Agent - Health	12/15/2011	10/1/2013
Inactive	Humana Insurance Company	301104	Agent - Life	12/15/2011	10/1/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	12/15/2011	10/1/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	12/15/2011	10/1/2013
Inactive	Independent Order of Foresters	300743	Agent - Health	4/13/2011	9/30/2011
Inactive	Independent Order of Foresters	300743	Agent - Life	4/13/2011	9/30/2011
Inactive	Kanawha Insurance Company	300127	Agent - Health	12/15/2011	10/1/2013
Inactive	Kanawha Insurance Company	300127	Agent - Life	12/15/2011	10/1/2013
Inactive	Manhattan National Life Insurance Company	301011	Agent - Life	11/29/1995	3/31/1997
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	1/17/2012	12/26/2012
Inactive	Omaha Insurance Company	751908	Agent - Health	3/30/2012	6/24/2013
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	12/4/2006	9/30/2011
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Life	12/4/2006	9/30/2011
Inactive	Peoples Benefit Life Insurance Company	301895	Agent - Health	1/31/2005	9/19/2007
Inactive	Peoples Benefit Life Insurance Company	301895	Agent - Life	1/31/2005	9/19/2007
Inactive	Physicians Life Insurance Company	300924	Agent - Health	3/12/2004	9/28/2006
Inactive	Physicians Life Insurance Company	300924	Agent - Life	5/30/2001	9/28/2006
Inactive	Physicians Mutual Insurance Company, Inc.	301084	Agent - Health	5/30/2001	9/28/2006
Inactive	Pioneer Life Insurance Company	300110	Agent - Health	9/30/1993	10/18/1996
Inactive	Pioneer Life Insurance Company	300110	Agent - Life	9/30/1993	10/18/1996
Inactive	Time Insurance Company	300683	Agent - Health	2/21/2005	12/27/2006
Inactive	Time Insurance Company	300683	Agent - Life	2/21/2005	12/27/2006
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	10/15/2010	9/30/2011
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	10/15/2010	9/30/2011
Inactive	United American Insurance Company	300910	Agent - Health	7/1/1998	12/31/1999
Inactive	United American Insurance Company	300910	Agent - Life	7/1/1998	12/31/1999
Inactive	United World Life Insurance Company	300532	Agent - Health	2/22/2006	4/16/2010
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	1/17/2012	12/26/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	1/17/2012	12/26/2012
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	7/14/1995	9/9/1996
Inactive	Unity Financial Life Insurance Company	301054	Agent - Life	6/1/2007	11/22/2011
Inactive	Wilco Life Insurance Company	300122	Agent - Life	5/10/1999	6/14/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Health	3/30/2011	9/30/2011
Inactive	Designated Agent Company Inc.	681257	Agent - Life	3/30/2011	9/30/2011