DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Marshall-Brooks, Lacosta Nacole	DOIID	343108	NAIC NPN	3182940

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	11/4/1999	6/30/2006
Inactive	Non Resident	Agent	Life	11/4/1999	6/30/2006
* 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	Balboa Life Insurance Company	301327	Agent - Health	12/1/2004	11/30/2005
Inactive	Balboa Life Insurance Company	301327	Agent - Life	12/1/2004	11/30/2005
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	11/19/2004	6/30/2006
Inactive	Stonebridge Life Insurance Company	301614	Agent - Health	7/22/2003	5/4/2005
Inactive	Stonebridge Life Insurance Company	301614	Agent - Life	7/22/2003	5/4/2005
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	7/22/2003	5/4/2005
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	7/22/2003	5/4/2005
Inactive	Union Fidelity Life Insurance Company	301136	Agent - Health	11/4/1999	6/14/2002
Inactive	Union Fidelity Life Insurance Company	301136	Agent - Life	11/4/1999	6/14/2002

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Americall Corporation	520281	Agent - Life	2/9/2005	11/30/2005
Inactive	Americall Corporation	520281	Agent - Health	2/9/2005	6/30/2006