DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Dybiec, Donald J	DOIID	348354	NAIC NPN	967075

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	1/29/1996	9/30/2010
Inactive	Non Resident	Agent	Health	1/29/1996	9/30/2010
* 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	Commonwealth Annuity and Life Insurance Company	300798	Agent - Health	1/29/1996	12/31/2005
Inactive	Commonwealth Annuity and Life Insurance Company	300798	Agent - Life	1/29/1996	12/31/2005
Inactive	Nationwide Life Insurance Company	300495	Agent - Health	12/11/2002	6/27/2003
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	12/11/2002	6/27/2003

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	TBS Agency, Inc.	502294	Agent - Life
Denied	TBS Agency, Inc.	502294	Agent - Health