DEPARTMENT OF INSURANCE

Affiliations

Name	Dornbusch, Edward Nicholas	DOIID	349696	NAIC NPN	48028

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	General Lines	8/4/1986	8/15/2000
Inactive	Resident	Agent	Property	8/15/2000	6/30/2008
Inactive	Resident	Agent	Life	10/1/1986	6/30/2008
Inactive	Resident	Agent	Casualty	8/15/2000	6/30/2008
Inactive	Resident	Agent	Health	11/19/1986	6/30/2008
* 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 - General Lines	8/18/1992	3/31/1998
Inactive	ACE Fire Underwriters Insurance Company	301679	Agent - General Lines	8/18/1992	3/31/1998
Inactive	ACE Property and Casualty Insurance Company	300520	Agent - General Lines	8/18/1992	3/31/1998
Inactive	Alea North America Insurance Company	301594	Agent - Casualty	12/27/2000	3/31/2002
Inactive	Alea North America Insurance Company	301594	Agent - Property	12/27/2000	3/31/2002
Inactive	AmTrust Insurance Company	300179	Agent - General Lines	4/13/1989	2/26/1996
Inactive	American Alternative Insurance Corporation	301697	Agent - General Lines	5/30/1996	8/28/1997
Inactive	American Casualty Company of Reading, Pennsylvania	300956	Agent - Casualty	8/15/2000	12/12/2003
Inactive	American Casualty Company of Reading, Pennsylvania	300956	Agent - General Lines	4/10/1987	8/15/2000
Inactive	American Casualty Company of Reading, Pennsylvania	300956	Agent - Property	8/15/2000	12/12/2003
Inactive	American Economy Insurance Company	300315	Agent - Casualty	8/15/2000	6/30/2008
Inactive	American Economy Insurance Company	300315	Agent - General Lines	11/1/1998	8/15/2000
Inactive	American Economy Insurance Company	300315	Agent - Property	8/15/2000	6/30/2008
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	2/4/2002	6/30/2008
Inactive	American Fire and Casualty Company	300567	Agent - Property	2/4/2002	6/30/2008
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Health	3/7/1988	6/30/2008
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Life	3/7/1988	6/30/2008
Inactive	American Guarantee and Liability Insurance Company	301216	Agent - General Lines	8/4/1986	1/6/1997
Inactive	American Reliable Insurance Company	301889	Agent - General Lines	12/11/1998	6/28/1999
Inactive	American States Insurance Company	301230	Agent - Casualty	8/15/2000	6/30/2008
Inactive	American States Insurance Company	301230	Agent - General Lines	11/1/1998	8/15/2000
Inactive	American States Insurance Company	301230	Agent - Property	8/15/2000	6/30/2008
Inactive	American Zurich Insurance Company	300592	Agent - General Lines	3/17/1988	1/6/1997
Inactive	Anthem Life Insurance Company	301209	Agent - Health	7/15/1993	10/22/1999
Inactive	Anthem Life Insurance Company	301209	Agent - Life	7/15/1993	10/22/1999
Inactive	Assurance Company of America	300432	Agent - Casualty	8/15/2000	6/30/2008
Inactive	Assurance Company of America	300432	Agent - General Lines	10/20/1989	8/15/2000
Inactive	Assurance Company of America	300432	Agent - Property	8/15/2000	6/30/2008
Inactive	Bankers Standard Insurance Company	301620	Agent - General Lines	8/18/1992	3/31/1998
Inactive	Brighthouse Life Insurance Company	301829	Agent - Health	10/3/1962	12/17/1998
Inactive	Brighthouse Life Insurance Company	301829	Agent - Life	10/3/1962	12/17/1998
Inactive	Buckeye Union Insurance Company (The)	300597	Agent - General Lines	2/5/1997	3/31/1998
Inactive	Century Indemnity Company	301310	Agent - General Lines	8/18/1992	3/31/1998
Inactive	Cigna National Health Insurance Company	300235	Agent - Health	4/5/2001	1/21/2003
Inactive	Cigna National Health Insurance Company	300235	Agent - Life	4/5/2001	1/21/2003
Inactive	Colonial American Casualty & Surety Company	300769	Agent - Casualty	10/18/2002	6/30/2008
Inactive	Colonial American Casualty & Surety Company	300769	Agent - Property	10/18/2002	6/30/2008
Inactive	Commercial Insurance Company of Newark, New Jersey	300328	Agent - General Lines	2/3/1997	3/31/1998
Inactive	Connecticut General Life Insurance Company	301333	Agent - Health	11/19/1986	1/9/2006
Inactive	Connecticut General Life Insurance Company	301333	Agent - Life	10/1/1986	1/9/2006
Inactive	Consolidated American Insurance Company	301701	Agent - General Lines	12/7/1989	3/31/1996
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	9/8/2007	6/30/2008
Inactive	Consolidated Insurance Company	300943	Agent - Property	9/8/2007	6/30/2008
Inactive	Continental Casualty Company	301019	Agent - Casualty	8/15/2000	12/12/2003
Inactive	Continental Casualty Company	301019	Agent - General Lines	4/10/1987	8/15/2000
Inactive	Continental Casualty Company	301019	Agent - Property	8/15/2000	12/12/2003
Inactive	Continental Insurance Company (The)	301242	Agent - Casualty	8/15/2000	10/11/2001
Inactive	Continental Insurance Company (The)	301242	Agent - General Lines	2/5/1997	8/15/2000
Inactive	Continental Insurance Company (The)	301242	Agent - Property	8/15/2000	10/11/2001
Inactive	Falls Lake National Insurance Company	301796	Agent - General Lines	4/25/1996	6/29/2000
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	8/15/2000	7/12/2001
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - General Lines	8/24/1993	8/15/2000
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Property	8/15/2000	7/12/2001
Inactive	Fidelity and Casualty Company of New York (The)	300160	Agent - Casualty	8/15/2000	10/11/2001
Inactive	Fidelity and Casualty Company of New York (The)	300160	Agent - General Lines	2/4/1997	8/15/2000
Inactive	Fidelity and Casualty Company of New York (The)	300160	Agent - Property	8/15/2000	10/11/2001
Inactive	Fidelity and Deposit Company of Maryland	300976	Agent - Casualty	8/15/2000	6/30/2008
Inactive	Fidelity and Deposit Company of Maryland	300976	Agent - General Lines	4/17/1990	8/15/2000
Inactive	Fidelity and Deposit Company of Maryland	300976	Agent - Property	8/15/2000	6/30/2008
Inactive	Firemen's Insurance Company of Newark, New Jersey	300247	Agent - General Lines	2/4/1997	3/31/1998
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	7/1/2004	2/2/2006
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	7/1/2004	2/2/2006
Inactive	General Insurance Company of America	300261	Agent - Casualty	8/15/2000	6/30/2008
Inactive	General Insurance Company of America	300261	Agent - General Lines	12/23/1991	8/15/2000
Inactive	General Insurance Company of America	300261	Agent - Property	8/15/2000	6/30/2008
Inactive	Glens Falls Insurance Company (The)	301922	Agent - General Lines	2/3/1997	12/30/1999
Inactive	Great American Alliance Insurance Company	301247	Agent - Casualty	12/27/2000	6/30/2008
Inactive	Great American Alliance Insurance Company	301247	Agent - Property	12/27/2000	6/30/2008
Inactive	Great American Assurance Company	300327	Agent - Casualty	12/27/2000	6/30/2008
Inactive	Great American Assurance Company	300327	Agent - Property	12/27/2000	6/30/2008
Inactive	Great American Insurance Company	301586	Agent - Casualty	8/15/2000	6/30/2008
Inactive	Great American Insurance Company	301586	Agent - General Lines	6/23/1997	8/15/2000
Inactive	Great American Insurance Company	301586	Agent - Property	8/15/2000	6/30/2008
Inactive	Great American Insurance Company of New York	301897	Agent - Casualty	12/27/2000	6/30/2008
Inactive	Great American Insurance Company of New York	301897	Agent - Property	12/27/2000	6/30/2008
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Health	7/26/1994	12/14/2000
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Life	7/26/1994	12/14/2000
Inactive	Indemnity Insurance Company of North America	301760	Agent - General Lines	8/18/1992	3/31/1998
Inactive	Indiana Insurance Company	301909	Agent - Casualty	9/8/2007	6/30/2008
Inactive	Indiana Insurance Company	301909	Agent - Property	9/8/2007	6/30/2008
Inactive	Infinity Casualty Insurance Company	301280	Agent - General Lines	8/3/1990	6/29/2000
Inactive	Insurance Company of North America	300226	Agent - General Lines	8/18/1992	3/31/1998
Inactive	Kansas City Fire and Marine Insurance Company	301936	Agent - General Lines	2/4/1997	12/30/1999
Inactive	Kentucky National Insurance Company	301625	Agent - General Lines	2/25/1987	3/31/1996
Inactive	Maryland Casualty Company	301719	Agent - Casualty	8/15/2000	6/30/2008
Inactive	Maryland Casualty Company	301719	Agent - General Lines	10/20/1989	8/15/2000
Inactive	Maryland Casualty Company	301719	Agent - Property	8/15/2000	6/30/2008
Inactive	Meridian Mutual Insurance Company	301303	Agent - General Lines	6/28/1993	3/31/1998
Inactive	Metropolitan General Insurance Company	300709	Agent - Casualty	8/15/2000	7/12/2001
Inactive	Metropolitan General Insurance Company	300709	Agent - General Lines	8/24/1993	8/15/2000
Inactive	Metropolitan General Insurance Company	300709	Agent - Property	8/15/2000	7/12/2001
Inactive	National Fire Insurance Company of Hartford	301063	Agent - Casualty	8/15/2000	12/12/2003
Inactive	National Fire Insurance Company of Hartford	301063	Agent - General Lines	4/10/1987	8/15/2000
Inactive	National Fire Insurance Company of Hartford	301063	Agent - Property	8/15/2000	12/12/2003
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	9/8/2007	6/30/2008
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	9/8/2007	6/30/2008
Inactive	Northern Insurance Company of New York	301317	Agent - Casualty	8/15/2000	6/30/2008
Inactive	Northern Insurance Company of New York	301317	Agent - General Lines	10/20/1989	8/15/2000
Inactive	Northern Insurance Company of New York	301317	Agent - Property	8/15/2000	6/30/2008
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	2/4/2002	6/30/2008
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	2/4/2002	6/30/2008
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	8/15/2000	6/30/2008
Inactive	Ohio Security Insurance Company	300622	Agent - General Lines	10/4/1999	8/15/2000
Inactive	Ohio Security Insurance Company	300622	Agent - Property	8/15/2000	6/30/2008
Inactive	Old American Indemnity Company	301882	Agent - General Lines	12/31/1986	3/31/1998
Inactive	Pacific Employers Insurance Company	301753	Agent - General Lines	8/18/1992	3/31/1998
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Casualty	9/8/2007	6/30/2008
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Property	9/8/2007	6/30/2008
Inactive	Peerless Insurance Company	301910	Agent - Casualty	9/8/2007	6/30/2008
Inactive	Peerless Insurance Company	301910	Agent - Property	9/8/2007	6/30/2008
Inactive	Security National Insurance Company	301151	Agent - General Lines	4/13/1989	2/26/1996
Inactive	South Carolina Insurance Company	300080	Agent - General Lines	11/2/1989	3/31/1998
Inactive	Standard Insurance Company	300185	Agent - Health	3/11/2003	6/30/2008
Inactive	Standard Insurance Company	300185	Agent - Life	3/11/2003	6/30/2008
Inactive	TIG Insurance Company	301750	Agent - Casualty	8/15/2000	12/17/2002
Inactive	TIG Insurance Company	301750	Agent - General Lines	6/5/1996	8/15/2000
Inactive	TIG Insurance Company	301750	Agent - Property	8/15/2000	12/17/2002
Inactive	Transcontinental Insurance Company	301731	Agent - Casualty	8/15/2000	12/12/2003
Inactive	Transcontinental Insurance Company	301731	Agent - General Lines	4/10/1987	8/15/2000
Inactive	Transcontinental Insurance Company	301731	Agent - Property	8/15/2000	12/12/2003
Inactive	Transportation Insurance Company	301575	Agent - Casualty	8/15/2000	12/12/2003
Inactive	Transportation Insurance Company	301575	Agent - General Lines	4/10/1987	8/15/2000
Inactive	Transportation Insurance Company	301575	Agent - Property	8/15/2000	12/12/2003
Inactive	Travelers Casualty and Surety Company	301067	Agent - Casualty	3/29/2001	6/30/2008
Inactive	Travelers Casualty and Surety Company	301067	Agent - Property	3/29/2001	6/30/2008
Inactive	Trinity Universal Insurance Company	300911	Agent - General Lines	4/13/1989	2/26/1996
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	11/19/1986	12/7/2005
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	11/19/1986	12/7/2005
Inactive	United American Insurance Company	300910	Agent - Health	9/26/2007	6/30/2008
Inactive	United American Insurance Company	300910	Agent - Life	9/26/2007	6/30/2008
Inactive	Valley Forge Insurance Company	301052	Agent - Casualty	8/15/2000	12/12/2003
Inactive	Valley Forge Insurance Company	301052	Agent - General Lines	4/10/1987	8/15/2000
Inactive	Valley Forge Insurance Company	301052	Agent - Property	8/15/2000	12/12/2003
Inactive	West American Insurance Company	301112	Agent - Casualty	2/4/2002	6/30/2008
Inactive	West American Insurance Company	301112	Agent - Property	2/4/2002	6/30/2008
Inactive	Western Surety Company	300283	Agent - General Lines	6/14/1995	8/14/2000
Inactive	Zurich American Insurance Company	301121	Agent - General Lines	8/5/1986	1/6/1997
Inactive	Zurich American Insurance Company of Illinois	301805	Agent - General Lines	3/17/1988	1/6/1997

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Dental Choice Agency Inc.	398085	Agent - Health	1/29/2002	6/30/2008
Inactive	E. N. Dornbusch Agency Inc.	398456	Agent - General Lines	6/9/1993	8/15/2000
Inactive	E. N. Dornbusch Agency Inc.	398456	Agent - Life	6/9/1993	6/30/2008
Inactive	E. N. Dornbusch Agency Inc.	398456	Agent - Health	6/9/1993	6/30/2008
Inactive	E. N. Dornbusch Agency Inc.	398456	Agent - Property	8/15/2000	6/30/2008
Inactive	E. N. Dornbusch Agency Inc.	398456	Agent - Casualty	8/15/2000	6/30/2008
Inactive	Medlink Inc	400721	Agent - Life	6/15/1993	6/30/2008
Inactive	Medlink Inc	400721	Agent - Health	6/15/1993	6/30/2008