DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Black, William Pershing	DOIID	354984	NAIC NPN	1462064

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Denied	Non Resident	Agent	Casualty
Inactive	Non Resident	Agent	Life	9/30/1998	8/31/2008
Inactive	Non Resident	Agent	Health	9/30/1998	8/31/2008
* 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 - Health	11/9/2004	3/9/2005
Inactive	American Fidelity Assurance Company	301004	Agent - Health	8/22/2005	1/10/2006
Inactive	American Fidelity Assurance Company	301004	Agent - Life	8/22/2005	1/10/2006
Inactive	American Heritage Life Insurance Company	300272	Agent - Health	6/16/2006	6/23/2008
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	6/16/2006	6/23/2008
Inactive	Pan-American Life Insurance Company	301530	Agent - Health	10/13/2005	1/24/2006
Inactive	Pan-American Life Insurance Company	301530	Agent - Life	10/13/2005	1/24/2006
Inactive	Peoples Benefit Life Insurance Company	301895	Agent - Health	9/30/1998	9/28/2007
Inactive	Peoples Benefit Life Insurance Company	301895	Agent - Life	9/30/1998	9/28/2007
Inactive	Stonebridge Life Insurance Company	301614	Agent - Health	10/14/2005	1/12/2006
Inactive	Stonebridge Life Insurance Company	301614	Agent - Life	10/14/2005	1/12/2006
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	8/24/2005	4/20/2006
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	8/24/2005	4/20/2006

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Benefit Guaranty LLC	595049	Agent - Life	9/29/2004	1/30/2006
Inactive	Benefit Guaranty LLC	595049	Agent - Health	9/29/2004	1/30/2006