DEPARTMENT OF INSURANCE

Affiliations

Name	Fairchild, Douglas D	DOIID	358082	NAIC NPN	1937071

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Life	6/28/1990	7/7/1998
Inactive	Resident	Agent	Health	6/28/1990	7/7/1998
* 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	American Heritage Life Insurance Company	300272	Agent - Health	8/25/1992	3/31/1997
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	8/25/1992	3/31/1997
Inactive	American National Insurance Company	301861	Agent - Health	2/17/1995	7/7/1998
Inactive	American National Insurance Company	301861	Agent - Life	2/17/1995	7/7/1998
Inactive	Ameritas Life Insurance Corporation	300126	Agent - Health	11/30/1993	7/7/1998
Inactive	Ameritas Life Insurance Corporation	300126	Agent - Life	11/30/1993	7/7/1998
Inactive	Companion Life Insurance Company	300191	Agent - Health	8/13/1991	7/7/1998
Inactive	Companion Life Insurance Company	300191	Agent - Life	8/13/1991	7/7/1998
Inactive	Conseco Medical Insurance Company	300719	Agent - Health	8/18/1994	7/7/1998
Inactive	Conseco Medical Insurance Company	300719	Agent - Life	8/18/1994	7/7/1998
Inactive	General American Life Insurance Company	300280	Agent - Health	9/4/1990	8/25/1997
Inactive	General American Life Insurance Company	300280	Agent - Life	9/4/1990	8/25/1997
Inactive	Humana Insurance Company	301104	Agent - Health	9/25/1990	7/7/1998
Inactive	Humana Insurance Company	301104	Agent - Life	9/25/1990	7/7/1998
Inactive	John Alden Life Insurance Company	300573	Agent - Health	4/19/1995	3/31/1997
Inactive	John Alden Life Insurance Company	300573	Agent - Life	4/19/1995	3/31/1997
Inactive	Lincoln Life & Annuity Company of New York	300636	Agent - Health	11/20/1990	3/31/1997
Inactive	Lincoln Life & Annuity Company of New York	300636	Agent - Life	11/20/1990	3/31/1997
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	7/25/1996	7/7/1998
Inactive	Nationwide Life Insurance Company	300495	Agent - Health	10/30/1990	7/7/1998
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	10/30/1990	7/7/1998
Inactive	Principal Life Insurance Company	300129	Agent - Health	5/24/1991	7/7/1998
Inactive	Principal Life Insurance Company	300129	Agent - Life	5/24/1991	7/7/1998
Inactive	Reassure America Life Insurance Company	300678	Agent - Health	11/6/1996	7/7/1998
Inactive	Reassure America Life Insurance Company	300678	Agent - Life	11/6/1996	7/7/1998
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	8/18/1995	3/31/1997
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	8/18/1995	3/31/1997

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bennett Insurance Service Inc.	399537	Agent - Health	9/20/1990	7/7/1998
Inactive	Bennett Insurance Service Inc.	399537	Agent - Life	9/20/1990	7/7/1998
Inactive	Fairchild Marketing Inc.	399211	Agent - Health	6/28/1990	7/7/1998
Inactive	Fairchild Marketing Inc.	399211	Agent - Life	6/28/1990	7/7/1998
Inactive	Healthplan Services, Inc.	401230	Agent - Health	8/31/1995	3/31/1997