DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Dorman, Carmen M	DOIID	370695	NAIC NPN	7200471

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Credit Life & Health	7/8/1999	8/7/2000
Inactive	Non Resident	Agent	Limited Line Credit	8/7/2000	8/21/2000
* 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	Southern Financial Life Insurance Company	300664	Agent - Credit Life & Health	7/8/1999	8/7/2000
Inactive	Southern Financial Life Insurance Company	300664	Agent - Limited Line Credit	8/7/2000	8/21/2000

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	PNC Bank NA	400230	Agent - Credit Life & Health	7/8/1999	8/7/2000
Inactive	PNC Bank NA	400230	Agent - Limited Line Credit	8/7/2000	8/21/2000