DEPARTMENT OF INSURANCE

Affiliations

Name	Dombrosky, David Alan	DOIID	375109	NAIC NPN	765795

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Variable Life and Variable Annuities	1/13/2003	1/31/2006
Inactive	Non Resident	Agent	Casualty	8/15/2000	1/31/2006
Inactive	Non Resident	Agent	Property	8/15/2000	1/31/2006
Inactive	Non Resident	Agent	Health	1/12/2003	1/31/2006
Inactive	Non Resident	Agent	Life	1/13/2003	1/31/2006
Inactive	Non Resident	Agent	General Lines	12/10/1998	8/15/2000
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Brighthouse Life Insurance Company	301829	Agent - Health	1/13/2003	1/31/2006
Inactive	Brighthouse Life Insurance Company	301829	Agent - Life	1/13/2003	1/31/2006
Inactive	Brighthouse Life Insurance Company	301829	Agent - Variable Life and Variable Annuities	1/13/2003	1/31/2006
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - General Lines	12/10/1998	8/15/2000
Inactive	General American Life Insurance Company	300280	Agent - Health	12/20/2005	1/31/2006
Inactive	General American Life Insurance Company	300280	Agent - Life	12/20/2005	1/31/2006
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Health	12/20/2005	1/31/2006
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Life	12/20/2005	1/31/2006
Inactive	MetLife Life and Annuity Company of Connecticut	301593	Agent - Health	1/13/2003	1/31/2006
Inactive	MetLife Life and Annuity Company of Connecticut	301593	Agent - Life	1/13/2003	1/31/2006
Inactive	MetLife Life and Annuity Company of Connecticut	301593	Agent - Variable Life and Variable Annuities	1/13/2003	1/31/2006
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	12/20/2005	1/31/2006
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	12/20/2005	1/31/2006
Inactive	New England Life Insurance Company	300343	Agent - Health	12/20/2005	1/31/2006
Inactive	New England Life Insurance Company	300343	Agent - Life	12/20/2005	1/31/2006
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Casualty	8/15/2000	1/31/2006
Inactive	Standard Fire Insurance Company (The)	301068	Agent - General Lines	6/19/2000	8/15/2000
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Property	8/15/2000	1/31/2006
Inactive	The Phoenix Insurance Company	301502	Agent - General Lines	12/10/1998	8/15/2000
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - General Lines	9/13/1999	8/15/2000
Inactive	Travelers Indemnity Company (The)	301855	Agent - General Lines	12/10/1998	8/15/2000
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - General Lines	12/10/1998	8/15/2000
Inactive	Travelers Property Casualty Company of America	301649	Agent - General Lines	12/10/1998	8/15/2000

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	BRIGHTHOUSE SECURITIES LLC	400820	Agent - Health	1/31/2005	1/31/2006
Inactive	BRIGHTHOUSE SECURITIES LLC	400820	Agent - Life	1/31/2005	1/31/2006
Inactive	BRIGHTHOUSE SECURITIES LLC	400820	Agent - Variable Life and Variable Annuities	1/31/2005	1/31/2006