DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Crisman, Thomas Jon	DOIID	389728	NAIC NPN	333129

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	11/9/1993	4/30/2003
Inactive	Non Resident	Agent	Health	11/9/1993	4/30/2003
* 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	Penn Mutual Life Insurance Company	301394	Agent - Health	11/9/1993	4/30/2003
Inactive	Penn Mutual Life Insurance Company	301394	Agent - Life	11/9/1993	4/30/2003

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Hornor Townsend & Kent LLC	400531	Agent - Life	2/27/2003	4/30/2003
Inactive	Hornor Townsend & Kent LLC	400531	Agent - Health	2/27/2003	4/30/2003