DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Haywood Insurance Agency Inc.	DOIID	398817	NAIC NPN	7221184

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	3/31/1982	10/31/2006
Inactive	Resident	Agent	Life	3/31/1982	10/31/2006
* 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 States Life Insurance Company	301884	Agent - Health	3/31/1982	12/6/2004
Inactive	American States Life Insurance Company	301884	Agent - Life	3/31/1982	12/6/2004
Inactive	Continental Casualty Company	301019	Agent - Health	11/16/1989	12/19/2002
Inactive	Symetra Life Insurance Company	301691	Agent - Health	3/31/1982	10/31/2006
Inactive	Symetra Life Insurance Company	301691	Agent - Life	3/31/1982	10/31/2006
Inactive	Transamerica Life Insurance and Annuity Company	300148	Agent - Life	8/22/2001	8/17/2005
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Health	12/6/1991	8/17/2005
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Life	12/6/1991	8/17/2005

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Haywood, Charles Luther	322519	Agent - Health	3/31/1992	10/31/2006
Inactive	Haywood, Charles Luther	322519	Agent - Life	3/31/1992	10/31/2006
Inactive	Thoroughbred Associates Inc.	399133	Agent - Health	9/21/1992	12/31/2001
Inactive	Thoroughbred Associates Inc.	399133	Agent - Life	9/21/1992	12/31/2001

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Thoroughbred Associates Inc.	399133	Agent - Life	1/16/2001	12/31/2001
Inactive	Thoroughbred Associates Inc.	399133	Agent - Health	1/16/2001	12/31/2001