DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Executive Insurance Agency Inc.	DOIID	398898	NAIC NPN	7221253

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	4/4/1991	3/12/2001
Inactive	Resident	Agent	Life	4/4/1991	3/12/2001
* 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	Life Insurance Company of Alabama	301439	Agent - Health	4/4/1991	3/31/1997
Inactive	Life Insurance Company of Alabama	301439	Agent - Life	4/4/1991	3/31/1997
Inactive	Reliance Standard Life Insurance Company	300584	Agent - Health	10/25/1993	3/12/2001
Inactive	Reliance Standard Life Insurance Company	300584	Agent - Life	10/25/1993	3/12/2001

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Drury, Samuel R	368270	Agent - Health
Denied	Drury, Samuel R	368270	Agent - Life