DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	National Retirement Services Inc.	DOIID	399205	NAIC NPN	7221486

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	10/12/1989	9/2/1998
Inactive	Resident	Agent	Life	10/12/1989	9/2/1998
* 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 Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	6/19/1992	9/2/1998
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	6/19/1992	9/2/1998
Inactive	American Republic Insurance Company	300861	Agent - Health	7/26/1991	6/24/1996
Inactive	American Republic Insurance Company	300861	Agent - Life	7/26/1991	6/24/1996
Inactive	Bankers United Life Assurance Company	300296	Agent - Health	4/4/1991	9/2/1997
Inactive	Bankers United Life Assurance Company	300296	Agent - Life	4/4/1991	9/2/1997
Inactive	Conseco Insurance Company	301202	Agent - Health	6/15/1993	6/21/1996
Inactive	Conseco Insurance Company	301202	Agent - Life	6/15/1993	6/21/1996
Inactive	MassMutual Ascend Life Insurance Company	300320	Agent - Life	11/22/1991	3/31/1997
Inactive	Midland Life Insurance Company (The)	300310	Agent - Health	10/2/1990	3/31/1997
Inactive	Midland Life Insurance Company (The)	300310	Agent - Life	10/2/1990	3/31/1997
Inactive	Senior Health Insurance Company of Pennsylvania	300251	Agent - Health	10/12/1989	6/21/1996
Inactive	Senior Health Insurance Company of Pennsylvania	300251	Agent - Life	10/12/1989	6/21/1996
Inactive	Standard Life Insurance Company of Indiana	300116	Agent - Health	2/3/1994	6/17/1996
Inactive	Standard Life Insurance Company of Indiana	300116	Agent - Life	2/3/1994	6/17/1996
Inactive	Wilco Life Insurance Company	300122	Agent - Health	3/18/1991	7/1/1996
Inactive	Wilco Life Insurance Company	300122	Agent - Life	3/18/1991	7/1/1996

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Carrico, William F.	378507	Agent - Health	10/2/1991	9/2/1998
Inactive	Cory, Roger Wayne	341415	Agent - Health	10/12/1989	6/21/1996
Inactive	Cory, Roger Wayne	341415	Agent - Life	10/12/1989	6/21/1996
Inactive	Lecompte, Marilyn Anne	372115	Agent - Health	2/7/1992	9/2/1998