DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	FSR Inc.	DOIID	399539	NAIC NPN	7221741

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	General Lines	3/28/1994	12/9/1999
Inactive	Resident	Agent	Life	3/28/1994	9/29/2000
Inactive	Resident	Agent	Health	3/28/1994	9/29/2000
* 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	Investors Life Insurance Company of Indiana	301657	Agent - Health	3/28/1994	3/31/1997
Inactive	Investors Life Insurance Company of Indiana	301657	Agent - Life	3/28/1994	3/31/1997
Inactive	Jackson National Life Insurance Company	300486	Agent - Health	8/28/1997	9/29/2000
Inactive	Jackson National Life Insurance Company	300486	Agent - Life	8/28/1997	9/29/2000
Inactive	Meridian Mutual Insurance Company	301303	Agent - General Lines	3/28/1994	12/9/1999

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Mutual Underwriters Insurance Agency	398925	Agent - General Lines	5/16/1994	12/9/1999
Inactive	Mutual Underwriters Insurance Agency	398925	Agent - Health	5/16/1994	9/29/2000
Inactive	Mutual Underwriters Insurance Agency	398925	Agent - Life	5/16/1994	9/29/2000
Inactive	Rassiga, Frank Stephen	383508	Agent - General Lines	8/28/1997	12/9/1999
Inactive	Rassiga, Frank Stephen	383508	Agent - Health	8/28/1997	9/29/2000
Inactive	Rassiga, Frank Stephen	383508	Agent - Life	8/28/1997	9/29/2000