DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Conquest Marketing Group Inc.	DOIID	400552	NAIC NPN	7222492

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	8/28/1997	9/30/1998
Inactive	Non Resident	Agent	Life	9/30/1998	5/31/2003
* 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	Aviva Life Insurance Company	301615	Agent - Health	11/19/1997	9/30/1998
Inactive	Aviva Life Insurance Company	301615	Agent - Life	9/30/1998	7/1/2002
Inactive	Forethought Life Insurance Company	301407	Agent - Health	8/28/1997	9/30/1998
Inactive	Forethought Life Insurance Company	301407	Agent - Life	9/30/1998	7/1/2002

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Cable, Russell Dean	357625	Agent - Health	8/28/1997	7/19/1998
Inactive	Cable, Russell Dean	357625	Agent - Life	8/28/1997	7/19/1998
Inactive	Davis, Dawson Robinson	378447	Agent - Life	8/28/1997	7/1/2002