DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Capital Funding Corporation	DOIID	400870	NAIC NPN	2107757

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	4/6/1994	3/31/1997
Inactive	Non Resident	Agent	Life	4/6/1994	4/15/1999
* 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	Bankers United Life Assurance Company	300296	Agent - Health	11/2/1994	3/31/1997
Inactive	Bankers United Life Assurance Company	300296	Agent - Life	11/2/1994	3/31/1997
Inactive	Banner Life Insurance Company	301696	Agent - Life	7/12/1995	12/31/1998
Inactive	National Western Life Insurance Company	301515	Agent - Health	9/27/1994	4/25/1996
Inactive	National Western Life Insurance Company	301515	Agent - Life	9/27/1994	4/25/1996
Inactive	Senior Health Insurance Company of Pennsylvania	300251	Agent - Health	4/6/1994	1/5/1996
Inactive	Senior Health Insurance Company of Pennsylvania	300251	Agent - Life	4/6/1994	1/5/1996
Inactive	USG Annuity & Life Company	300457	Agent - Life	5/13/1994	4/15/1999

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Brugger, Michele Renee	357287	Agent - Health	10/5/1994	3/31/1997
Inactive	Brugger, Michele Renee	357287	Agent - Life	10/5/1994	3/31/1997
Inactive	Grogan, Douglas Hulon	368617	Agent - Health	10/5/1994	7/1/1996
Inactive	Grogan, Douglas Hulon	368617	Agent - Life	10/5/1994	7/1/1996
Inactive	Siener, Gregory Kent	362047	Agent - Health	10/5/1994	3/31/1997
Inactive	Siener, Gregory Kent	362047	Agent - Life	10/5/1994	3/31/1997
Inactive	Weber, Loyd William	350079	Agent - Health	4/6/1994	3/31/1997
Inactive	Weber, Loyd William	350079	Agent - Life	4/6/1994	3/31/1997