DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Benchmark Brokerage, Inc.	DOIID	502118	NAIC NPN	7223051

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	2/1/2000	5/31/2004
Inactive	Resident	Agent	Life	2/1/2000	5/31/2004
* 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	5/1/2000	12/31/2001
Inactive	Bankers United Life Assurance Company	300296	Agent - Life	5/1/2000	12/31/2001
Inactive	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	11/1/2000	2/27/2003
Inactive	Lafayette Life Insurance Company (The)	301039	Agent - Health	2/1/2000	3/25/2004
Inactive	Lafayette Life Insurance Company (The)	301039	Agent - Life	2/1/2000	3/25/2004
Inactive	Life Investors Insurance Company of America	301793	Agent - Health	12/31/2001	9/19/2003
Inactive	Life Investors Insurance Company of America	301793	Agent - Life	12/31/2001	9/19/2003
Inactive	Paul Revere Life Insurance Company	300971	Agent - Health	10/17/2000	12/11/2002
Inactive	Paul Revere Life Insurance Company	300971	Agent - Life	10/17/2000	12/11/2002
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	10/17/2000	5/31/2004
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	10/17/2000	5/31/2004
Inactive	Transamerica Assurance Company	300893	Agent - Health	5/1/2000	5/31/2004
Inactive	Transamerica Assurance Company	300893	Agent - Life	5/1/2000	5/31/2004
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	5/1/2000	5/31/2004
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	5/1/2000	5/31/2004
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	10/17/2000	5/31/2004
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	10/17/2000	5/31/2004

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Anderson, Charles Earl	393325	Agent - Health	2/1/2000	3/6/2003
Inactive	Anderson, Charles Earl	393325	Agent - Life	2/1/2000	3/6/2003
Inactive	Anderson, Charles Todd	328974	Agent - Health	2/1/2000	7/1/2002
Inactive	Anderson, Charles Todd	328974	Agent - Life	2/1/2000	7/1/2002
Inactive	Anderson, Eric Earl	311358	Agent - Health	2/1/2000	3/6/2003
Inactive	Anderson, Eric Earl	311358	Agent - Life	2/1/2000	3/6/2003
Inactive	Johnson, Steven Allen	374237	Agent - Health	2/1/2000	3/6/2003
Inactive	Johnson, Steven Allen	374237	Agent - Life	2/1/2000	3/6/2003