DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Champion-Ship, Inc. DBA : Champion-Ship Auto Sales	DOIID	509459	NAIC NPN	7223122

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Credit Life & Health	5/30/2000	8/7/2000
Inactive	Resident	Agent	Limited Line Credit	8/8/2007	3/31/2016
* 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 Heritage Life Insurance Company	300363	Agent - Limited Line Credit	8/8/2007	10/22/2010
Inactive	Southern Financial Life Insurance Company	300664	Agent - Credit Life & Health	5/30/2000	8/7/2000
Inactive	Southern Financial Life Insurance Company	300664	Agent - Limited Line Credit	8/7/2000	4/3/2007

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Brubaker, Bruce	362030	Agent - Credit Life & Health	5/30/2000	8/7/2000
Inactive	Brubaker, Bruce	362030	Agent - Limited Line Credit	8/7/2000	4/2/2007
Inactive	Brubaker, Tyler Chalmer	358977	Agent - Credit Life & Health	5/30/2000	8/7/2000
Inactive	Brubaker, Tyler Chalmer	358977	Agent - Limited Line Credit	8/8/2007	3/31/2016