DEPARTMENT OF INSURANCE

Affiliations

Name	Petersen, Richard Steven	DOIID	509935	NAIC NPN	3428670

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	6/13/2000	11/30/2014
Inactive	Non Resident	Agent	Life	6/13/2000	11/30/2014
* 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	American General Life Insurance Company	301585	Agent - Health	12/27/2012	11/30/2014
Inactive	American General Life Insurance Company	301585	Agent - Life	12/27/2012	11/30/2014
Inactive	American National Insurance Company	301861	Agent - Health	5/9/2013	2/25/2014
Inactive	American National Insurance Company	301861	Agent - Life	5/9/2013	2/25/2014
Inactive	Continental Casualty Company	301019	Agent - Health	8/23/2001	12/6/2004
Inactive	Guarantee Reserve Life Insurance Company	300608	Agent - Health	5/11/2001	10/30/2003
Inactive	Guarantee Reserve Life Insurance Company	300608	Agent - Life	5/11/2001	10/30/2003
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	5/5/2004	11/16/2011
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	5/5/2004	11/16/2011
Inactive	Minnesota Life Insurance Company	300488	Agent - Health	3/6/2009	1/6/2015
Inactive	Minnesota Life Insurance Company	300488	Agent - Life	3/6/2009	1/6/2015
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	2/10/2005	11/30/2014
Inactive	Stonebridge Life Insurance Company	301614	Agent - Health	6/13/2000	10/27/2004
Inactive	Stonebridge Life Insurance Company	301614	Agent - Life	6/13/2000	10/27/2004
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	3/4/2002	10/27/2004
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	3/4/2002	10/27/2004
Inactive	United States Life Insurance Company in the City of New York	301126	Agent - Health	12/27/2012	11/30/2014
Inactive	United States Life Insurance Company in the City of New York	301126	Agent - Life	12/27/2012	11/30/2014
Inactive	Wilcac Life Insurance Company	301573	Agent - Health	8/23/2001	12/6/2004
Inactive	Wilcac Life Insurance Company	301573	Agent - Life	8/23/2001	12/6/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Financial Insurance Services, Inc.	514710	Agent - Life	10/22/2001	7/16/2014
Inactive	Financial Insurance Services, Inc.	514710	Agent - Health	10/22/2001	7/16/2014