DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Perna, Michael Domenic	DOIID	510129	NAIC NPN	614670

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	7/17/2000	1/31/2008
Inactive	Non Resident	Agent	Health	7/17/2000	1/31/2008
* 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	EMC National Life Company	300388	Agent - Health	8/25/2003	5/9/2005
Inactive	EMC National Life Company	300388	Agent - Life	8/25/2003	5/9/2005
Inactive	National Travelers Life Company	300304	Agent - Health	7/17/2000	6/30/2003
Inactive	National Travelers Life Company	300304	Agent - Life	7/17/2000	6/30/2003
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	9/22/2006	1/31/2008
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	9/22/2006	1/31/2008
Inactive	Security Financial Life Insurance Company	300208	Agent - Health	5/1/2004	12/20/2006
Inactive	Security Financial Life Insurance Company	300208	Agent - Life	5/1/2004	12/20/2006
Inactive	Transamerica Assurance Company	300893	Agent - Health	8/21/2000	10/1/2004
Inactive	Transamerica Assurance Company	300893	Agent - Life	8/21/2000	10/1/2004
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	5/14/2004	1/31/2008
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	5/14/2004	1/31/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	EBC Inc	518231	Agent - Life	12/5/2000	3/3/2008
Inactive	EBC Inc	518231	Agent - Health	12/5/2000	3/3/2008