DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Lane, William F	DOIID	512892	NAIC NPN	624418

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	9/5/2000	1/14/2016
Inactive	Non Resident	Agent	Property	9/5/2000	1/14/2016
Inactive	Non Resident	Agent	Health	7/16/2014	1/14/2016
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	2/27/2015	11/30/2015
* 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	Aegis Security Insurance Company	300492	Agent - Casualty	9/5/2000	1/14/2016
Inactive	Aegis Security Insurance Company	300492	Agent - Health	8/21/2014	1/14/2016
Inactive	Aegis Security Insurance Company	300492	Agent - Property	9/5/2000	1/14/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aegis General Insurance Agency Inc	609072	Agent - Property	5/23/2005	1/14/2016
Inactive	Aegis General Insurance Agency Inc	609072	Agent - Casualty	5/23/2005	1/14/2016
Inactive	Aegis General Insurance Agency Inc	609072	Agent - Health	8/6/2014	1/14/2016
Inactive	Aegis General Insurance Agency Inc	609072	Surplus Lines Broker - Not Applicable	3/11/2015	11/30/2015