DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Formick, Joseph Louis	DOIID	515828	NAIC NPN	2515914

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	12/6/2000	8/31/2004
Inactive	Non Resident	Agent	Life	12/6/2000	8/31/2004
* 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	First Colony Life Insurance Company	301179	Agent - Health	8/20/2001	2/24/2004
Inactive	First Colony Life Insurance Company	301179	Agent - Life	8/20/2001	2/24/2004
Inactive	North American Company for Life and Health Insurance	300291	Agent - Life	4/2/2002	8/31/2004
Inactive	Reassure America Life Insurance Company	301902	Agent - Health	8/27/2001	8/31/2004
Inactive	Reassure America Life Insurance Company	301902	Agent - Life	8/27/2001	8/31/2004
Inactive	ReliaStar Life Insurance Company	301712	Agent - Health	10/1/2003	4/1/2004
Inactive	ReliaStar Life Insurance Company	301712	Agent - Life	10/1/2003	4/1/2004
Inactive	Security-Connecticut Life Insurance Company	300316	Agent - Health	12/6/2000	10/1/2003
Inactive	Security-Connecticut Life Insurance Company	300316	Agent - Life	12/6/2000	10/1/2003

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	BestQuote Agency Inc	511004	Agent - Life	2/14/2001	2/27/2004
Inactive	BestQuote Agency Inc	511004	Agent - Health	2/14/2001	2/27/2004