DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Keller, David Wayne	DOIID	519568	NAIC NPN	1481411

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	12/20/2000	2/2/2006
Inactive	Non Resident	Agent	Life	12/20/2000	2/2/2006
* 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	John Alden Life Insurance Company	300573	Agent - Health	12/20/2000	2/2/2006
Inactive	John Alden Life Insurance Company	300573	Agent - Life	12/20/2000	2/2/2006

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Nsm Sales Corporation	399627	Agent - Life	4/3/2001	5/31/2004
Inactive	Nsm Sales Corporation	399627	Agent - Health	4/3/2001	5/31/2004