DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Leach, Theodore James	DOIID	525842	NAIC NPN	3983521

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	5/7/2001	3/29/2002
Inactive	Non Resident	Agent	Life	5/7/2001	5/31/2004
* 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	Chase Insurance Life and Annuity Company	300518	Agent - Health	5/7/2001	3/29/2002
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	5/7/2001	3/29/2002
Inactive	Fidelity Life Association, A Legal Reserve Life Insurance Company	300774	Agent - Health	5/21/2001	3/29/2002
Inactive	Fidelity Life Association, A Legal Reserve Life Insurance Company	300774	Agent - Life	5/21/2001	3/29/2002
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Life	5/31/2001	5/31/2004
Inactive	North American Company for Life and Health Insurance	300291	Agent - Life	6/18/2001	5/31/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Term Access, Inc.	511455	Agent - Health	6/4/2001	3/29/2002
Inactive	Term Access, Inc.	511455	Agent - Life	6/4/2001	8/22/2002