DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Fazzone, Timothy J	DOIID	540498	NAIC NPN	2341598

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	7/1/2022	2/29/2024
Inactive	Non Resident	Agent	Life	7/1/2022	2/29/2024
* 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	American General Life Insurance Company	301585	Agent - Health	9/8/2005	5/6/2009
Inactive	American National Insurance Company	301861	Agent - Health	3/29/2004	2/29/2012
Inactive	American National Insurance Company	301861	Agent - Life	1/8/2009	2/29/2012
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Health	1/24/2007	10/4/2009
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	1/24/2007	10/4/2009
Inactive	Lafayette Life Insurance Company (The)	301039	Agent - Health	3/1/2006	2/29/2012
Inactive	Lafayette Life Insurance Company (The)	301039	Agent - Life	3/1/2006	2/29/2012
Inactive	National Western Life Insurance Company	301515	Agent - Health	3/31/2004	9/2/2005
Inactive	Nationwide Life Insurance Company	300495	Agent - Health	7/14/2022	9/30/2022
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	7/14/2022	9/30/2022
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Health	7/14/2022	9/30/2022
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	7/14/2022	9/30/2022
Inactive	Penn Treaty Network America Insurance Company	301297	Agent - Health	4/5/2004	3/31/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Annuity Marketing Group LLC	587837	Agent - Health	4/14/2004	11/26/2008