DEPARTMENT OF INSURANCE

Affiliations

Name	Firek Jr, Gregory Thomas	DOIID	548106	NAIC NPN	5944085

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Denied	Resident	Agent	Variable Life and Variable Annuities		10/7/2004
Inactive	Resident	Agent	Life	4/15/2002	10/7/2004
Inactive	Resident	Agent	Health	4/15/2002	10/7/2004
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Jackson National Life Insurance Company	300486	Agent - Life	6/12/2002	4/6/2004
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	6/23/2003	10/7/2004
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Health	4/21/2003	5/26/2004
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Life	4/21/2003	5/26/2004
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Health	4/21/2003	5/26/2004
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Life	4/21/2003	5/26/2004
Inactive	Western National Life Insurance Company	300461	Agent - Life	4/21/2003	4/5/2004
Inactive	Western National Life Insurance Company	300461	Agent - Variable Life and Variable Annuities	4/21/2003	10/7/2004
Inactive	Western-Southern Life Assurance Company	301590	Agent - Health	4/15/2002	9/14/2004
Inactive	Western-Southern Life Assurance Company	301590	Agent - Life	4/15/2002	9/14/2004
Denied	Western-Southern Life Assurance Company	301590	Agent - Variable Life and Variable Annuities

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Fifth Third Insurance Agency Inc	399341	Agent - Life	4/27/2004	10/7/2004
Inactive	Fifth Third Insurance Agency Inc	399341	Agent - Variable Life and Variable Annuities	4/27/2004	10/7/2004