DEPARTMENT OF INSURANCE

Affiliations

Name	Shein, Donald Jeffrey	DOIID	548362	NAIC NPN	4634722

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	5/6/2002	9/30/2010
Inactive	Non Resident	Agent	Health	5/6/2002	9/30/2010
Inactive	Non Resident	Agent	Variable Life and Variable Annuities	5/6/2002	9/30/2010
* 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	Fortitude Life Insurance & Annuity Company	301503	Agent - Life	10/27/2003	9/30/2010
Inactive	Fortitude Life Insurance & Annuity Company	301503	Agent - Variable Life and Variable Annuities	10/27/2003	9/30/2010
Inactive	Pruco Life Insurance Company	300954	Agent - Health	5/6/2002	9/30/2010
Inactive	Pruco Life Insurance Company	300954	Agent - Life	5/6/2002	9/30/2010
Inactive	Pruco Life Insurance Company	300954	Agent - Variable Life and Variable Annuities	5/6/2002	9/30/2010
Inactive	Prudential Insurance Company of America	300784	Agent - Health	5/6/2002	9/30/2010
Inactive	Prudential Insurance Company of America	300784	Agent - Life	5/6/2002	9/30/2010
Inactive	Prudential Insurance Company of America	300784	Agent - Variable Life and Variable Annuities	5/6/2002	9/30/2010
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Health	6/14/2002	12/16/2008
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Variable Life and Variable Annuities	6/14/2002	2/1/2007

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Prudential Equity Group, LLC	399017	Agent - Health	2/16/2004	3/4/2005
Inactive	Prudential Equity Group, LLC	399017	Agent - Life	2/16/2004	3/4/2005
Inactive	Prudential Equity Group, LLC	399017	Agent - Variable Life and Variable Annuities	2/16/2004	3/4/2005
Inactive	Wells Fargo Advisors Insurance Agency LLC	399972	Agent - Health	6/8/2004	9/30/2010
Inactive	Wells Fargo Advisors Insurance Agency LLC	399972	Agent - Life	6/8/2004	9/30/2010
Inactive	Wells Fargo Advisors Insurance Agency LLC	399972	Agent - Variable Life and Variable Annuities	6/8/2004	9/30/2010