DEPARTMENT OF INSURANCE

Affiliations

Name	Purzycki, Richard S	DOIID	548440	NAIC NPN	2060318

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	4/26/2002	1/31/2011
Inactive	Non Resident	Agent	Property	10/19/2010	1/31/2011
Inactive	Non Resident	Agent	Life	4/26/2002	1/31/2011
Inactive	Non Resident	Agent	Casualty	10/19/2010	1/31/2011
* 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	Allianz Life Insurance Company of North America	301791	Agent - Health	9/15/2009	1/31/2011
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	9/15/2009	1/31/2011
Inactive	American Investors Life Insurance Company, Inc.	301358	Agent - Life	6/11/2009	9/30/2009
Inactive	Anthem Life Insurance Company	301209	Agent - Health	8/11/2005	1/31/2011
Inactive	Anthem Life Insurance Company	301209	Agent - Life	8/11/2005	1/31/2011
Inactive	Athene Annuity & Life Assurance Company	301798	Agent - Health	12/7/2006	1/31/2011
Inactive	Athene Annuity & Life Assurance Company	301798	Agent - Life	12/7/2006	1/31/2011
Inactive	Athene Annuity and Life Company	301893	Agent - Life	7/31/2009	1/31/2011
Inactive	Columbian Life Insurance Company	300810	Agent - Health	5/9/2005	1/31/2011
Inactive	Columbian Life Insurance Company	300810	Agent - Life	5/9/2005	1/31/2011
Inactive	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	8/7/2007	3/10/2009
Inactive	First Colony Life Insurance Company	301179	Agent - Health	9/27/2002	1/1/2007
Inactive	First Colony Life Insurance Company	301179	Agent - Life	9/27/2002	1/1/2007
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Health	10/17/2002	12/23/2008
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Life	10/17/2002	12/23/2008
Inactive	Genworth Life Insurance Company	300623	Agent - Health	5/31/2005	1/31/2011
Inactive	Genworth Life Insurance Company	300623	Agent - Life	5/31/2005	1/31/2011
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Health	7/25/2009	1/31/2011
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	7/25/2009	1/31/2011
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Health	9/27/2002	1/25/2005
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Life	9/27/2002	1/25/2005
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Health	7/26/2005	1/31/2011
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Life	7/26/2005	1/31/2011
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Health	9/9/2002	4/2/2007
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Life	9/9/2002	4/2/2007
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	9/10/2005	2/24/2011
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	9/10/2005	2/24/2011
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	12/9/2004	1/31/2011
Inactive	Peoples Benefit Life Insurance Company	301895	Agent - Health	8/22/2002	10/1/2007
Inactive	Peoples Benefit Life Insurance Company	301895	Agent - Life	8/22/2002	10/1/2007
Inactive	SilverScript Insurance Company	663526	Agent - Health	11/18/2010	1/31/2011
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	12/21/2007	1/31/2011
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	12/21/2007	1/31/2011
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Health	9/23/2005	10/1/2008
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Life	9/23/2005	10/1/2008
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	4/26/2002	6/10/2009
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	4/26/2002	6/10/2009
Inactive	United World Life Insurance Company	300532	Agent - Health	12/9/2004	12/15/2010
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	12/9/2004	1/31/2011
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	12/9/2004	1/31/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	United Financial Services Inc	400566	Agent - Health	11/10/2007	1/31/2011
Inactive	United Financial Services Inc	400566	Agent - Life	11/10/2007	1/31/2011