DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Richards, Jacob Matthew	DOIID	562909	NAIC NPN	7279907

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	1/31/2003	10/4/2004
* 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	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	7/24/2003	10/4/2004
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Life	2/6/2004	10/4/2004
Inactive	Western National Life Insurance Company	300461	Agent - Life	2/11/2003	10/4/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Natcity Insurance Services Inc.	400871	Agent - Life	4/17/2003	10/4/2004