DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Laird, Charles Leroy	DOIID	568939	NAIC NPN	366506

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	5/2/2003	12/31/2006
Inactive	Non Resident	Agent	Health	5/2/2003	12/31/2006
* 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	Everlake Life Insurance Company	300873	Agent - Life	3/2/2005	12/13/2005
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	6/27/2003	12/16/2004
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	6/27/2003	12/16/2004
Inactive	Western National Life Insurance Company	300461	Agent - Life	7/3/2003	1/4/2006

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	1/4/2006