DEPARTMENT OF INSURANCE
Affiliations
NameCharak, Conrad WDOIID573914NAIC NPN6522186
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveNon ResidentAgentHealth8/1/20032/28/2013 
InactiveNon ResidentAgentLife8/1/20032/28/2013 
InactiveNon ResidentAgentVariable Life and Variable Annuities8/1/20032/28/2013 
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveForesters Life Insurance and Annuity Company300882Agent - Health8/1/20034/15/2011
InactiveForesters Life Insurance and Annuity Company300882Agent - Life8/1/20034/15/2011
InactiveForesters Life Insurance and Annuity Company300882Agent - Variable Life and Variable Annuities8/1/20034/15/2011
InactiveVenerable Insurance and Annuity Company301006Agent - Life11/12/200411/2/2007
InactiveVenerable Insurance and Annuity Company301006Agent - Variable Life and Variable Annuities11/12/200411/2/2007
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveForesters Financial Services, Inc583036Agent - Health1/12/20045/5/2011
InactiveForesters Financial Services, Inc583036Agent - Life1/12/20045/5/2011
InactiveForesters Financial Services, Inc583036Agent - Variable Life and Variable Annuities1/12/20045/5/2011

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