DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Burnham, Michael Louis	DOIID	575077	NAIC NPN	525122

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	9/8/2003	4/30/2006
Inactive	Non Resident	Agent	Casualty	9/8/2003	4/30/2006
* 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	FCCI Insurance Company	557454	Agent - Casualty	12/6/2004	4/30/2006
Inactive	FCCI Insurance Company	557454	Agent - Property	12/6/2004	4/30/2006
Inactive	Great West Casualty Company	301015	Agent - Casualty	9/8/2003	5/5/2004
Inactive	Great West Casualty Company	301015	Agent - Property	9/8/2003	5/5/2004
Inactive	Monroe Guaranty Insurance Company	300771	Agent - Casualty	12/6/2004	4/30/2006
Inactive	Monroe Guaranty Insurance Company	300771	Agent - Property	12/6/2004	4/30/2006
Inactive	National Trust Insurance Company	300367	Agent - Casualty	12/6/2004	4/30/2006
Inactive	National Trust Insurance Company	300367	Agent - Property	12/6/2004	4/30/2006

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Hylant Group, Inc.	523019	Agent - Casualty	4/11/2005	4/30/2006
Inactive	Hylant Group, Inc.	523019	Agent - Property	4/11/2005	4/30/2006