DEPARTMENT OF INSURANCE

Affiliations

Name	Manifold Jr, William James	DOIID	579216	NAIC NPN	601556

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	11/12/2003	4/30/2019
Inactive	Non Resident	Agent	Life	11/12/2003	4/30/2019
Inactive	Non Resident	Agent	Variable Life and Variable Annuities	11/12/2003	4/30/2019
* 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

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	7/16/2009	12/23/2013
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	7/16/2009	12/23/2013
Inactive	American Continental Insurance Company	643130	Agent - Health	6/2/2014	11/12/2014
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	1/14/2009	4/30/2019
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	1/14/2009	4/30/2019
Inactive	American Republic Insurance Company	300861	Agent - Health	3/10/2005	6/5/2013
Inactive	American Republic Insurance Company	300861	Agent - Life	3/10/2005	6/5/2013
Inactive	Ameritas Life Insurance Corporation	300126	Agent - Health	12/31/2016	4/30/2019
Inactive	Ameritas Life Insurance Corporation	300126	Agent - Life	12/31/2016	4/30/2019
Inactive	Assurity Life Insurance Company	301099	Agent - Health	2/8/2015	5/15/2017
Inactive	Assurity Life Insurance Company	301099	Agent - Life	2/8/2015	5/15/2017
Inactive	Coventry Health and Life Insurance Company	301771	Agent - Health	5/12/2009	4/30/2019
Inactive	Everly Life Insurance Company	561641	Agent - Life	5/20/2015	3/7/2017
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	5/12/2009	4/30/2019
Inactive	Genworth Life Insurance Company	300623	Agent - Health	3/7/2007	12/14/2016
Inactive	Genworth Life Insurance Company	300623	Agent - Life	3/7/2007	12/14/2016
Inactive	Gerber Life Insurance Company	300529	Agent - Health	10/21/2014	8/22/2017
Inactive	Gerber Life Insurance Company	300529	Agent - Life	10/21/2014	8/22/2017
Inactive	Government Personnel Mutual Life Insurance Company	301862	Agent - Health	4/7/2011	12/26/2012
Inactive	Government Personnel Mutual Life Insurance Company	301862	Agent - Life	4/7/2011	12/26/2012
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	3/14/2007	12/30/2009
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	3/14/2007	12/30/2009
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	10/1/2008	6/8/2011
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	10/1/2008	6/8/2011
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	6/27/2007	11/26/2009
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	6/27/2007	11/26/2009
Inactive	Pacific Life Insurance Company	301848	Agent - Life	8/30/2007	4/30/2019
Inactive	Pacific Life Insurance Company	301848	Agent - Variable Life and Variable Annuities	8/30/2007	4/30/2019
Inactive	Pennsylvania Life Insurance Company	301321	Agent - Health	10/20/2011	1/29/2013
Inactive	Protective Life Insurance Company	300638	Agent - Health	10/18/2006	4/30/2019
Inactive	Protective Life Insurance Company	300638	Agent - Life	10/18/2006	4/30/2019
Inactive	Protective Life Insurance Company	300638	Agent - Variable Life and Variable Annuities	10/18/2006	4/30/2019
Inactive	Prudential Insurance Company of America	300784	Agent - Health	8/6/2009	12/23/2014
Inactive	Prudential Insurance Company of America	300784	Agent - Life	8/6/2009	12/23/2014
Inactive	Reliance Standard Life Insurance Company	300584	Agent - Health	1/22/2015	4/30/2019
Inactive	Reliance Standard Life Insurance Company	300584	Agent - Life	1/22/2015	4/30/2019
Inactive	Security Life Insurance Company of America	300936	Agent - Health	9/27/2012	12/31/2016
Inactive	Security Life Insurance Company of America	300936	Agent - Life	9/27/2012	12/31/2016
Inactive	SilverScript Insurance Company	663526	Agent - Health	11/10/2009	4/30/2019
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Health	9/10/2008	5/6/2019
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Life	9/10/2008	5/6/2019
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Variable Life and Variable Annuities	9/10/2008	5/6/2019
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Health	9/10/2008	5/6/2019
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Life	9/10/2008	5/6/2019
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Variable Life and Variable Annuities	9/10/2008	5/6/2019
Inactive	Time Insurance Company	300683	Agent - Health	10/21/2011	4/30/2019
Inactive	Time Insurance Company	300683	Agent - Life	10/21/2011	4/30/2019
Inactive	United American Insurance Company	300910	Agent - Health	6/29/2015	12/13/2017
Inactive	United American Insurance Company	300910	Agent - Life	6/29/2015	12/13/2017
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	9/5/2008	12/15/2009
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	9/5/2008	12/15/2009
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	9/5/2008	12/15/2009
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	9/5/2008	12/15/2009
Inactive	Woodmen of the World Life Insurance Society	301446	Agent - Health	4/20/2004	10/10/2017
Inactive	Woodmen of the World Life Insurance Society	301446	Agent - Life	4/20/2004	10/10/2017
Inactive	Woodmen of the World Life Insurance Society	301446	Agent - Variable Life and Variable Annuities	4/20/2004	10/10/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Woodmen Insurance Agency, Inc.	579244	Agent - Health	3/10/2005	4/30/2019
Inactive	Woodmen Insurance Agency, Inc.	579244	Agent - Life	4/27/2007	4/30/2019
Inactive	Woodmen Insurance Agency, Inc.	579244	Agent - Variable Life and Variable Annuities	8/9/2004	4/30/2019