DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Holbrook, Jacob Adam	DOIID	581885	NAIC NPN	7957805

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	1/4/2010	6/18/2011
Inactive	Resident	Agent	Life	1/4/2010	6/18/2011
* 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	New York Life Insurance and Annuity Corporation	300726	Agent - Life	11/23/2010	6/18/2011
Inactive	Principal Life Insurance Company	300129	Agent - Health	2/12/2009	8/31/2009
Inactive	Principal Life Insurance Company	300129	Agent - Life	2/12/2009	8/31/2009
Inactive	Western National Life Insurance Company	300461	Agent - Life	8/29/2008	8/31/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Keycorp Ins Agency Usa Inc	602413	Agent - Health	5/29/2009	8/31/2009
Inactive	Keycorp Ins Agency Usa Inc	602413	Agent - Life	5/29/2009	8/31/2009