DEPARTMENT OF INSURANCE

Affiliations

Name	Boersig, David S	DOIID	587512	NAIC NPN	5019835

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	4/6/2004	10/31/2010
Inactive	Non Resident	Agent	Life	4/6/2004	10/31/2010
Inactive	Non Resident	Agent	Variable Life and Variable Annuities	4/6/2004	10/31/2010
* 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 - Life	5/26/2005	10/31/2010
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Variable Life and Variable Annuities	5/26/2005	10/31/2010
Inactive	Delaware Life Insurance Company	301256	Agent - Life	6/23/2005	11/5/2007
Inactive	Delaware Life Insurance Company	301256	Agent - Variable Life and Variable Annuities	6/23/2005	11/5/2007
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Health	4/19/2004	10/31/2010
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Life	4/19/2004	10/31/2010
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Variable Life and Variable Annuities	4/19/2004	10/31/2010
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Health	4/19/2004	10/31/2010
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Life	4/19/2004	10/31/2010
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Variable Life and Variable Annuities	4/19/2004	10/31/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Edward D Jones & Co. Limited Partnership	398146	Agent - Life	4/23/2004	5/17/2005
Inactive	Edward D Jones & Co. Limited Partnership	398146	Agent - Health	4/23/2004	5/17/2005
Inactive	Edward D Jones & Co. Limited Partnership	398146	Agent - Variable Life and Variable Annuities	4/23/2004	5/17/2005
Inactive	Ubs Financial Services Ins Agency Inc	399373	Agent - Life	5/18/2005	10/31/2010
Inactive	Ubs Financial Services Ins Agency Inc	399373	Agent - Health	5/18/2005	10/31/2010
Inactive	Ubs Financial Services Ins Agency Inc	399373	Agent - Variable Life and Variable Annuities	5/18/2005	10/31/2010