DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Small, Diane M	DOIID	601479	NAIC NPN	1980471

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	1/19/2005	9/30/2011
Inactive	Non Resident	Agent	Life	1/19/2005	9/30/2011
Inactive	Non Resident	Agent	Health	1/19/2005	9/30/2011
Inactive	Non Resident	Agent	Casualty	1/19/2005	9/30/2011
* 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	Colonial Life and Accident Insurance Company	300846	Agent - Health	1/12/2006	9/30/2011
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	1/12/2006	9/30/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	HRH Metro North East LLC	536157	Agent - Casualty
Denied	HRH Metro North East LLC	536157	Agent - Property