DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Farley, Charles Douglas	DOIID	614112	NAIC NPN	8148205

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	8/22/2005	1/31/2012
Inactive	Non Resident	Agent	Casualty	8/22/2005	1/31/2012
* 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	American Family Home Insurance Company	301817	Agent - Casualty	9/8/2009	1/31/2012
Inactive	American Family Home Insurance Company	301817	Agent - Property	9/8/2009	1/31/2012
Inactive	American Modern Home Insurance Company	300791	Agent - Casualty	9/8/2009	1/31/2012
Inactive	American Modern Home Insurance Company	300791	Agent - Property	9/8/2009	1/31/2012
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	9/8/2009	1/31/2012
Inactive	American Modern Select Insurance Company	581481	Agent - Property	9/8/2009	1/31/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CMH Homes, Inc.	398100	Agent - Casualty	12/15/2010	1/31/2012
Inactive	CMH Homes, Inc.	398100	Agent - Property	12/15/2010	1/31/2012