DEPARTMENT OF INSURANCE
Affiliations
NameForlenza Jr, Samuel DOIID626197NAIC NPN8715431
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
DeniedResidentAgentHealth   
InactiveResidentAgentVariable Life and Variable Annuities3/28/200611/1/2008 
InactiveResidentAgentLife3/28/200611/1/2008 
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAugustar Life Assurance Corporation301113Agent - Life7/19/200611/1/2008
InactiveAugustar Life Assurance Corporation301113Agent - Variable Life and Variable Annuities10/11/20061/16/2008
InactiveAugustar Life Insurance Company301816Agent - Life7/19/200611/1/2008
InactiveAugustar Life Insurance Company301816Agent - Variable Life and Variable Annuities10/11/20061/16/2008
InactiveFortitude Life Insurance & Annuity Company301503Agent - Life4/25/200612/13/2006
InactiveFortitude Life Insurance & Annuity Company301503Agent - Variable Life and Variable Annuities4/25/200612/13/2006
InactiveJohn Hancock Life Insurance Company300821Agent - Life4/13/200612/11/2006
InactiveJohn Hancock Life Insurance Company300821Agent - Variable Life and Variable Annuities4/13/200612/20/2006
InactiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Life4/13/200611/1/2008
InactiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Variable Life and Variable Annuities4/13/200611/1/2008
InactiveJohn Hancock Variable Life Insurance Company301914Agent - Life4/13/200612/11/2006
InactiveJohn Hancock Variable Life Insurance Company301914Agent - Variable Life and Variable Annuities4/13/200612/20/2006
InactiveTalcott Resolution Life Insurance Company301759Agent - Life7/3/200711/1/2008
InactiveTalcott Resolution Life Insurance Company301759Agent - Variable Life and Variable Annuities7/3/200711/1/2008
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Life7/3/200711/1/2008
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Variable Life and Variable Annuities7/3/200711/1/2008
InactiveWestern Reserve Life Assurance Company of Ohio300760Agent - Life4/13/200612/2/2008
InactiveWestern Reserve Life Assurance Company of Ohio300760Agent - Variable Life and Variable Annuities4/13/200612/2/2008
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveWorld Financial Group Insurance Agency, LLC400520Agent - Life4/19/200612/29/2006
InactiveWorld Financial Group Insurance Agency, LLC400520Agent - Variable Life and Variable Annuities4/19/200612/29/2006

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