DEPARTMENT OF INSURANCE

Affiliations

Name	Green, David	DOIID	661512	NAIC NPN	8896521

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	8/9/2007	12/31/2013
Inactive	Non Resident	Agent	Property	8/9/2007	12/31/2013
Inactive	Non Resident	Agent	Variable Life and Variable Annuities	8/9/2007	12/31/2013
Inactive	Non Resident	Agent	Casualty	8/9/2007	12/31/2013
Inactive	Non Resident	Agent	Life	8/9/2007	12/31/2013
* 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	Security Benefit Life Insurance Company	300583	Agent - Health	4/24/2009	12/31/2013
Inactive	Security Benefit Life Insurance Company	300583	Agent - Life	4/24/2009	12/31/2013
Inactive	Security Benefit Life Insurance Company	300583	Agent - Variable Life and Variable Annuities	4/24/2009	12/31/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Seabury & Smith Inc	394854	Agent - Health	2/3/2011	12/31/2013
Inactive	Seabury & Smith Inc	394854	Agent - Life	2/3/2011	12/31/2013