DEPARTMENT OF INSURANCE

Affiliations

Name	Jacobs, Gary M	DOIID	665457	NAIC NPN	3546898

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Administrator	Not Applicable	10/4/2007	3/31/2013
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CHCS Services, Inc	397791	Administrator - Not Applicable	11/14/2007	5/20/2011
Inactive	Worldnet Services Corp.	749877	Administrator - Not Applicable	3/10/2011	3/1/2013