DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Siwiec, David J	DOIID	667420	NAIC NPN	1645361

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	11/1/2007	7/31/2010
* 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	New York Life Insurance and Annuity Corporation	300726	Agent - Life	4/12/2010	7/31/2010
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Life	6/18/2008	7/31/2010
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Life	2/12/2008	7/31/2010
Inactive	Transamerica Advisors Life Insurance Company	300539	Agent - Life	6/16/2008	10/30/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Merrill Lynch Life Agency Inc.	400527	Agent - Life	6/24/2008	7/31/2010
Inactive	SBS Insurance Brokers of Kentucky Inc.	398096	Agent - Life	2/12/2008	4/21/2009