DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Duffy Jr, Charles P	DOIID	671950	NAIC NPN	2067284

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	1/17/2008	6/30/2010
Inactive	Non Resident	Agent	Life	1/17/2008	6/30/2010
* 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	Boston Mutual Life Insurance Company	300143	Agent - Health	3/27/2008	4/3/2009
Inactive	Boston Mutual Life Insurance Company	300143	Agent - Life	3/27/2008	4/3/2009
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	4/28/2008	12/30/2009
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	4/28/2008	12/30/2009
Inactive	ReliaStar Life Insurance Company	301712	Agent - Health	6/11/2008	6/30/2010
Inactive	ReliaStar Life Insurance Company	301712	Agent - Life	6/11/2008	6/30/2010
Inactive	Trustmark Insurance Company	300317	Agent - Health	6/2/2008	5/29/2009
Inactive	Trustmark Insurance Company	300317	Agent - Life	6/2/2008	5/29/2009
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	4/28/2008	12/30/2009
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	4/28/2008	12/30/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	The Farmington Company	534046	Agent - Life	4/14/2008	6/30/2010
Inactive	The Farmington Company	534046	Agent - Health	4/14/2008	6/30/2010