DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Brychell, Christopher Stephen	DOIID	674783	NAIC NPN	8171616

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	2/22/2008	10/31/2013
Inactive	Non Resident	Agent	Life	2/22/2008	10/31/2013
* 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	Mutual of Omaha Insurance Company	301012	Agent - Health	3/27/2008	12/26/2012
Inactive	Omaha Insurance Company	751908	Agent - Health	2/29/2012	6/24/2013
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	3/27/2008	12/26/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	3/27/2008	12/26/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Fundamental Insurance and Retirement Planning	675147	Agent - Life	5/30/2008	12/26/2012
Inactive	Fundamental Insurance and Retirement Planning	675147	Agent - Health	5/30/2008	6/24/2013