DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Rafael, Anthony M	DOIID	684466	NAIC NPN	11064351

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	7/18/2008	8/2/2011
Inactive	Non Resident	Agent	Health	7/18/2008	8/2/2011
* 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	CSI Life Insurance Company	596032	Agent - Life	9/9/2009	1/19/2010
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	8/15/2008	8/2/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	PCCW Teleservices (US) , Inc.	533374	Agent - Health	8/15/2008	3/8/2011
Denied	PCCW Teleservices (US) , Inc.	533374	Agent - Life