DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Forsythe, Crystal Lea	DOIID	685431	NAIC NPN	11149195

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	7/23/2008	9/30/2009
Inactive	Non Resident	Agent	Health	7/23/2008	9/30/2009
* 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	Hartford Life and Accident Insurance Company	300878	Agent - Health	9/24/2008	9/30/2009
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	9/24/2008	9/30/2009
Inactive	Minnesota Life Insurance Company	300488	Agent - Health	3/2/2009	9/30/2009
Inactive	Minnesota Life Insurance Company	300488	Agent - Life	3/2/2009	9/30/2009
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	1/19/2009	11/6/2009
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	1/19/2009	11/6/2009
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	1/19/2009	11/6/2009

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	9/24/2008	9/30/2009
Inactive	PCCW Teleservices (US) , Inc.	533374	Agent - Life	9/24/2008	9/30/2009