DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Complete Insurance Source Inc.	DOIID	708355	NAIC NPN	8106683

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Administrator	Not Applicable	9/23/2009	3/26/2013
Inactive	Non Resident	Agent	Health	6/25/2009	9/26/2012
Inactive	Non Resident	Agent	Life	6/25/2009	9/26/2012
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Goin, Bruce Robert	687303	Administrator - Not Applicable	9/23/2009	3/26/2013
Inactive	Goin, Bruce Robert	687303	Agent - Health	6/25/2009	9/26/2012
Inactive	Goin, Bruce Robert	687303	Agent - Life	6/25/2009	9/26/2012