DEPARTMENT OF INSURANCE

Affiliations

Name	Boone Jr, Samuel Ralph	DOIID	709744	NAIC NPN	630483

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Administrator	Not Applicable	7/21/2009	9/9/2021
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Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Usis, Inc.	708529	Administrator - Not Applicable	7/21/2009	3/31/2021