DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Waller, David Michael	DOIID	729770	NAIC NPN	7944379

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	6/7/2010	8/31/2012
Inactive	Non Resident	Agent	Health	6/7/2010	8/31/2012
* 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	American National Insurance Company	301861	Agent - Health	4/28/2011	8/31/2012
Inactive	American National Insurance Company	301861	Agent - Life	4/28/2011	8/31/2012
Inactive	Balboa Life Insurance Company	301327	Agent - Health	6/14/2010	8/5/2011
Inactive	Balboa Life Insurance Company	301327	Agent - Life	6/14/2010	8/5/2011
Inactive	Minnesota Life Insurance Company	300488	Agent - Health	9/27/2010	10/26/2011
Inactive	Minnesota Life Insurance Company	300488	Agent - Life	9/27/2010	10/26/2011
Inactive	Omaha Insurance Company	751908	Agent - Health	3/30/2012	8/31/2012
Inactive	ReliaStar Life Insurance Company	301712	Agent - Life	6/14/2010	8/31/2012
Inactive	Security Life of Denver Insurance Company	300648	Agent - Life	6/14/2010	8/31/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	10/11/2010	8/31/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	10/11/2010	8/31/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Banc of America Insurance Services, Inc.	400875	Agent - Health	7/7/2010	6/21/2011
Inactive	Banc of America Insurance Services, Inc.	400875	Agent - Life	7/7/2010	6/21/2011