DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Agency Four Ins Marketing Group LLC	DOIID	794526	NAIC NPN	16786816

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	7/8/2016	2/6/2020
Inactive	Non Resident	Agent	Life	12/28/2012	2/6/2020
Withdrawn	Non Resident	Managing General Agent	Not Applicable
* 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	Banner Life Insurance Company	301696	Agent - Life	10/11/2013	2/7/2018
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	7/8/2016	2/6/2020
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	5/24/2016	2/6/2020
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	5/30/2017	2/6/2020
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	5/30/2017	2/6/2020
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	4/7/2016	2/6/2020

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Hamm, William E	392731	Agent - Health	7/8/2016	2/6/2020
Inactive	Hamm, William E	392731	Agent - Life	12/28/2012	2/6/2020