DEPARTMENT OF INSURANCE

Name	Cupka, Thomas W	DOIID	306914	NAIC NPN	1963026

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	12/3/1998	4/6/2000
Inactive	Non Resident	Agent	Health	12/3/1998	4/6/2000
Inactive	Non Resident	Agent	Casualty	3/28/2008	7/31/2010
Inactive	Non Resident	Agent	Property	3/28/2008	7/31/2010

*If a status is Pending, Pending Replacement,or the record displays Affidavit on File, click on them for more details.

No License Renewal Information

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date. Licensees subject to CE must complete CE requirements before Next Compliance Date in order to successfully complete the License Renewal Process.

Address Information

Type	Address
Business / Home Office	1712 Magnavox Way Ft Wayne, IN 46801
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(260) 459-5822