DEPARTMENT OF INSURANCE

Name	Fidelity Assurance Inc.	DOIID	399978	NAIC NPN	1045245

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Inactive	Non Resident	Agent	Health	8/23/1999	5/31/2003
Inactive	Non Resident	Agent	Life	8/23/1999	5/31/2003

*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.

Address Information

Type	Address
Business / Home Office	5051 66th St North St Petersburg, FL 33709