Agency Information

CSFG INSURANCE AGENCY INC

Address:

4050 INNSLAKE DRIVE

GLEN ALLEN, VA 23060

Phone

804-612-9700

URL:

Email:

sgray@capitolsecurities.com

National Producer Number:

1626115

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res. Producer Firm	17957	04/29/2004	Active	08/20/2020	08/31/2023

Qualification Type	Original Issue Date	Status	Effective Date
Health	04/29/2004	Active	08/20/2020
Life	04/29/2004	Active	08/20/2020
Var. Annuities/Var. Life	04/29/2004	Active	08/20/2020

Company Name	Appointment Type	Status	Active Date
1320
CLEAR SPRING LIFE AND ANNUITY COMPANY	Life	Active	01/23/2023
114006
Company Name	Appointment Type	Status	Active Date
EAGLE LIFE INSURANCE COMPANY	Life	Active	07/22/2021
897
Company Name	Appointment Type	Status	Active Date
JACKSON NATIONAL LIFE INSURANCE COMPANY	Life	Active	08/20/2020
	Var. Annuities/Var. Life	Active	08/20/2020

row(s) 1 - 4 of 4

Name	Association Type	Agent	Begin Date	End Date
MARIO DALLA VALLE	Designated Resp Lic Prdcr	No	08/20/2020	-

1 - 1