DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Stevens, Jacqueline Ann	DOIID	1002337	NAIC NPN	10108811

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	7/25/2018	8/31/2021
Inactive	Non Resident	Agent	Life	7/25/2018	8/31/2021
* 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	CMFG Life Insurance Company	300929	Agent - Health	8/2/2018	7/19/2019
Inactive	CMFG Life Insurance Company	300929	Agent - Life	8/2/2018	7/19/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Sutherland Global Services Inc	601788	Agent - Life	5/15/2019	7/19/2019
Inactive	Sutherland Global Services Inc	601788	Agent - Health	5/15/2019	7/19/2019