DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Carman, Jacob K	DOIID	1014726	NAIC NPN	18849637

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	10/12/2018	3/31/2023
Inactive	Non Resident	Agent	Health	10/12/2018	3/31/2023
* 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	Ameritas Life Insurance Corporation	300126	Agent - Health	4/21/2020	3/31/2023
Inactive	Everest Reinsurance Company	301836	Agent - Health	8/4/2020	11/8/2022
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Health	10/23/2018	11/7/2022
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Life	10/23/2018	11/7/2022
Inactive	LifeShield National Insurance Company	737111	Agent - Health	1/4/2019	11/7/2022
Inactive	New York Life Insurance Company	300431	Agent - Health	12/22/2020	11/3/2022
Inactive	New York Life Insurance Company	300431	Agent - Life	12/22/2020	11/3/2022
Inactive	United States Fire Insurance Company	582240	Agent - Health	12/18/2018	11/14/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	S A S I D Inc	648814	Agent - Health	10/6/2021	11/11/2022
Inactive	S A S I D Inc	648814	Agent - Life	10/6/2021	11/7/2022