DEPARTMENT OF INSURANCE
Affiliations
NamePassavant, Kristie MitchellDOIID1069152NAIC NPN7649554
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveNon ResidentAgentHealth12/26/201911/30/2021 
InactiveNon ResidentAgentLife12/26/201911/30/2021 
InactiveNon ResidentAgentVariable Life and Variable Annuities12/26/201911/30/2021 
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAllianz Life Insurance Company of North America301791Agent - Health6/24/202011/30/2021
InactiveAllianz Life Insurance Company of North America301791Agent - Life6/24/202011/30/2021
InactiveAllianz Life Insurance Company of North America301791Agent - Variable Life and Variable Annuities6/24/202011/30/2021
InactiveCMFG Life Insurance Company300929Agent - Health1/27/20205/16/2021
InactiveCMFG Life Insurance Company300929Agent - Life1/27/20205/16/2021
InactiveCMFG Life Insurance Company300929Agent - Variable Life and Variable Annuities1/27/20205/16/2021
InactiveEagle Life Insurance Company701261Agent - Life11/17/202011/30/2021
InactiveFortitude Life Insurance & Annuity Company301503Agent - Life3/4/202111/30/2021
InactiveFortitude Life Insurance & Annuity Company301503Agent - Variable Life and Variable Annuities3/4/202111/30/2021
InactiveJackson National Life Insurance Company300486Agent - Life2/4/20211/27/2022
InactiveJackson National Life Insurance Company300486Agent - Variable Life and Variable Annuities2/4/20211/27/2022
InactiveMEMBERS Life Insurance Company301289Agent - Health1/27/20205/16/2021
InactiveMEMBERS Life Insurance Company301289Agent - Life1/27/20205/16/2021
InactiveMEMBERS Life Insurance Company301289Agent - Variable Life and Variable Annuities1/27/20205/16/2021
InactivePruco Life Insurance Company300954Agent - Variable Life and Variable Annuities3/4/20214/27/2021
InactivePrudential Insurance Company of America300784Agent - Life3/4/202111/30/2021
InactivePrudential Insurance Company of America300784Agent - Variable Life and Variable Annuities3/4/202111/30/2021
InactiveRiverSource Life Insurance Company301952Agent - Health1/11/202111/30/2021
InactiveRiverSource Life Insurance Company301952Agent - Life1/11/202111/30/2021
InactiveRiverSource Life Insurance Company301952Agent - Variable Life and Variable Annuities1/11/202111/30/2021
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveCetera Investment Services LLC398143Agent - Life1/27/202011/17/2020
InactiveCetera Investment Services LLC398143Agent - Health1/27/202011/17/2020
InactiveCetera Investment Services LLC398143Agent - Variable Life and Variable Annuities1/27/202011/17/2020

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