DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Christa Nicole	DOIID	1169691	NAIC NPN	20056163

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	10/29/2021		6/30/2026
Active	Non Resident	Agent	Life	10/29/2021		6/30/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	04/15/2024	06/30/2024	05/23/2024	05/23/2024	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Lumico Life Insurance Company	300354	Agent - Life	10/29/2021	2/12/2024
Active	United of Omaha Life Insurance Company	300156	Agent - Health	6/23/2023
Active	United of Omaha Life Insurance Company	300156	Agent - Life	6/23/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	TZ Insurance Solutions LLC	727470	Agent - Life	1/23/2024
Active	TZ Insurance Solutions LLC	727470	Agent - Health	1/23/2024