DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Gorman, Timothy M	DOIID	1204847	NAIC NPN	3518587

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Pending Replacement	Non Resident	Agent	Life	5/13/2022		9/30/2024
Pending Replacement	Non Resident	Agent	Health	5/13/2022		9/30/2024
* 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	07/15/2024	09/30/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Paychex Insurance Agency Inc	509469	Agent - Life
Denied	Paychex Insurance Agency Inc	509469	Agent - Health