DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Blackheath Partners LLC	DOIID	1340650	NAIC NPN	20887567

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	9/18/2024		3/31/2026
Active	Non Resident	Agent	Health	7/17/2024		3/31/2026
* 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	01/15/2026	03/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	10/1/2024
Active	Pruco Life Insurance Company	300954	Agent - Life	11/4/2024
Active	Transamerica Life Insurance Company	300571	Agent - Health	10/29/2024
Active	Transamerica Life Insurance Company	300571	Agent - Life	10/29/2024

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Eller, Matthew	892655	Agent - Health	7/17/2024
Active	Eller, Matthew	892655	Agent - Life	9/18/2024