DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Douglass, Terry L	DOIID	306223	NAIC NPN	7158425

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	3/23/2006	7/1/2015
* 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	Empower Annuity Insurance Company of America	300259	Agent - Life	3/26/2001	10/16/2003
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Life	3/27/2000	10/7/2004
Inactive	Jackson National Life Insurance Company	300486	Agent - Life	10/23/2008	5/4/2012
Inactive	John Alden Life Insurance Company	300573	Agent - Life	3/13/1996	3/31/1997
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Life	11/24/1998	5/10/1999
Denied	Lincoln National Life Insurance Company (The)	301382	Agent - Life
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Life	5/2/1994	6/30/2005
Inactive	National Guardian Life Insurance Company	300596	Agent - Life	4/30/1996	12/1/1998
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	6/25/2003	3/28/2004
Inactive	Southern Financial Life Insurance Company	300664	Agent - Life	9/26/2011	7/1/2015
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	6/12/1995	10/7/2004
Inactive	Western National Life Insurance Company	300461	Agent - Life	4/27/2006	11/23/2011
Inactive	Western-Southern Life Assurance Company	301590	Agent - Life	5/22/2000	9/15/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Fifth Third Insurance Agency Inc	399341	Agent - Life	10/19/2000	6/30/2005
Inactive	Integra Bank National Association	558914	Agent - Life	11/7/2006	1/31/2012