DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Johnson, Keith R	DOIID	314895	NAIC NPN	363447

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	4/2/1987	8/11/2003
Inactive	Non Resident	Agent	Health	4/2/1987	8/11/2003
* 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	American Fidelity Assurance Company	301004	Agent - Health	4/2/1987	8/11/2003
Inactive	American Fidelity Assurance Company	301004	Agent - Life	4/2/1987	8/11/2003
Inactive	American United Life Insurance Company	300498	Agent - Health	11/24/1999	3/8/2000
Inactive	American United Life Insurance Company	300498	Agent - Life	11/24/1999	3/8/2000

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Fidelity General Agency Inc.	399316	Agent - Life	9/13/1996	8/11/2003
Inactive	American Fidelity General Agency Inc.	399316	Agent - Health	9/13/1996	8/11/2003