DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Klotz, Kimberly L	DOIID	320110	NAIC NPN	7167805

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Credit Life & Health	12/9/1994	3/11/1998
Inactive	Resident	Agent	Health	12/27/1993	11/1/1996
Inactive	Resident	Agent	Life	12/27/1993	5/18/1998
* 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	Banc One Kentucky Insurance Company	300824	Agent - Credit Life & Health	10/25/1996	3/11/1998
Denied	Glenbrook Life and Annuity Company	301384	Agent - Health
Denied	Glenbrook Life and Annuity Company	301384	Agent - Life
Inactive	Keyport Life Insurance Company	300319	Agent - Life	6/28/1996	5/18/1998
Inactive	Life Investors Insurance Company of America	301793	Agent - Life	7/3/1996	5/18/1998
Inactive	National Guardian Life Insurance Company	300596	Agent - Credit Life & Health	12/9/1994	6/27/1996
Inactive	Nationwide Life Insurance Company	300495	Agent - Health	12/27/1993	3/12/1996
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	12/27/1993	3/12/1996
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	7/11/1997	5/18/1998
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	6/29/1994	11/1/1996
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	6/29/1994	11/1/1996
Inactive	Western National Life Insurance Company	300461	Agent - Life	10/24/1995	7/1/1996

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Star Bank-N.A.	399936	Agent - Credit Life & Health	6/18/1996	3/11/1998