DEPARTMENT OF INSURANCE

Affiliations

Name	Southworth, Shirley William	DOIID	338829	NAIC NPN	138785

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Life	6/26/1988		8/31/2026
Active	Resident	Agent	Health	6/26/1988		8/31/2026
Active	Resident	Agent	Property	8/15/2000		8/31/2026
Active	Resident	Agent	Casualty	8/4/2000		8/31/2026
Inactive	Resident	Agent	General Lines	6/5/1975	8/15/2000
* 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	AIG Assurance Company	300897	Agent - Casualty	8/15/2000	9/24/2010
Inactive	AIG Assurance Company	300897	Agent - General Lines	5/5/1994	8/15/2000
Inactive	AIG Assurance Company	300897	Agent - Property	8/15/2000	9/24/2010
Inactive	American Equity Investment Life Insurance Company	300389	Agent - Life	6/12/2009	11/11/2011
Active	American Family Home Insurance Company	301817	Agent - Casualty	12/6/2021
Active	American Family Home Insurance Company	301817	Agent - Property	12/6/2021
Inactive	American Modern Home Insurance Company	300791	Agent - Casualty	8/15/2000	11/29/2021
Inactive	American Modern Home Insurance Company	300791	Agent - General Lines	5/23/1998	8/15/2000
Inactive	American Modern Home Insurance Company	300791	Agent - Property	8/15/2000	11/29/2021
Inactive	American National Life Insurance Company of Texas	300912	Agent - Health	3/28/2007	11/23/2010
Inactive	American National Life Insurance Company of Texas	300912	Agent - Life	3/28/2007	11/23/2010
Inactive	American Republic Insurance Company	300861	Agent - Health	10/9/1990	12/14/2000
Inactive	American Republic Insurance Company	300861	Agent - Life	10/9/1990	12/14/2000
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Health	9/26/2006	11/15/2008
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Life	9/26/2006	11/15/2008
Inactive	Assurance Company of America	300432	Agent - General Lines	9/13/1994	3/31/1996
Inactive	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - General Lines	4/29/1997	10/18/1999
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	11/6/2008	12/20/2024
Inactive	Bristol West Insurance Company	301655	Agent - Property	11/6/2008	12/20/2024
Inactive	Central States Indemnity Company of Omaha	300285	Agent - Health	11/11/2011	8/13/2018
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - General Lines	4/29/1997	10/18/1999
Active	Citizens Security Life Insurance Company	301257	Agent - Life	11/17/2009
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	8/28/2008	9/8/2010
Inactive	CompBenefits Insurance Company	301864	Agent - Health	8/28/2008	9/8/2010
Inactive	CompBenefits Insurance Company	301864	Agent - Life	8/28/2008	9/8/2010
Inactive	Continental General Insurance Company	300691	Agent - Health	12/5/1990	12/28/1998
Inactive	Continental General Insurance Company	300691	Agent - Life	12/5/1990	12/28/1998
Active	Dairyland Insurance Company	301370	Agent - Casualty	11/26/2001
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	6/21/2010	9/8/2010
Inactive	Encova Life Insurance Company	301818	Agent - Life	3/20/2009	11/30/2017
Inactive	Falls Lake National Insurance Company	301796	Agent - Casualty	8/4/2000	12/15/2003
Inactive	Farmers Insurance Exchange	300336	Agent - Casualty	2/4/2008	8/22/2012
Inactive	Farmers Insurance Exchange	300336	Agent - Property	2/4/2008	8/22/2012
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	3/5/2003	3/19/2025
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	3/5/2003	3/19/2025
Inactive	Foremost Signature Insurance Company	300140	Agent - Casualty	3/5/2003	12/1/2003
Inactive	Foremost Signature Insurance Company	300140	Agent - Property	3/5/2003	12/1/2003
Inactive	Forethought Life Insurance Company	301407	Agent - Life	2/22/2007	3/9/2010
Inactive	Generali - U.S. Branch	301128	Agent - Casualty	8/15/2000	3/31/2002
Inactive	Generali - U.S. Branch	301128	Agent - General Lines	7/8/1991	8/15/2000
Inactive	Generali - U.S. Branch	301128	Agent - Property	8/15/2000	3/31/2002
Inactive	Gerber Life Insurance Company	300529	Agent - Health	10/28/2009	12/15/2011
Inactive	Gerber Life Insurance Company	300529	Agent - Life	10/28/2009	12/15/2011
Inactive	Glatfelter Insurance Company	301640	Agent - General Lines	9/13/1994	3/31/1996
Inactive	Globe American Casualty Company	301033	Agent - Casualty	8/15/2000	3/6/2003
Inactive	Globe American Casualty Company	301033	Agent - General Lines	2/23/1998	8/15/2000
Inactive	Globe American Casualty Company	301033	Agent - Property	8/15/2000	3/6/2003
Inactive	Golden Rule Insurance Company	301943	Agent - Health	6/26/1988	11/12/1998
Inactive	Golden Rule Insurance Company	301943	Agent - Life	6/26/1988	11/12/1998
Inactive	Grange Life Insurance Company	300128	Agent - Health	10/15/2015	12/22/2016
Inactive	Grange Life Insurance Company	300128	Agent - Life	10/15/2015	12/22/2016
Inactive	Granite State Insurance Company	300818	Agent - Casualty	8/15/2000	9/24/2010
Inactive	Granite State Insurance Company	300818	Agent - General Lines	6/23/2000	8/15/2000
Inactive	Granite State Insurance Company	300818	Agent - Property	8/15/2000	9/24/2010
Inactive	Hallmark National Insurance Company	300494	Agent - Casualty	7/24/2009	1/22/2018
Inactive	Hallmark National Insurance Company	300494	Agent - Property	7/24/2009	1/22/2018
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Casualty	9/15/2003	12/2/2005
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Property	9/15/2003	12/2/2005
Inactive	Hartford Casualty Insurance Company	301332	Agent - Casualty	8/15/2000	12/2/2005
Inactive	Hartford Casualty Insurance Company	301332	Agent - General Lines	6/23/1998	8/15/2000
Inactive	Hartford Casualty Insurance Company	301332	Agent - Property	8/15/2000	12/2/2005
Inactive	Hartford Fire Insurance Company	300628	Agent - Casualty	9/15/2003	12/2/2005
Inactive	Hartford Fire Insurance Company	300628	Agent - Property	9/15/2003	12/2/2005
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Casualty	9/15/2003	12/2/2005
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Property	9/15/2003	12/2/2005
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Casualty	9/15/2003	12/2/2005
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Property	9/15/2003	12/2/2005
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/28/2006	9/8/2010
Inactive	Humana Insurance Company	301104	Agent - Health	9/28/2006	9/8/2010
Inactive	Humana Insurance Company	301104	Agent - Life	9/28/2006	9/8/2010
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/28/2006	9/8/2010
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	9/28/2006	9/8/2010
Inactive	Illinois National Insurance Company	301367	Agent - Casualty	7/30/2003	9/24/2010
Inactive	Illinois National Insurance Company	301367	Agent - General Lines	10/24/1989	8/15/2000
Inactive	Illinois National Insurance Company	301367	Agent - Property	7/30/2003	9/24/2010
Inactive	Infinity Casualty Insurance Company	301280	Agent - Casualty	8/15/2000	12/15/2003
Inactive	Infinity Casualty Insurance Company	301280	Agent - General Lines	6/30/1980	8/15/2000
Inactive	Infinity Insurance Company	300416	Agent - General Lines	8/31/1994	3/31/1996
Inactive	Infinity Standard Insurance Company	301643	Agent - Casualty	8/15/2000	10/15/2004
Inactive	Infinity Standard Insurance Company	301643	Agent - General Lines	7/16/1992	8/15/2000
Inactive	Infinity Standard Insurance Company	301643	Agent - Property	8/15/2000	10/15/2004
Inactive	Integon National Insurance Company	301600	Agent - General Lines	10/18/1993	3/31/1998
Inactive	Inter-State Assurance Company	301556	Agent - Life	8/1/1997	5/10/2002
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Health	2/17/1993	12/17/1998
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Life	2/17/1993	12/17/1998
Inactive	Jackson National Life Insurance Company	300486	Agent - Life	8/13/1990	4/26/2001
Inactive	John Alden Life Insurance Company	300573	Agent - Health	1/26/2011	1/24/2013
Inactive	John Alden Life Insurance Company	300573	Agent - Life	1/26/2011	1/24/2013
Active	Kentucky Home Life Insurance Company	300477	Agent - Health	11/18/2020
Active	Kentucky Home Life Insurance Company	300477	Agent - Life	11/18/2020
Inactive	Kentucky National Insurance Company	301625	Agent - Casualty	8/15/2000	10/15/2003
Inactive	Kentucky National Insurance Company	301625	Agent - General Lines	5/8/1978	8/15/2000
Inactive	Kentucky National Insurance Company	301625	Agent - Property	8/15/2000	10/15/2003
Inactive	LifeUSA Insurance Company	300386	Agent - Health	2/16/1994	4/22/1996
Inactive	LifeUSA Insurance Company	300386	Agent - Life	2/16/1994	4/22/1996
Inactive	Lincoln General Insurance Company	301580	Agent - Casualty	1/19/2004	4/17/2006
Inactive	Lincoln General Insurance Company	301580	Agent - Property	1/19/2004	4/17/2006
Inactive	Lincoln Heritage Life Insurance Company	500016	Agent - Health	5/10/2013	1/11/2015
Inactive	Lincoln Heritage Life Insurance Company	500016	Agent - Life	5/10/2013	1/11/2015
Inactive	Maryland Casualty Company	301719	Agent - General Lines	9/13/1994	3/31/1996
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	5/9/2012	6/24/2013
Inactive	National Insurance Association	301386	Agent - Casualty	8/15/2000	3/6/2003
Inactive	National Insurance Association	301386	Agent - General Lines	7/27/1993	8/15/2000
Inactive	National Insurance Association	301386	Agent - Property	8/15/2000	3/6/2003
Inactive	National Summit Insurance Company	300348	Agent - Casualty	8/15/2000	7/23/2003
Inactive	National Summit Insurance Company	300348	Agent - General Lines	8/26/1996	8/15/2000
Inactive	National Summit Insurance Company	300348	Agent - Property	8/15/2000	7/23/2003
Inactive	North American Company for Life and Health Insurance	300291	Agent - Health	1/25/1994	10/28/1996
Inactive	North American Company for Life and Health Insurance	300291	Agent - Life	1/25/1994	10/28/1996
Inactive	Northern Insurance Company of New York	301317	Agent - General Lines	9/13/1994	3/31/1996
Inactive	Omaha Insurance Company	751908	Agent - Health	5/9/2012	6/24/2013
Inactive	Omni Indemnity Company	301456	Agent - Casualty	8/15/2000	12/2/2005
Inactive	Omni Indemnity Company	301456	Agent - General Lines	5/30/2000	8/15/2000
Inactive	Omni Indemnity Company	301456	Agent - Property	8/15/2000	12/2/2005
Inactive	Omni Insurance Company	301545	Agent - General Lines	10/21/1987	3/31/2000
Inactive	PAFCO General Insurance Company	301645	Agent - Casualty	8/15/2000	10/4/2001
Inactive	PAFCO General Insurance Company	301645	Agent - General Lines	6/5/1975	8/15/2000
Inactive	PAFCO General Insurance Company	301645	Agent - Property	8/15/2000	10/4/2001
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	1/25/2007	7/17/2012
Inactive	Permanent General Assurance Corporation	300883	Agent - General Lines	11/10/1995	3/31/1998
Inactive	Plymouth Rock Assurance Preferred Corporation	301834	Agent - Casualty	9/10/2007	1/25/2011
Inactive	Plymouth Rock Assurance Preferred Corporation	301834	Agent - Property	9/10/2007	1/25/2011
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	6/25/2004	1/13/2025
Inactive	Progressive Casualty Insurance Company	300696	Agent - General Lines	5/8/1989	3/31/1998
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	6/25/2004	1/13/2025
Inactive	Progressive Northern Insurance Company	301378	Agent - Casualty	5/31/2017	1/13/2025
Inactive	Progressive Northern Insurance Company	301378	Agent - Property	5/31/2017	1/13/2025
Inactive	Providence Washington Insurance Company	301160	Agent - General Lines	1/29/1991	3/24/1997
Inactive	Redland Insurance Company	300687	Agent - General Lines	6/30/1993	8/14/1996
Inactive	Royal Neighbors of America	301646	Agent - Life	1/28/2009	12/9/2014
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Casualty	1/17/2005	12/2/2005
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Property	1/17/2005	12/2/2005
Inactive	Shenandoah Life Insurance Company	300130	Agent - Health	9/26/2006	3/31/2009
Inactive	Shenandoah Life Insurance Company	300130	Agent - Life	9/26/2006	12/16/2007
Inactive	South Carolina Insurance Company	300080	Agent - General Lines	4/18/1998	6/5/2000
Inactive	Standard Fire Insurance Company (The)	301068	Agent - General Lines	4/29/1997	10/18/1999
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	12/11/2000	1/11/2011
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Life	12/11/2000	1/11/2011
Inactive	The Phoenix Insurance Company	301502	Agent - General Lines	4/29/1997	10/18/1999
Inactive	Time Insurance Company	300683	Agent - Health	10/30/2012	12/20/2014
Inactive	Time Insurance Company	300683	Agent - Life	10/30/2012	12/20/2014
Inactive	Titan Indemnity Company	300556	Agent - Casualty	3/3/2011	6/22/2017
Inactive	Titan Indemnity Company	300556	Agent - Property	3/3/2011	6/22/2017
Inactive	Travelers Casualty and Surety Company	301067	Agent - General Lines	4/29/1997	10/18/1999
Active	Trexis Insurance Corporation	599902	Agent - Casualty	1/10/2005
Active	Trexis One Insurance Corporation	684197	Agent - Casualty	10/15/2008
Inactive	Truck Insurance Exchange	300335	Agent - Casualty	2/4/2008	8/22/2012
Inactive	Truck Insurance Exchange	300335	Agent - Property	2/4/2008	8/22/2012
Inactive	Trumbull Insurance Company	300242	Agent - Casualty	8/15/2000	12/2/2005
Inactive	Trumbull Insurance Company	300242	Agent - General Lines	6/26/1998	8/15/2000
Inactive	Trumbull Insurance Company	300242	Agent - Property	8/15/2000	12/2/2005
Inactive	Twin City Fire Insurance Company	300721	Agent - Casualty	9/15/2003	12/2/2005
Inactive	Twin City Fire Insurance Company	300721	Agent - Property	9/15/2003	12/2/2005
Inactive	Union Bankers Insurance Company	301769	Agent - Health	11/13/2006	12/28/2007
Inactive	United American Insurance Company	300910	Agent - Health	11/16/2005	3/6/2006
Inactive	United American Insurance Company	300910	Agent - Life	11/16/2005	3/6/2006
Inactive	United Financial Casualty Company	301886	Agent - Casualty	1/4/2017	1/13/2025
Inactive	United Financial Casualty Company	301886	Agent - Property	1/4/2017	1/13/2025
Inactive	United Investors Life Insurance Company	301873	Agent - Life	11/16/2005	3/6/2006
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	5/9/2012	6/24/2013
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	5/9/2012	6/24/2013
Inactive	Victoria Fire & Casualty Company	300313	Agent - Casualty	2/8/2007	6/22/2017
Inactive	Victoria Fire & Casualty Company	300313	Agent - Property	2/8/2007	6/22/2017
Inactive	Western Surety Company	300283	Agent - Casualty	8/15/2000	11/14/2001
Inactive	Western Surety Company	300283	Agent - General Lines	8/9/1996	8/15/2000
Active	William Penn Association	300101	Agent - Life	10/30/2008
Inactive	Windhaven National Insurance Company	300094	Agent - Casualty	8/15/2000	12/15/2003
Inactive	Windhaven National Insurance Company	300094	Agent - General Lines	9/27/1993	8/15/2000

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	6/25/1996	2/28/2005
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	6/25/1996	2/28/2005