DEPARTMENT OF INSURANCE

Affiliations

Name	Keller, Kip K	DOIID	340784	NAIC NPN	2432816

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	10/21/1994	9/30/2018
Inactive	Non Resident	Agent	Variable Life and Variable Annuities	5/31/2001	9/30/2018
Inactive	Non Resident	Agent	Health	10/21/1994	9/30/2018
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Fortitude Life Insurance & Annuity Company	301503	Agent - Life	8/26/2002	9/30/2018
Inactive	Fortitude Life Insurance & Annuity Company	301503	Agent - Variable Life and Variable Annuities	8/26/2002	9/30/2018
Inactive	Pacific Life Insurance Company	301848	Agent - Health	8/19/2002	3/12/2009
Inactive	Pacific Life Insurance Company	301848	Agent - Life	8/19/2002	3/12/2009
Inactive	Pacific Life Insurance Company	301848	Agent - Variable Life and Variable Annuities	8/19/2002	3/12/2009
Inactive	Pruco Life Insurance Company	300954	Agent - Life	2/22/2010	9/30/2018
Inactive	Pruco Life Insurance Company	300954	Agent - Variable Life and Variable Annuities	2/22/2010	9/30/2018
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	4/22/2009	9/30/2018
Inactive	Transamerica Life Insurance Company	300571	Agent - Variable Life and Variable Annuities	4/22/2009	9/30/2018
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	10/1/2014	9/30/2018
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	10/1/2014	9/30/2018
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Variable Life and Variable Annuities	10/1/2014	9/30/2018
Inactive	Western Reserve Life Assurance Company of Ohio	300760	Agent - Health	10/21/1994	10/1/2014
Inactive	Western Reserve Life Assurance Company of Ohio	300760	Agent - Life	10/21/1994	10/1/2014
Inactive	Western Reserve Life Assurance Company of Ohio	300760	Agent - Variable Life and Variable Annuities	5/31/2001	10/1/2014

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	World Financial Group Insurance Agency, LLC	400520	Agent - Life	8/9/2001	9/30/2018
Inactive	World Financial Group Insurance Agency, LLC	400520	Agent - Health	8/9/2001	9/30/2018
Inactive	World Financial Group Insurance Agency, LLC	400520	Agent - Variable Life and Variable Annuities	8/9/2001	9/30/2018
Inactive	World Marketing Alliance Inc.	398156	Agent - Life	3/12/2001	3/21/2003
Inactive	World Marketing Alliance Inc.	398156	Agent - Variable Life and Variable Annuities	4/2/2001	12/16/2002