DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Burnworth, Shirley G	DOIID	341785	NAIC NPN	7187839

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	3/28/1988	5/31/2020
Inactive	Resident	Agent	Credit Personal Property & Unemployment	1/23/1989	8/7/2000
Inactive	Resident	Agent	Life	3/28/1988	5/31/2020
Inactive	Resident	Agent	Vehicle Physical Damage	1/23/1989	1/21/2010
Inactive	Resident	Agent	Limited Line Credit	8/7/2000	5/31/2020
* 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 Bankers Insurance Company of Florida	300360	Agent - Credit Personal Property & Unemployment	11/4/1992	4/21/1997
Inactive	American General Assurance Company	300586	Agent - Health	1/26/1999	9/26/2002
Inactive	American General Assurance Company	300586	Agent - Life	1/26/1999	9/26/2002
Inactive	American Health and Life Insurance Company	300844	Agent - Health	2/21/2017	10/29/2019
Inactive	American Health and Life Insurance Company	300844	Agent - Life	2/21/2017	10/29/2019
Inactive	American Health and Life Insurance Company	300844	Agent - Limited Line Credit	2/21/2017	10/29/2019
Inactive	American Security Insurance Company	300901	Agent - Credit Personal Property & Unemployment	5/16/1995	8/7/2000
Inactive	American Security Insurance Company	300901	Agent - Limited Line Credit	8/7/2000	11/6/2002
Inactive	Merit Life Insurance Co.	300150	Agent - Health	7/9/1998	12/12/2018
Inactive	Merit Life Insurance Co.	300150	Agent - Life	8/30/1989	12/12/2018
Inactive	Old Republic Life Insurance Company	301214	Agent - Health	7/25/1988	11/2/1998
Inactive	Old Republic Life Insurance Company	301214	Agent - Life	7/25/1988	11/2/1998
Inactive	Protective Life Insurance Company	300638	Agent - Health	3/28/1988	6/26/1996
Inactive	Protective Life Insurance Company	300638	Agent - Life	3/28/1988	6/26/1996
Inactive	Triton Insurance Company	300654	Agent - Limited Line Credit	2/21/2017	10/29/2019
Inactive	Yosemite Insurance Company	301519	Agent - Credit Personal Property & Unemployment	1/23/1989	8/7/2000
Inactive	Yosemite Insurance Company	301519	Agent - Health	1/23/1989	1/20/2010
Inactive	Yosemite Insurance Company	301519	Agent - Limited Line Credit	8/7/2000	1/23/2018
Inactive	Yosemite Insurance Company	301519	Agent - Vehicle Physical Damage	1/23/1989	1/20/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Interstate Agency Inc	610890	Agent - Life	8/10/2018	2/21/2019
Inactive	Interstate Agency Inc	610890	Agent - Health	8/10/2018	2/21/2019
Inactive	Interstate Agency Inc	610890	Agent - Limited Line Credit	8/10/2018	2/21/2019
Inactive	OneMain Financial Of America, Inc	821439	Agent - Life	2/22/2016	3/2/2018
Inactive	OneMain Financial Of America, Inc	821439	Agent - Health	2/22/2016	3/2/2018
Inactive	OneMain Financial Of America, Inc	821439	Agent - Limited Line Credit	3/17/2016	3/2/2018
Inactive	Onemain Assurance Services LLC	751094	Agent - Life	6/19/2018	10/29/2019
Inactive	Onemain Assurance Services LLC	751094	Agent - Health	6/19/2018	10/29/2019
Inactive	Onemain Assurance Services LLC	751094	Agent - Limited Line Credit	8/22/2018	10/29/2019