DEPARTMENT OF INSURANCE

Affiliations

Name	Triplett, Terry Wayne	DOIID	344069	NAIC NPN	1492499

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Limited Line Credit	3/5/2010	8/31/2014
Inactive	Resident	Agent	Health	10/21/1993	7/1/2006
Inactive	Resident	Agent	Life	8/28/2012	9/1/2014
* 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 Memorial Life Insurance Company	301445	Agent - Life	8/30/2012	1/10/2013
Inactive	Brighthouse Life Insurance Company	301829	Agent - Health	5/14/1997	7/1/1998
Inactive	Brighthouse Life Insurance Company	301829	Agent - Life	5/14/1997	7/1/1998
Inactive	Central States Health and Life Company of Omaha	301874	Agent - Health	4/8/2002	1/27/2005
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Health	12/30/1996	3/31/1997
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Life	12/30/1996	3/31/1997
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Life	10/1/1996	5/6/1998
Inactive	MetLife Life and Annuity Company of Connecticut	301593	Agent - Health	5/14/1997	7/1/1998
Inactive	MetLife Life and Annuity Company of Connecticut	301593	Agent - Life	5/14/1997	7/1/1998
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	10/21/1993	1/2/1997
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	7/28/2003	12/16/2004
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Life	2/6/2004	7/1/2006
Inactive	Senior Health Insurance Company of Pennsylvania	300251	Agent - Health	5/14/1997	7/1/1998
Inactive	Senior Health Insurance Company of Pennsylvania	300251	Agent - Life	5/14/1997	7/1/1998
Inactive	Southern Financial Life Insurance Company	300664	Agent - Health	4/1/1999	1/16/2003
Inactive	Southern Financial Life Insurance Company	300664	Agent - Life	4/1/1999	1/16/2003
Inactive	Southern Financial Life Insurance Company	300664	Agent - Limited Line Credit	3/11/2010	8/31/2014
Inactive	Time Insurance Company	300683	Agent - Health	5/14/1997	7/1/1998
Inactive	Time Insurance Company	300683	Agent - Life	5/14/1997	7/1/1998
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	10/21/1993	1/2/1997
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	10/21/1993	1/2/1997
Inactive	Western National Life Insurance Company	300461	Agent - Life	3/24/1999	2/1/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Healthplan Services, Inc.	401230	Agent - Health	8/31/1995	3/31/1997
Inactive	Natcity Insurance Services Inc.	400871	Agent - Life	2/21/2003	2/28/2005
Inactive	National City Insurance Group Inc.	399045	Agent - Life	8/13/2004	2/28/2005