DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Kilburne, Jerry Wayne	DOIID	344981	NAIC NPN	2798927

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	7/12/2001	4/30/2003
Inactive	Non Resident	Agent	Life	7/12/2001	4/30/2003
* 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	Kansas City Life Insurance Company	301444	Agent - Health	8/30/2001	8/1/2002
Inactive	Kansas City Life Insurance Company	301444	Agent - Life	8/30/2001	8/1/2002
Inactive	Liberty Life Insurance Company	301542	Agent - Health	3/9/1993	10/7/1996
Inactive	Liberty Life Insurance Company	301542	Agent - Life	3/9/1993	10/7/1996
Inactive	New York Life Insurance Company	300431	Agent - Health	7/12/2001	1/28/2003
Inactive	New York Life Insurance Company	300431	Agent - Life	7/12/2001	1/28/2003
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	8/7/2001	4/30/2003

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Cornerstone Senior Services LLC	399590	Agent - Life	9/16/1996	10/7/1996
Inactive	Cornerstone Senior Services LLC	399590	Agent - Health	9/16/1996	10/7/1996
Inactive	Senior American Benefits, LLC	502287	Agent - Life	7/26/2001	1/28/2003
Inactive	Senior American Benefits, LLC	502287	Agent - Health	7/26/2001	3/19/2003