DEPARTMENT OF INSURANCE

Affiliations

Name	Puckett, Timothy David	DOIID	345457	NAIC NPN	5500356

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Life	1/4/2011		12/31/2025
Active	Resident	Agent	Health	1/4/2011		12/31/2025
Denied	Resident	Agent	Casualty
Inactive	Resident	Agent	Property	8/29/2002	8/7/2008
* 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	Aetna Health Inc.	300694	Agent - Health	6/11/2002	4/18/2007
Inactive	Aetna Life Insurance Company	301140	Agent - Health	6/11/2002	4/18/2007
Inactive	Aetna Life Insurance Company	301140	Agent - Life	6/11/2002	4/18/2007
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	9/9/1996	3/28/2007
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	9/9/1996	3/28/2007
Inactive	American Heritage Life Insurance Company	300272	Agent - Health	9/19/1996	7/20/2006
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	9/19/1996	7/20/2006
Inactive	American National Insurance Company	301861	Agent - Health	12/2/2013	6/3/2021
Active	American National Insurance Company	301861	Agent - Life	12/2/2013
Inactive	Assurity Life Insurance Company	301099	Agent - Health	9/14/1998	2/26/2003
Inactive	Assurity Life Insurance Company	301099	Agent - Life	9/14/1998	2/26/2003
Inactive	Athene Annuity & Life Assurance Company	301798	Agent - Health	10/14/1997	10/10/2006
Inactive	Athene Annuity & Life Assurance Company	301798	Agent - Life	10/14/1997	10/10/2006
Active	Athene Annuity and Life Company	301893	Agent - Life	12/16/2021
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	6/27/2001	12/7/2007
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	6/27/2001	12/7/2007
Denied	Cincinnati Insurance Company	301298	Agent - Casualty
Inactive	Cincinnati Insurance Company	301298	Agent - Property	8/29/2002	5/6/2003
Inactive	Cincinnati Life Insurance Company (The)	300601	Agent - Health	8/20/1996	1/8/2001
Inactive	Cincinnati Life Insurance Company (The)	300601	Agent - Life	8/20/1996	1/8/2001
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Health	10/3/2006	3/26/2007
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	10/3/2006	3/26/2007
Inactive	Columbian Life Insurance Company	300810	Agent - Life	3/4/2022	11/7/2022
Inactive	Continental Casualty Company	301019	Agent - Health	5/28/1998	10/29/2002
Inactive	Continental General Insurance Company	300691	Agent - Health	10/27/2000	11/6/2002
Inactive	Continental General Insurance Company	300691	Agent - Life	10/27/2000	11/6/2002
Inactive	Delaware Life Insurance Company	301256	Agent - Life	1/1/2020	12/21/2021
Inactive	Elips Life Insurance Company	301087	Agent - Health	4/21/2022	1/31/2024
Active	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	3/9/2022
Inactive	First Colony Life Insurance Company	301179	Agent - Life	9/25/1996	7/17/2001
Active	Forethought Life Insurance Company	301407	Agent - Health	7/1/2020
Active	Forethought Life Insurance Company	301407	Agent - Life	7/1/2020
Active	Gerber Life Insurance Company	300529	Agent - Health	5/31/2017
Active	Gerber Life Insurance Company	300529	Agent - Life	5/31/2017
Inactive	Guarantee Life Insurance Company	301560	Agent - Health	7/29/1998	4/17/2000
Inactive	Guarantee Life Insurance Company	301560	Agent - Life	7/29/1998	4/17/2000
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	10/2/2000	12/7/2007
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	10/2/2000	12/7/2007
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	4/2/2003	3/29/2007
Inactive	Humana Insurance Company	301104	Agent - Health	4/2/2003	3/29/2007
Inactive	Humana Insurance Company	301104	Agent - Life	4/2/2003	3/29/2007
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Health	3/18/1997	12/18/2001
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	12/1/2017	12/29/2020
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	12/1/2017	12/29/2020
Inactive	Lafayette Life Insurance Company (The)	301039	Agent - Life	6/29/2001	11/20/2007
Inactive	Liberty National Life Insurance Company	300827	Agent - Health	3/19/2007	3/24/2008
Inactive	Liberty National Life Insurance Company	300827	Agent - Life	3/19/2007	3/24/2008
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	11/19/2015	8/25/2016
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	11/19/2015	8/25/2016
Inactive	Lumico Life Insurance Company	300354	Agent - Health	9/10/2020	11/1/2022
Inactive	Lumico Life Insurance Company	300354	Agent - Life	9/8/2020	2/6/2025
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	11/6/2000	11/27/2007
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	11/6/2000	11/27/2007
Inactive	Midland Life Insurance Company (The)	300310	Agent - Life	8/19/1999	3/31/2001
Inactive	Modern Woodmen of America	301213	Agent - Life	3/6/1992	6/13/1996
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	2/9/2024	1/22/2025
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Health	4/20/2021	12/12/2022
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	4/20/2021	12/12/2022
Inactive	Omaha Insurance Company	751908	Agent - Health	4/27/2016	3/22/2017
Inactive	Paul Revere Life Insurance Company	300971	Agent - Health	6/30/1999	8/24/2000
Inactive	Paul Revere Life Insurance Company	300971	Agent - Life	6/30/1999	8/24/2000
Inactive	Principal Life Insurance Company	300129	Agent - Health	10/2/1996	4/3/2007
Inactive	Principal Life Insurance Company	300129	Agent - Life	10/2/1996	4/3/2007
Inactive	Protective Life Insurance Company	300638	Agent - Health	1/1/2007	11/26/2007
Inactive	Protective Life Insurance Company	300638	Agent - Life	1/1/2007	11/26/2007
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	6/30/1999	8/24/2000
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	6/30/1999	8/24/2000
Inactive	Pruco Life Insurance Company	300954	Agent - Life	5/1/2019	11/25/2020
Inactive	Shenandoah Life Insurance Company	300130	Agent - Health	1/28/1997	5/23/2007
Inactive	Shenandoah Life Insurance Company	300130	Agent - Life	1/28/1997	5/23/2007
Inactive	Time Insurance Company	300683	Agent - Health	9/14/1998	12/27/2006
Inactive	Time Insurance Company	300683	Agent - Life	9/14/1998	12/27/2006
Active	Transamerica Life Insurance Company	300571	Agent - Health	1/20/2011
Active	Transamerica Life Insurance Company	300571	Agent - Life	1/20/2011
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	1/4/2011	10/1/2020
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	1/4/2011	10/1/2020
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Health	12/11/2000	7/8/2005
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Life	12/11/2000	7/8/2005
Inactive	United World Life Insurance Company	300532	Agent - Health	4/19/2019	8/1/2020
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	9/20/2023	8/22/2024
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	9/20/2023	8/22/2024
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	2/26/1999	11/21/2005
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	2/26/1999	11/21/2005
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	9/25/1996	3/31/1997
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	9/25/1996	3/31/1997
Inactive		300277	Agent - Health	10/2/1996	1/1/2007
Inactive		300277	Agent - Life	10/2/1996	1/1/2007

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Dental Choice Agency Inc.	398085	Agent - Health	5/10/2016
Inactive	Kentucky Association of Counties Ins Agency Inc.	398642	Agent - Life	12/12/2001	2/28/2007
Inactive	Kentucky Association of Counties Ins Agency Inc.	398642	Agent - Health	12/12/2001	2/28/2007
Inactive	Peel & Holland Inc	398400	Agent - Life	7/8/1996	11/6/1996
Inactive	Peel & Holland Security Planning Inc.	398597	Agent - Life	7/9/1997	9/18/2006
Inactive	Peel & Holland Security Planning Inc.	398597	Agent - Health	7/9/1997	9/18/2006
Inactive	West Kentucky Group Benefits	401049	Agent - Life	12/28/1998	2/24/2003
Inactive	West Kentucky Group Benefits	401049	Agent - Health	12/28/1998	2/24/2003