DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Secrist, Kelly Ann	DOIID	347624	NAIC NPN	7190378

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	10/21/2019	10/1/2022
Inactive	Resident	Agent	Credit Life & Health	10/27/1997	8/3/1999
Inactive	Resident	Agent	Life	10/21/2019	10/1/2022
* 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	Empower Annuity Insurance Company of America	300259	Agent - Life	9/16/2002	10/16/2003
Inactive	Gerber Life Insurance Company	300529	Agent - Health	10/24/2019	1/7/2020
Inactive	Gerber Life Insurance Company	300529	Agent - Life	10/24/2019	1/7/2020
Inactive	Jackson National Life Insurance Company	300486	Agent - Life	4/5/2003	7/1/2006
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	6/9/2003	12/16/2004
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	6/9/2003	12/16/2004
Inactive	Southern Financial Life Insurance Company	300664	Agent - Credit Life & Health	12/28/1998	8/3/1999
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Credit Life & Health	10/27/1997	12/28/1998
Inactive	Western National Life Insurance Company	300461	Agent - Life	8/7/2001	7/1/2006
Inactive	Western-Southern Life Assurance Company	301590	Agent - Health	7/24/2001	7/1/2006
Inactive	Western-Southern Life Assurance Company	301590	Agent - Life	7/24/2001	7/1/2006

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Fifth Third Insurance Agency Inc	399341	Agent - Life	4/27/2004	7/1/2006