DEPARTMENT OF INSURANCE

Affiliations

Name	Owens, Perry Dale	DOIID	348121	NAIC NPN	7190610

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Variable Life and Variable Annuities	5/31/2001	9/1/2013
Inactive	Resident	Agent	Casualty	8/15/2000	9/1/2013
Inactive	Resident	Agent	Property	8/15/2000	9/1/2013
Inactive	Resident	Agent	General Lines	9/12/1995	8/15/2000
Inactive	Resident	Agent	Life	4/7/1993	9/1/2013
Inactive	Resident	Agent	Health	4/7/1993	9/1/2013
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Allstate Indemnity Company	300778	Agent - Casualty	8/15/2000	5/15/2012
Inactive	Allstate Indemnity Company	300778	Agent - General Lines	8/28/1996	8/15/2000
Inactive	Allstate Indemnity Company	300778	Agent - Property	8/15/2000	5/15/2012
Inactive	Allstate Insurance Company	300773	Agent - Casualty	8/15/2000	5/15/2012
Inactive	Allstate Insurance Company	300773	Agent - General Lines	8/28/1996	8/15/2000
Inactive	Allstate Insurance Company	300773	Agent - Property	8/15/2000	5/15/2012
Inactive	Allstate Property and Casualty Insurance Company	300593	Agent - Casualty	8/12/2005	5/15/2012
Inactive	Allstate Property and Casualty Insurance Company	300593	Agent - Property	8/12/2005	5/15/2012
Inactive	American Heritage Life Insurance Company	300272	Agent - Health	12/5/2000	4/17/2012
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	12/5/2000	4/17/2012
Inactive	American Network Insurance Company	301156	Agent - Health	6/3/1998	2/25/2002
Inactive	Ameritas Life Insurance Corporation	300126	Agent - Health	3/3/1994	12/11/2000
Inactive	Ameritas Life Insurance Corporation	300126	Agent - Life	3/3/1994	12/11/2000
Inactive	Assurance Company of America	300432	Agent - General Lines	9/12/1995	3/31/1996
Inactive	Assurity Life Insurance Company	301099	Agent - Health	5/8/2006	5/3/2012
Inactive	Assurity Life Insurance Company	301099	Agent - Life	5/8/2006	5/3/2012
Inactive	Beazley Insurance Company, Inc.	300899	Agent - General Lines	6/18/1996	11/9/1998
Inactive	Boston Mutual Life Insurance Company	300143	Agent - Health	6/2/1994	3/31/1997
Inactive	Boston Mutual Life Insurance Company	300143	Agent - Life	6/2/1994	3/31/1997
Inactive	Celtic Insurance Company	300877	Agent - Health	4/8/1994	3/31/1997
Inactive	Celtic Insurance Company	300877	Agent - Life	4/8/1994	3/31/1997
Inactive	Citizens Security Life Insurance Company	301257	Agent - Health	4/7/1993	3/2/1999
Inactive	Citizens Security Life Insurance Company	301257	Agent - Life	4/7/1993	3/2/1999
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Health	5/29/1996	5/27/1997
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	5/29/1996	5/27/1997
Inactive	Everlake Life Insurance Company	300873	Agent - Health	8/28/1996	5/15/2012
Inactive	Everlake Life Insurance Company	300873	Agent - Life	8/28/1996	5/15/2012
Inactive	Everlake Life Insurance Company	300873	Agent - Variable Life and Variable Annuities	5/31/2001	5/15/2012
Inactive	Fortitude Life Insurance & Annuity Company	301503	Agent - Life	8/14/2006	11/11/2011
Inactive	Fortitude Life Insurance & Annuity Company	301503	Agent - Variable Life and Variable Annuities	8/14/2006	11/11/2011
Inactive	Glatfelter Insurance Company	301640	Agent - General Lines	9/12/1995	3/31/1996
Inactive	Lincoln Benefit Life Company	301110	Agent - Health	6/18/1998	5/15/2012
Inactive	Lincoln Benefit Life Company	301110	Agent - Life	6/12/1997	5/15/2012
Inactive	Lincoln Benefit Life Company	301110	Agent - Variable Life and Variable Annuities	5/31/2001	5/15/2012
Inactive	Maryland Casualty Company	301719	Agent - General Lines	9/12/1995	3/31/1996
Inactive	Meridian Mutual Insurance Company	301303	Agent - General Lines	3/11/1996	3/31/1998
Inactive	Meridian Security Insurance Company	300423	Agent - General Lines	3/11/1996	3/31/1998
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	6/26/1996	1/21/2005
Inactive	National Insurance Association	301386	Agent - Casualty	8/15/2000	2/11/2002
Inactive	National Insurance Association	301386	Agent - General Lines	11/29/1995	8/15/2000
Inactive	National Insurance Association	301386	Agent - Property	8/15/2000	2/11/2002
Inactive	National Summit Insurance Company	300348	Agent - General Lines	2/16/1996	3/31/1998
Inactive	Northern Insurance Company of New York	301317	Agent - General Lines	9/12/1995	3/31/1996
Inactive	Pan-American Assurance Company	301533	Agent - Health	12/28/1995	5/12/2005
Inactive	Pan-American Assurance Company	301533	Agent - Life	12/28/1995	5/12/2005
Inactive	Pan-American Life Insurance Company	301530	Agent - Health	12/28/1995	5/12/2005
Inactive	Pan-American Life Insurance Company	301530	Agent - Life	12/28/1995	5/12/2005
Inactive	Paul Revere Life Insurance Company	300971	Agent - Health	6/4/1998	12/11/2002
Inactive	Paul Revere Life Insurance Company	300971	Agent - Life	6/4/1998	12/11/2002
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	6/4/1998	12/11/2006
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	6/4/1998	12/11/2006
Inactive	Pruco Life Insurance Company	300954	Agent - Life	4/30/2010	11/11/2011
Inactive	Pruco Life Insurance Company	300954	Agent - Variable Life and Variable Annuities	4/30/2010	11/11/2011
Inactive	Time Insurance Company	300683	Agent - Health	4/7/1993	12/27/1995
Inactive	Time Insurance Company	300683	Agent - Life	4/7/1993	12/27/1995
Inactive	United World Life Insurance Company	300532	Agent - Health	3/15/1994	3/31/1997
Inactive	United World Life Insurance Company	300532	Agent - Life	3/15/1994	3/31/1997
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	7/31/1996	1/21/2005
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	7/31/1996	1/21/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Perry Owens Ins. Inc.	399905	Agent - General Lines	5/1/1998	8/15/2000
Inactive	Perry Owens Ins. Inc.	399905	Agent - Life	5/1/1998	3/31/2012
Inactive	Perry Owens Ins. Inc.	399905	Agent - Health	5/1/1998	3/31/2012
Inactive	Perry Owens Ins. Inc.	399905	Agent - Property	8/15/2000	3/31/2012
Inactive	Perry Owens Ins. Inc.	399905	Agent - Casualty	8/15/2000	5/15/2012
Inactive	Trimble Insurance Agency Inc.	398527	Agent - Life	5/22/1996	5/31/2004
Inactive	Trimble Insurance Agency Inc.	398527	Agent - Health	5/22/1996	5/31/2004