DEPARTMENT OF INSURANCE
Affiliations
NameBurchett, Jack RandallDOIID352400NAIC NPN4403327
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveResidentAgentHealth4/27/20102/1/2014 
InactiveResidentAgentGeneral Lines6/4/19638/15/2000 
InactiveResidentAgentCasualty8/15/20001/31/2010 
InactiveResidentAgentProperty8/15/20001/31/2010 
InactiveResidentAgentLife4/27/20102/1/2014 
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAllianz Life Insurance Company of North America301791Agent - Health6/3/19989/1/2003
InactiveAllianz Life Insurance Company of North America301791Agent - Life6/3/19989/1/2003
InactiveAmerican General Life Insurance Company301585Agent - Health2/27/201110/20/2011
InactiveAmerican General Life Insurance Company301585Agent - Life2/27/201110/20/2011
InactiveAthene Annuity and Life Company301893Agent - Life9/16/20101/12/2013
InactiveBanner Life Insurance Company301696Agent - Life11/17/199710/14/2003
InactiveC.M. Life Insurance Company301335Agent - Health9/3/20081/31/2010
InactiveC.M. Life Insurance Company301335Agent - Life9/3/20081/31/2010
InactiveChase Insurance Life and Annuity Company300518Agent - Health9/25/19953/31/1997
InactiveChase Insurance Life and Annuity Company300518Agent - Life9/6/20024/1/2007
InactiveCitizens Security Life Insurance Company301257Agent - Health9/9/20031/31/2010
InactiveCitizens Security Life Insurance Company301257Agent - Life9/9/20031/31/2010
InactiveClarica Life Insurance Company - U.S.300207Agent - Health9/20/19943/31/1997
InactiveClarica Life Insurance Company - U.S.300207Agent - Life9/20/19943/31/1997
InactiveFidelity Life Association, A Legal Reserve Life Insurance Company300774Agent - Life9/6/200210/28/2008
InactiveGenworth Life Insurance Company300623Agent - Health1/4/200810/4/2009
InactiveGenworth Life Insurance Company300623Agent - Life1/4/200810/4/2009
InactiveGreat American Casualty Insurance Company301764Agent - Casualty8/15/20004/13/2004
InactiveGreat American Casualty Insurance Company301764Agent - General Lines6/9/19818/15/2000
InactiveGreat American Casualty Insurance Company301764Agent - Property8/15/20004/13/2004
InactiveIL Annuity and Insurance Company300772Agent - Life2/8/19999/24/1999
InactiveJackson National Life Insurance Company300486Agent - Life10/27/20051/12/2006
InactiveLifeUSA Insurance Company300386Agent - Health6/3/19988/2/2002
InactiveLifeUSA Insurance Company300386Agent - Life6/3/19988/2/2002
InactiveLincoln Life & Annuity Company of New York300636Agent - Health10/9/19913/31/1997
InactiveLincoln Life & Annuity Company of New York300636Agent - Life10/9/19913/31/1997
InactiveMassachusetts Mutual Life Insurance Company300445Agent - Health9/3/20081/31/2010
InactiveMassachusetts Mutual Life Insurance Company300445Agent - Life9/3/20081/31/2010
InactiveMidland Life Insurance Company (The)300310Agent - Health4/1/19973/31/2001
InactiveMidland Life Insurance Company (The)300310Agent - Life4/1/19973/31/2001
InactiveNorth American Company for Life and Health Insurance300291Agent - Health7/22/20081/31/2010
InactiveNorth American Company for Life and Health Insurance300291Agent - Life7/22/200812/4/2009
InactiveProtective Life Insurance Company300638Agent - Life4/1/200712/24/2009
InactiveReliaStar Life Insurance Company301712Agent - Life8/28/20001/10/2006
InactiveResponse Worldwide Direct Auto Insurance Company300121Agent - Casualty8/15/20003/31/2004
InactiveResponse Worldwide Direct Auto Insurance Company300121Agent - General Lines6/4/19638/15/2000
InactiveResponse Worldwide Direct Auto Insurance Company300121Agent - Property8/15/20003/31/2004
InactiveSecurity-Connecticut Life Insurance Company300316Agent - Health5/4/19991/23/2003
InactiveSecurity-Connecticut Life Insurance Company300316Agent - Life5/4/19991/23/2003
InactiveStandard Life Insurance Company of Indiana300116Agent - Health9/26/19943/31/1997
InactiveStandard Life Insurance Company of Indiana300116Agent - Life9/26/19943/31/1997
InactiveTransamerica Premier Life Insurance Company300558Agent - Health10/15/19563/15/2005
InactiveTransamerica Premier Life Insurance Company300558Agent - Life10/15/19563/15/2005
InactiveU.S. Financial Life Insurance Company301812Agent - Health11/1/19953/27/2003
InactiveU.S. Financial Life Insurance Company301812Agent - Life11/1/19953/27/2003
InactiveUnited Presidential Life Insurance Company300422Agent - Life12/30/19983/31/2001
InactiveUnitedHealthcare Insurance Company300946Agent - Health5/29/200812/15/2009
InactiveUnitedHealthcare Insurance Company300946Agent - Life5/29/200812/15/2009
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health5/29/200812/15/2009
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Health5/29/200812/15/2009
InactiveVenerable Insurance and Annuity Company301006Agent - Life8/1/20053/15/2010
InactiveWest Coast Life Insurance Company301607Agent - Health8/27/20071/31/2010
InactiveWest Coast Life Insurance Company301607Agent - Life8/30/20061/31/2010
InactiveWestern National Life Insurance Company300461Agent - Life2/2/200411/5/2007
InactiveWilco Life Insurance Company300122Agent - Health9/28/19945/2/2003
InactiveWilco Life Insurance Company300122Agent - Life9/28/19946/22/2001
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveC & B Insurance Agency Of Pikeville, Inc.554371Agent - Life8/26/20021/31/2010
InactiveC & B Insurance Agency Of Pikeville, Inc.554371Agent - Health8/26/20021/31/2010
InactiveDental Choice Agency Inc.398085Agent - Health6/6/201110/20/2011
InactiveHealthplan Services, Inc.401230Agent - Health8/31/19953/31/1997
InactiveTriple B Insurance Agency of Pikeville Inc.399510Agent - Life6/30/19871/31/2010
InactiveTriple B Insurance Agency of Pikeville Inc.399510Agent - Health6/30/19871/31/2010

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