DEPARTMENT OF INSURANCE

Affiliations

Name	Thomas, Jim	DOIID	367193	NAIC NPN	1499106

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	5/24/2002	10/31/2013
Inactive	Non Resident	Agent	Property	5/24/2002	10/31/2013
Inactive	Non Resident	Agent	Health	5/24/2002	10/31/2013
Inactive	Non Resident	Agent	Casualty	5/24/2002	10/31/2013
* 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	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	3/12/2003	6/30/2004
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	3/12/2003	6/30/2004
Inactive	Baltimore Life Insurance Company	300286	Agent - Health	8/9/2007	4/20/2009
Inactive	Baltimore Life Insurance Company	300286	Agent - Life	8/9/2007	4/20/2009
Inactive	Central States Health and Life Company of Omaha	301874	Agent - Life	8/24/2009	11/22/2011
Inactive	Central States Indemnity Company of Omaha	300285	Agent - Casualty	8/24/2009	11/22/2011
Inactive	Central States Indemnity Company of Omaha	300285	Agent - Health	8/24/2009	11/22/2011
Inactive	Cincinnati Equitable Life Insurance Company	641870	Agent - Life	11/20/2008	10/27/2010
Inactive	Colorado Bankers Life Insurance Company	301845	Agent - Health	10/9/2009	3/20/2012
Inactive	Colorado Bankers Life Insurance Company	301845	Agent - Life	10/9/2009	3/20/2012
Inactive	Conseco Health Insurance Company	301725	Agent - Health	12/5/2002	8/2/2006
Inactive	Conseco Health Insurance Company	301725	Agent - Life	12/5/2002	8/2/2006
Inactive	Conseco Insurance Company	301202	Agent - Health	11/30/2004	1/23/2007
Inactive	Conseco Insurance Company	301202	Agent - Life	11/30/2004	1/23/2007
Inactive	Continental General Insurance Company	300691	Agent - Health	11/18/2002	4/21/2003
Inactive	Continental General Insurance Company	300691	Agent - Life	11/18/2002	4/21/2003
Inactive	Encova Life Insurance Company	301818	Agent - Life	1/31/2003	10/31/2013
Inactive	Lincoln Heritage Life Insurance Company	500016	Agent - Health	4/17/2007	9/27/2007
Inactive	Lincoln Heritage Life Insurance Company	500016	Agent - Life	4/17/2007	9/27/2007
Inactive	Nassau Life Insurance Company of Kansas	300667	Agent - Health	7/11/2005	8/1/2007
Inactive	Nassau Life Insurance Company of Kansas	300667	Agent - Life	7/11/2005	8/1/2007
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	6/3/2009	10/31/2013
Inactive	Pennsylvania Life Insurance Company	301321	Agent - Health	6/27/2005	8/1/2007
Inactive	Pennsylvania Life Insurance Company	301321	Agent - Life	6/27/2005	8/1/2007
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	7/1/2003	5/31/2005
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Life	7/1/2003	5/31/2005
Inactive	State Farm Fire and Casualty Company	301809	Agent - Casualty	5/24/2002	6/13/2002
Inactive	State Farm Fire and Casualty Company	301809	Agent - Property	5/24/2002	6/13/2002
Inactive	State Farm General Insurance Company	301122	Agent - Casualty	5/24/2002	6/13/2002
Inactive	State Farm General Insurance Company	301122	Agent - Property	5/24/2002	6/13/2002
Inactive	State Farm Life Insurance Company	301810	Agent - Life	5/24/2002	6/13/2002
Inactive	State Farm Mutual Automobile Insurance Company	301732	Agent - Casualty	5/24/2002	6/13/2002
Inactive	State Farm Mutual Automobile Insurance Company	301732	Agent - Health	5/24/2002	6/13/2002
Inactive	Sterling Life Insurance Company	301947	Agent - Health	10/17/2002	12/2/2002
Inactive	Sterling Life Insurance Company	301947	Agent - Life	10/17/2002	12/2/2002
Inactive	Stonebridge Life Insurance Company	301614	Agent - Health	6/4/2008	8/28/2012
Inactive	Stonebridge Life Insurance Company	301614	Agent - Life	6/4/2008	8/28/2012
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	5/9/2008	6/5/2008
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	5/9/2008	6/5/2008
Denied	United American Insurance Company	300910	Agent - Health
Denied	United American Insurance Company	300910	Agent - Life
Inactive	Western and Southern Life Insurance Company	301744	Agent - Health	10/7/1997	8/14/1998
Inactive	Western and Southern Life Insurance Company	301744	Agent - Life	10/7/1997	8/14/1998
Inactive	Western-Southern Life Assurance Company	301590	Agent - Health	10/7/1997	8/14/1998
Inactive	Western-Southern Life Assurance Company	301590	Agent - Life	10/7/1997	8/14/1998

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Extend Insurance Services, LLC	625753	Agent - Life	10/15/2008	10/31/2013
Inactive	Extend Insurance Services, LLC	625753	Agent - Health	10/15/2008	10/31/2013