DEPARTMENT OF INSURANCE
Affiliations
NameSelf, Timothy DOIID367266NAIC NPN7199010
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentVariable Life and Variable Annuities7/25/2023 1/31/2026
ActiveNon ResidentAgentLife7/25/2023 1/31/2026
InactiveNon ResidentAgentHealth10/7/20051/31/2020 
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveAllianz Life Insurance Company of North America301791Agent - Life8/8/2023 
ActiveAllianz Life Insurance Company of North America301791Agent - Variable Life and Variable Annuities8/8/2023 
InactiveAugustar Life Insurance Company301816Agent - Life4/3/20066/4/2007
InactiveAugustar Life Insurance Company301816Agent - Variable Life and Variable Annuities4/3/20066/4/2007
InactiveBrighthouse Life Insurance Company301829Agent - Health12/7/20071/31/2020
InactiveBrighthouse Life Insurance Company301829Agent - Life12/7/20071/31/2020
InactiveBrighthouse Life Insurance Company301829Agent - Variable Life and Variable Annuities12/7/20071/31/2020
InactiveDelaware Life Insurance Company301256Agent - Life9/26/200611/3/2009
InactiveDelaware Life Insurance Company301256Agent - Variable Life and Variable Annuities9/26/200611/3/2009
InactiveForethought Life Insurance Company301407Agent - Health12/5/20171/31/2020
InactiveForethought Life Insurance Company301407Agent - Life12/5/20171/31/2020
InactiveForethought Life Insurance Company301407Agent - Variable Life and Variable Annuities12/5/20171/31/2020
InactiveFortitude Life Insurance & Annuity Company301503Agent - Health7/9/200712/23/2014
InactiveFortitude Life Insurance & Annuity Company301503Agent - Life7/9/200712/23/2014
InactiveFortitude Life Insurance & Annuity Company301503Agent - Variable Life and Variable Annuities7/9/200712/23/2014
InactiveGeneral American Life Insurance Company300280Agent - Health7/5/200712/21/2009
InactiveGeneral American Life Insurance Company300280Agent - Life7/5/200712/21/2009
InactiveGeneral American Life Insurance Company300280Agent - Variable Life and Variable Annuities7/5/200712/21/2009
InactiveGenworth Life Insurance Company300623Agent - Health7/3/200710/4/2009
InactiveGenworth Life Insurance Company300623Agent - Life7/3/200710/4/2009
InactiveGenworth Life and Annuity Insurance Company301276Agent - Health7/3/200712/7/2012
InactiveGenworth Life and Annuity Insurance Company301276Agent - Life7/3/200712/7/2012
InactiveGenworth Life and Annuity Insurance Company301276Agent - Variable Life and Variable Annuities7/3/200712/7/2012
InactiveIndianapolis Life Insurance Company301381Agent - Health11/22/19947/1/1996
InactiveIndianapolis Life Insurance Company301381Agent - Life11/22/19947/1/1996
InactiveIntegrity Life Insurance Company301687Agent - Life6/30/200710/16/2012
InactiveIntegrity Life Insurance Company301687Agent - Variable Life and Variable Annuities6/30/200710/16/2012
InactiveJohn Hancock Life Insurance Company300821Agent - Health10/13/200512/30/2009
InactiveJohn Hancock Life Insurance Company300821Agent - Life10/13/200512/30/2009
InactiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Health10/13/20054/18/2012
ActiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Life7/26/2023 
InactiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Variable Life and Variable Annuities7/6/20074/18/2012
InactiveJohn Hancock Variable Life Insurance Company301914Agent - Health10/13/200512/12/2006
InactiveJohn Hancock Variable Life Insurance Company301914Agent - Life10/13/200512/12/2006
InactiveLincoln National Life Insurance Company (The)301382Agent - Health6/22/20077/24/2012
InactiveLincoln National Life Insurance Company (The)301382Agent - Life6/22/20077/24/2012
InactiveLincoln National Life Insurance Company (The)301382Agent - Variable Life and Variable Annuities6/22/20077/24/2012
InactiveMetLife Investors Insurance Company301872Agent - Health7/5/200711/14/2014
InactiveMetLife Investors Insurance Company301872Agent - Life7/5/200711/14/2014
InactiveMetLife Investors Insurance Company301872Agent - Variable Life and Variable Annuities7/5/200711/14/2014
InactiveMetLife Investors USA Insurance Company300845Agent - Health7/3/200711/14/2014
InactiveMetLife Investors USA Insurance Company300845Agent - Life7/3/200711/14/2014
InactiveMetLife Investors USA Insurance Company300845Agent - Variable Life and Variable Annuities7/3/200711/14/2014
InactiveMetLife Life and Annuity Company of Connecticut301593Agent - Health7/5/200712/7/2007
InactiveMetLife Life and Annuity Company of Connecticut301593Agent - Life7/5/200712/7/2007
InactiveMetLife Life and Annuity Company of Connecticut301593Agent - Variable Life and Variable Annuities7/5/200712/7/2007
InactiveNationwide Life Insurance Company300495Agent - Health11/6/201312/15/2014
InactiveNationwide Life Insurance Company300495Agent - Life11/6/201312/15/2014
InactiveNationwide Life Insurance Company300495Agent - Variable Life and Variable Annuities11/6/201312/15/2014
InactiveNew England Life Insurance Company300343Agent - Health7/5/200712/12/2009
InactiveNew England Life Insurance Company300343Agent - Life7/5/200712/12/2009
InactiveNew England Life Insurance Company300343Agent - Variable Life and Variable Annuities7/5/200712/12/2009
InactivePacific Life Insurance Company301848Agent - Life10/10/20063/14/2017
InactivePacific Life Insurance Company301848Agent - Variable Life and Variable Annuities10/10/20063/14/2017
InactivePruco Life Insurance Company300954Agent - Health7/9/200712/23/2014
InactivePruco Life Insurance Company300954Agent - Life7/9/200712/23/2014
InactivePruco Life Insurance Company300954Agent - Variable Life and Variable Annuities7/9/200712/23/2014
InactiveSun Life Assurance Company of Canada301811Agent - Health9/26/200611/23/2010
InactiveSun Life Assurance Company of Canada301811Agent - Life9/26/200611/12/2007
InactiveSunAmerica Annuity and Life Assurance Company301930Agent - Life4/20/20099/28/2012
InactiveSunAmerica Annuity and Life Assurance Company301930Agent - Variable Life and Variable Annuities4/20/20099/28/2012
InactiveTalcott Resolution Life Insurance Company301759Agent - Health2/28/200711/16/2011
InactiveTalcott Resolution Life Insurance Company301759Agent - Life2/28/200711/16/2011
InactiveTalcott Resolution Life Insurance Company301759Agent - Variable Life and Variable Annuities2/28/200711/16/2011
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Health7/25/201211/18/2014
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Life7/25/201211/18/2014
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Variable Life and Variable Annuities7/25/201211/18/2014
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveLPL FINANCIAL LLC399327Agent - Life4/9/20131/31/2020
InactiveLPL FINANCIAL LLC399327Agent - Health4/9/20131/31/2020
InactiveLPL FINANCIAL LLC399327Agent - Variable Life and Variable Annuities4/9/20131/31/2020
InactiveLinsco/Private Ledger Insurance Associates, Inc.400524Agent - Life4/12/20131/31/2020
InactiveLinsco/Private Ledger Insurance Associates, Inc.400524Agent - Health4/12/20131/31/2020

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