DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Shea, Kim T	DOIID	370408	NAIC NPN	1484944

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	2/13/1992	7/1/2002
Inactive	Resident	Agent	Health	2/13/1992	7/1/2002
Inactive	Resident	Life & Health Consultant	Not Applicable	2/7/1997	3/9/1999
* 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	9/13/1994	10/15/1998
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	9/13/1994	10/15/1998
Inactive	Paul Revere Life Insurance Company	300971	Agent - Health	12/27/1993	7/1/2002
Inactive	Paul Revere Life Insurance Company	300971	Agent - Life	12/27/1993	7/1/2002
Inactive	Principal Life Insurance Company	300129	Agent - Health	11/21/1994	7/1/2002
Inactive	Principal Life Insurance Company	300129	Agent - Life	11/21/1994	7/1/2002
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Health	5/20/1996	12/21/1998
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Life	5/20/1996	12/21/1998

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Qualified Plan Services Inc.	400090	Agent - Life	2/13/1992	7/1/2002
Inactive	Qualified Plan Services Inc.	400090	Agent - Health	2/13/1992	7/1/2002