DEPARTMENT OF INSURANCE

Affiliations

Name	Tackett, Jack David	DOIID	374425	NAIC NPN	7202156

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Life	4/20/1999	10/1/2022
Inactive	Resident	Agent	Health	4/20/1999	10/1/2022
Inactive	Resident	Temporary Agent	Ordinary Life (Temporary Life)	3/24/1999	4/20/1999
* 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	10/15/2010	10/10/2022
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	10/15/2010	10/10/2022
Inactive	Assurity Life Insurance Company	301099	Agent - Health	6/26/2009	11/5/2010
Inactive	Assurity Life Insurance Company	301099	Agent - Life	6/26/2009	11/5/2010
Inactive	Athene Annuity & Life Assurance Company of New York	300724	Agent - Life	10/2/2000	3/23/2012
Inactive	Central States Health and Life Company of Omaha	301874	Agent - Health	6/18/2001	12/16/2004
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	8/24/2011	6/15/2018
Inactive	CompBenefits Insurance Company	301864	Agent - Health	10/10/2012	7/2/2013
Inactive	CompBenefits Insurance Company	301864	Agent - Life	10/10/2012	7/2/2013
Inactive	Continental General Insurance Company	300691	Agent - Health	6/26/2000	12/6/2006
Inactive	Continental General Insurance Company	300691	Agent - Life	6/26/2000	12/6/2006
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	8/25/2011	6/15/2018
Inactive	Everly Life Insurance Company	561641	Agent - Life	12/12/2016	11/14/2018
Inactive	Gerber Life Insurance Company	300529	Agent - Health	8/27/2018	10/1/2022
Inactive	Gerber Life Insurance Company	300529	Agent - Life	8/27/2018	10/1/2022
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/12/2012	2/23/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	8/24/2011	6/15/2018
Inactive	Humana Insurance Company	301104	Agent - Health	8/23/2011	10/1/2022
Inactive	Humana Insurance Company	301104	Agent - Life	8/23/2011	10/1/2022
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	8/24/2011	6/15/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	8/24/2011	6/15/2018
Inactive	HumanaDental Insurance Company	301457	Agent - Health	4/27/2012	12/19/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	4/27/2012	12/19/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	11/10/2011	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	11/10/2011	10/22/2015
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	8/1/2013	4/27/2018
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	8/1/2013	4/27/2018
Inactive	Modern Woodmen of America	301213	Agent - Life	4/25/2001	10/8/2021
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	7/18/2005	12/15/2011
Inactive	Omaha Insurance Company	751908	Agent - Health	3/19/2014	1/22/2015
Inactive	Physicians Mutual Insurance Company	301084	Agent - Health	5/3/2004	5/7/2007
Inactive	Time Insurance Company	300683	Agent - Health	1/18/2006	12/28/2006
Inactive	Time Insurance Company	300683	Agent - Life	1/18/2006	12/28/2006
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	1/19/2001	6/23/2004
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	4/20/1999	5/14/2001
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	4/20/1999	5/14/2001
Inactive	Transamerica Premier Life Insurance Company	300558	Temporary Agent - Ordinary Life (Temporary Life)	3/24/1999	4/20/1999
Inactive	United Home Life Insurance Company	300421	Agent - Life	11/11/2019	11/19/2020
Inactive	United World Life Insurance Company	300532	Agent - Health	1/25/2021	12/22/2021
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	7/18/2005	12/15/2011
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	7/18/2005	12/15/2011
Inactive	Western and Southern Life Insurance Company	301744	Agent - Life	10/7/2004	5/8/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/13/2013	10/1/2022
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/13/2013	10/1/2022
Inactive	MWAGIA, Inc	549166	Agent - Life	2/28/2005	10/1/2022
Inactive	MWAGIA, Inc	549166	Agent - Health	2/28/2005	10/1/2022
Inactive	Medlink Inc	400721	Agent - Life	7/9/2009	10/1/2022
Inactive	Medlink Inc	400721	Agent - Health	7/9/2009	10/1/2022