DEPARTMENT OF INSURANCE

Affiliations

Name	Smith, Jackie Wayne	DOIID	375252	NAIC NPN	548588

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Administrator	Not Applicable	3/25/1999	11/30/2015
Denied	Resident	Agent	Health
Denied	Resident	Agent	Life
Inactive	Resident	Agent	Health Maintenance Organization	8/17/1999	3/1/2001
Inactive	Resident	Agent	Casualty	8/12/2016	12/1/2017
Inactive	Resident	Agent	Property	8/12/2016	12/1/2017
Inactive	Resident	Agent	General Lines	3/2/1993	8/15/2000
Inactive	Resident	Surplus Lines Broker	Not Applicable	8/12/2016	11/30/2017
* 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	Acceptance Insurance Company	300211	Agent - General Lines	12/21/1998	3/31/2000
Inactive	Aegis Security Insurance Company	300492	Agent - General Lines	7/1/1994	3/31/1998
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	6/15/1998	12/1/2015
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	6/15/1998	12/1/2015
Inactive	American Bankers Insurance Company of Florida	300360	Agent - Casualty	8/2/2006	12/1/2015
Inactive	American Bankers Insurance Company of Florida	300360	Agent - Property	8/2/2006	12/1/2015
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	2/3/1995	12/14/2015
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	2/3/1995	12/14/2015
Inactive	American Home Assurance Company	300246	Agent - Casualty	8/15/2000	7/12/2004
Inactive	American Home Assurance Company	300246	Agent - General Lines	11/27/1996	8/15/2000
Inactive	American Home Assurance Company	300246	Agent - Property	8/15/2000	7/12/2004
Inactive	American Reliable Insurance Company	301889	Agent - Casualty	7/20/2009	12/1/2015
Inactive	American Reliable Insurance Company	301889	Agent - Property	7/20/2009	12/1/2015
Inactive	Anthem Life Insurance Company	301209	Agent - Health	10/1/1996	12/1/2015
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/1/1996	12/1/2015
Inactive	Capitol Indemnity Corporation	301030	Agent - Casualty	5/18/2010	12/1/2015
Inactive	Capitol Indemnity Corporation	301030	Agent - Property	5/18/2010	12/1/2015
Inactive	Connecticut Surety Company (The)	300802	Agent - Casualty	8/15/2000	3/31/2002
Inactive	Connecticut Surety Company (The)	300802	Agent - General Lines	3/24/1999	8/15/2000
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	3/18/2002	7/20/2005
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Property	3/18/2002	7/20/2005
Inactive	First Financial Insurance Company	301951	Agent - Casualty	5/23/2002	12/1/2015
Inactive	First Financial Insurance Company	301951	Agent - Property	5/23/2002	12/1/2015
Inactive	Frontier Insurance Company	300528	Agent - Casualty	8/15/2000	3/31/2002
Inactive	Frontier Insurance Company	300528	Agent - General Lines	12/21/1999	8/15/2000
Inactive	Frontier Insurance Company	300528	Agent - Property	8/15/2000	3/31/2002
Inactive	Golden Rule Insurance Company	301943	Agent - Health	1/28/1993	12/16/2015
Inactive	Golden Rule Insurance Company	301943	Agent - Life	1/28/1993	12/16/2015
Inactive	Great American Insurance Company	301586	Agent - Casualty	8/15/2000	4/3/2003
Inactive	Great American Insurance Company	301586	Agent - General Lines	12/31/1998	8/15/2000
Inactive	Great American Insurance Company	301586	Agent - Property	8/15/2000	4/3/2003
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/1/2001	9/8/2010
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	8/17/1999	3/1/2001
Inactive	Humana Insurance Company	301104	Agent - Health	7/29/1999	9/8/2010
Inactive	Humana Insurance Company	301104	Agent - Life	7/29/1999	9/8/2010
Inactive	Illinois National Insurance Company	301367	Agent - Casualty	5/2/2003	7/12/2004
Inactive	Illinois National Insurance Company	301367	Agent - Property	5/2/2003	7/12/2004
Inactive	Infinity Casualty Insurance Company	301280	Agent - General Lines	3/2/1993	7/28/2000
Inactive	John Alden Life Insurance Company	300573	Agent - Health	6/5/2007	12/29/2010
Inactive	John Alden Life Insurance Company	300573	Agent - Life	6/5/2007	12/29/2010
Inactive	Kanawha Insurance Company	300127	Agent - Health	4/11/2008	9/8/2010
Inactive	Kanawha Insurance Company	300127	Agent - Life	4/11/2008	9/8/2010
Inactive	LifeUSA Insurance Company	300386	Agent - Health	7/3/1998	8/2/2002
Inactive	LifeUSA Insurance Company	300386	Agent - Life	7/3/1998	8/2/2002
Inactive	Medical Protective Company (The)	301207	Agent - Casualty	6/9/2003	12/1/2015
Inactive	Medical Protective Company (The)	301207	Agent - Property	6/9/2003	12/1/2015
Inactive	Metropolitan General Insurance Company	300709	Agent - Casualty	8/15/2000	7/20/2005
Inactive	Metropolitan General Insurance Company	300709	Agent - General Lines	8/19/1998	8/15/2000
Inactive	Metropolitan General Insurance Company	300709	Agent - Property	8/15/2000	7/20/2005
Inactive	National Casualty Company	301483	Agent - Casualty	8/15/2000	11/17/2003
Inactive	National Casualty Company	301483	Agent - General Lines	12/9/1996	8/15/2000
Inactive	National Casualty Company	301483	Agent - Property	8/15/2000	11/17/2003
Inactive	National Guardian Life Insurance Company	300596	Agent - Health	8/14/1996	3/31/1999
Inactive	National Guardian Life Insurance Company	300596	Agent - Life	8/14/1996	3/31/1999
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Casualty	8/15/2000	7/12/2004
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - General Lines	11/27/1996	8/15/2000
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Property	8/15/2000	7/12/2004
Inactive	Ohio State Life Insurance Company (The)	300865	Agent - Health	10/13/1994	4/23/1997
Inactive	Ohio State Life Insurance Company (The)	300865	Agent - Life	10/13/1994	4/23/1997
Inactive	Old Republic Insurance Company	301225	Agent - Casualty	1/12/2008	12/28/2015
Inactive	Old Republic Insurance Company	301225	Agent - Property	1/12/2008	12/28/2015
Inactive	Omni Insurance Company	301545	Agent - General Lines	8/5/1998	3/31/2000
Inactive	Penn Mutual Life Insurance Company	301394	Agent - Health	7/28/1992	12/12/2012
Inactive	Penn Mutual Life Insurance Company	301394	Agent - Life	7/28/1992	12/12/2012
Inactive	Platte River Insurance Company	301089	Agent - Casualty	5/18/2010	12/1/2015
Inactive	Platte River Insurance Company	301089	Agent - Property	5/18/2010	12/1/2015
Inactive	Redland Insurance Company	300687	Agent - Casualty	8/15/2000	12/13/2002
Inactive	Redland Insurance Company	300687	Agent - General Lines	1/29/1997	8/15/2000
Inactive	Redland Insurance Company	300687	Agent - Property	8/15/2000	12/13/2002
Inactive	Scottsdale Indemnity Company	300232	Agent - General Lines	12/9/1996	5/27/1997
Inactive	Selective Insurance Company of the Southeast	300381	Agent - Casualty	3/10/2009	12/1/2015
Inactive	Selective Insurance Company of the Southeast	300381	Agent - Property	3/10/2009	12/1/2015
Inactive	Sentry Select Insurance Company	301648	Agent - Casualty	2/19/2003	9/23/2008
Inactive	Sentry Select Insurance Company	301648	Agent - Property	2/19/2003	9/23/2008
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	2/8/2010	2/12/2014
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	2/8/2010	2/12/2014
Inactive	Trumbull Insurance Company	300242	Agent - Casualty	8/15/2000	11/5/2008
Inactive	Trumbull Insurance Company	300242	Agent - General Lines	8/5/1998	8/15/2000
Inactive	Trumbull Insurance Company	300242	Agent - Property	8/15/2000	11/5/2008
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	8/18/2015	12/16/2015
Inactive	Washington National Insurance Company	300587	Agent - Health	11/8/2010	11/29/2010
Inactive	Washington National Insurance Company	300587	Agent - Life	11/8/2010	11/29/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	6/25/1996	6/23/2008
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	6/25/1996	6/23/2008
Inactive	Designated Agent Company Inc.	681257	Agent - Life	6/27/2008	12/1/2015
Inactive	Designated Agent Company Inc.	681257	Agent - Health	6/27/2008	12/1/2015
Inactive	PBS Insurance Underwriting Corp	401286	Agent - General Lines	8/6/1998	8/15/2000
Inactive	PBS Insurance Underwriting Corp	401286	Surplus Lines Broker - Not Applicable	6/29/2006	11/30/2015
Inactive	PBS Insurance Underwriting Corp	401286	Administrator - Not Applicable	3/25/1999	11/30/2015
Denied	PBS Insurance Underwriting Corp	401286	Agent - Casualty
Denied	PBS Insurance Underwriting Corp	401286	Agent - Property
Inactive	Ryan Insurance, Inc.	399446	Agent - Life	4/8/1993	12/1/2015
Inactive	Ryan Insurance, Inc.	399446	Agent - Health	4/8/1993	12/1/2015
Inactive	Ryan Insurance, Inc.	399446	Agent - Casualty	8/17/2005	12/1/2015
Inactive	Ryan Insurance, Inc.	399446	Agent - Property	8/17/2005	12/1/2015