DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Derossitt, Gary W	DOIID	377047	NAIC NPN	1891390

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Credit Life & Health	5/12/1995	12/13/1999
* 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	Protective Life Insurance Company	300638	Agent - Credit Life & Health	5/12/1995	12/31/1998
Inactive	Protective Life Insurance Company of Kentucky	300663	Agent - Credit Life & Health	3/6/1997	12/13/1999

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Oxmoor Auto Inc.	399828	Agent - Credit Life & Health	6/26/1995	7/15/1996