DEPARTMENT OF INSURANCE

Affiliations

Name	Sackett, Matthew T	DOIID	500061	NAIC NPN	1494683

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	12/10/2010	1/31/2019
Inactive	Non Resident	Agent	Casualty	8/15/2000	1/31/2019
Inactive	Non Resident	Agent	Life	12/10/2010	1/31/2019
Inactive	Non Resident	Agent	General Lines	2/4/2000	8/15/2000
Inactive	Non Resident	Agent	Property	8/15/2000	1/31/2019
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	5/16/2008	6/9/2016
* 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	ACE American Insurance Company	300625	Agent - Casualty	6/3/2003	4/7/2005
Inactive	ACE American Insurance Company	300625	Agent - Property	6/3/2003	4/7/2005
Inactive	Fidelity and Guaranty Insurance Company	301009	Agent - Casualty	8/15/2000	5/24/2004
Inactive	Fidelity and Guaranty Insurance Company	301009	Agent - General Lines	2/4/2000	8/15/2000
Inactive	Fidelity and Guaranty Insurance Company	301009	Agent - Property	8/15/2000	5/24/2004
Inactive	Fidelity and Guaranty Insurance Underwriters Inc.	300559	Agent - Casualty	8/15/2000	5/24/2004
Inactive	Fidelity and Guaranty Insurance Underwriters Inc.	300559	Agent - General Lines	2/4/2000	8/15/2000
Inactive	Fidelity and Guaranty Insurance Underwriters Inc.	300559	Agent - Property	8/15/2000	5/24/2004
Inactive	National Casualty Company	301483	Agent - Casualty	4/1/2010	1/31/2019
Inactive	National Casualty Company	301483	Agent - Property	4/1/2010	1/31/2019
Inactive	Nationwide Life Insurance Company	300495	Agent - Health	2/4/2011	4/15/2016
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	2/4/2011	4/15/2016
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Casualty	2/4/2011	4/15/2016
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Property	2/4/2011	4/15/2016
Inactive	Scottsdale Indemnity Company	300232	Agent - Casualty	4/1/2010	1/31/2019
Inactive	Scottsdale Indemnity Company	300232	Agent - Property	4/1/2010	1/31/2019
Inactive	TravCo Personal Insurance Company	301284	Agent - Casualty	10/10/2002	5/24/2004
Inactive	TravCo Personal Insurance Company	301284	Agent - Property	10/10/2002	5/24/2004
Inactive	United States Fidelity and Guaranty Company	301449	Agent - Casualty	8/15/2000	5/24/2004
Inactive	United States Fidelity and Guaranty Company	301449	Agent - General Lines	2/4/2000	8/15/2000
Inactive	United States Fidelity and Guaranty Company	301449	Agent - Property	8/15/2000	5/24/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	K & K Insurance Group Inc	513466	Agent - Property	3/31/2014	4/5/2016
Inactive	K & K Insurance Group Inc	513466	Agent - Casualty	3/31/2014	4/5/2016
Inactive	K & K Insurance Group Inc	513466	Surplus Lines Broker - Not Applicable	6/13/2011	4/5/2016
Inactive	K & K Insurance Group Inc	513466	Agent - Health	3/31/2014	4/5/2016
Inactive	K & K Insurance Group Inc	513466	Agent - Life	3/31/2014	4/5/2016