DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Shirley, Michael Scott	DOIID	516158	NAIC NPN	2152986

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	10/6/2000	1/31/2010
Inactive	Non Resident	Agent	Life	10/6/2000	1/31/2010
* 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	Athene Annuity & Life Assurance Company	301798	Agent - Life	2/5/2008	1/31/2010
Inactive	Chase Insurance Life Company	301287	Agent - Health	10/6/2000	5/22/2006
Inactive	Chase Insurance Life Company	301287	Agent - Life	10/6/2000	5/22/2006
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	2/14/2005	5/22/2006
Inactive	Fidelity Life Association, A Legal Reserve Life Insurance Company	300774	Agent - Life	10/23/2006	5/6/2009
Inactive	Globe Life and Accident Insurance Company	300639	Agent - Health	5/25/2004	6/23/2006
Inactive	Globe Life and Accident Insurance Company	300639	Agent - Life	5/25/2004	6/23/2006
Inactive	Pruco Life Insurance Company	300954	Agent - Health	11/7/2007	11/5/2009
Inactive	Pruco Life Insurance Company	300954	Agent - Life	11/7/2007	11/5/2009
Inactive	Revol One Insurance Company	300681	Agent - Health	3/3/2008	12/9/2009
Inactive	Revol One Insurance Company	300681	Agent - Life	3/3/2008	12/9/2009
Inactive	United American Insurance Company	300910	Agent - Health	5/13/2004	6/4/2004
Inactive	United American Insurance Company	300910	Agent - Life	5/13/2004	6/4/2004
Inactive	United Investors Life Insurance Company	301873	Agent - Life	5/13/2004	6/4/2004
Inactive	Zurich American Life Insurance Company	300216	Agent - Life	7/30/2001	1/31/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	America Direct Ins Agency Inc	619155	Agent - Life	1/23/2007	5/12/2009
Denied	America Direct Ins Agency Inc	619155	Agent - Health