DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Brummet, Sherry Anne	DOIID	556947	NAIC NPN	2173449

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	9/16/2002	3/31/2006
Inactive	Non Resident	Agent	Life	9/16/2002	3/31/2006
* 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	Central States Health and Life Company of Omaha	301874	Agent - Health	12/6/2002	10/31/2004
Inactive	Central States Health and Life Company of Omaha	301874	Agent - Life	12/6/2002	10/31/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Fraternal Financial Services, Inc.	559781	Agent - Health	12/6/2002	10/31/2004
Inactive	American Fraternal Financial Services, Inc.	559781	Agent - Life	12/6/2002	10/31/2004