DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Evelyn, Kenneth	DOIID	560130	NAIC NPN	814141

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	12/2/2002	8/31/2009
Inactive	Non Resident	Agent	Health	12/2/2002	8/31/2009
* 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	Berkshire Life Insurance Company of America	300983	Agent - Health	5/15/2006	8/31/2009
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	5/15/2006	8/31/2009
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	5/15/2006	8/31/2009
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	5/15/2006	8/31/2009
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	9/20/2004	8/31/2009
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	9/20/2004	8/31/2009
Inactive	Reliance Standard Life Insurance Company	300584	Agent - Health	8/11/2003	8/31/2009
Inactive	Reliance Standard Life Insurance Company	300584	Agent - Life	8/11/2003	8/31/2009
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Health	9/20/2004	7/28/2009
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Life	9/20/2004	7/28/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Gallagher Benefit Services Inc	525782	Agent - Health	2/15/2007	8/31/2009
Inactive	Gallagher Benefit Services Inc	525782	Agent - Life	2/15/2007	8/31/2009