DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Heacock, Tish L	DOIID	567346	NAIC NPN	7651623

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	7/2/2003	4/30/2008
Inactive	Resident	Agent	Limited Line Credit	5/21/2007	4/30/2008
Inactive	Resident	Agent	Life	7/2/2003	4/30/2008
* 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	Jackson National Life Insurance Company	300486	Agent - Life	7/15/2003	5/11/2006
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	7/15/2003	12/16/2004
Inactive	Southern Financial Life Insurance Company	300664	Agent - Limited Line Credit	5/21/2007	4/30/2008
Inactive	Western National Life Insurance Company	300461	Agent - Life	7/9/2003	5/24/2006
Inactive	Western-Southern Life Assurance Company	301590	Agent - Health	7/8/2003	4/30/2008
Inactive	Western-Southern Life Assurance Company	301590	Agent - Life	7/8/2003	4/30/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Fifth Third Insurance Agency Inc	399341	Agent - Life	4/27/2004	4/30/2008