DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Forge Consulting LLC	DOIID	567353	NAIC NPN	7613051

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	3/10/2008		3/31/2028
Denied	Non Resident	Agent	Health
* 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
Active	Allianz Life Insurance Company of North America	301791	Agent - Life	7/15/2014
Active	American National Insurance Company	301861	Agent - Life	8/7/2009
Inactive	Athene Annuity & Life Assurance Company	301798	Agent - Life	7/13/2012	8/13/2015
Inactive	Athene Annuity and Life Company	301893	Agent - Life	10/20/2008	1/5/2011
Inactive	Berkshire Hathaway Life Insurance Company of Nebraska	300764	Agent - Life	1/2/2019	5/1/2026
Inactive	Brighthouse Life Insurance Company	301829	Agent - Life	4/8/2013	11/13/2018
Inactive	EquiTrust Life Insurance Company	502870	Agent - Life	7/2/2020	5/8/2024
Inactive	Genworth Life Insurance Company	300623	Agent - Life	9/11/2008	12/3/2019
Active	Integrity Life Insurance Company	301687	Agent - Life	6/18/2025
Inactive	Lincoln Life Assurance Company of Boston	301915	Agent - Life	4/12/2011	4/27/2018
Inactive	National Western Life Insurance Company	301515	Agent - Life	2/21/2012	1/24/2023
Active	New York Life Insurance Company	300431	Agent - Life	7/6/2012
Active	Pacific Life Insurance Company	301848	Agent - Life	11/13/2014
Active	Symetra Life Insurance Company	301691	Agent - Life	8/6/2009

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bair, John Theodore	563931	Agent - Life	3/10/2008	2/13/2012
Pending Replacement	Phillips, Henry S	662334	Agent - Life	10/20/2021
Inactive	Schell, Charles T	662459	Agent - Life	2/13/2012	10/20/2021