DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Shaffer, Nicole Christine	DOIID	594733	NAIC NPN	8214131

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Denied	Resident	Agent	Health
Inactive	Resident	Agent	Limited Line Credit	5/19/2008	4/14/2009
Inactive	Resident	Agent	Life	11/15/2004	7/1/2006
* 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	CMFG Life Insurance Company	300929	Agent - Limited Line Credit	5/19/2008	4/14/2009
Inactive	Everlake Life Insurance Company	300873	Agent - Life	3/1/2005	10/12/2005
Inactive	Jackson National Life Insurance Company	300486	Agent - Life	12/15/2004	10/19/2005
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	12/13/2004	11/12/2005
Inactive	Western National Life Insurance Company	300461	Agent - Life	12/10/2004	10/18/2005
Inactive	Western-Southern Life Assurance Company	301590	Agent - Life	12/9/2004	10/11/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bluegrass Community Federal Credit Union	646826	Agent - Limited Line Credit	5/22/2008	4/14/2009