DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Head, Michael Kelley	DOIID	606234	NAIC NPN	6662628

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	3/31/2005	3/31/2012
Inactive	Non Resident	Agent	Life	3/31/2005	3/31/2012
* 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	8/10/2005	3/31/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	JNL Southeast Agency, LLC	605678	Agent - Life	8/29/2005	3/31/2012