DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Haysley, Kelly Taliaferro	DOIID	606499	NAIC NPN	8439694

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Adjuster	Independent	2/14/2006	4/8/2009
Inactive	Resident	Agent	Life	12/5/2008	12/11/2009
Inactive	Resident	Agent	Health	12/5/2008	12/11/2009
Inactive	Resident	Apprentice Adjuster	Not Applicable	4/11/2005	2/14/2006
Denied	Resident	Life & Health Consultant	Not Applicable
* 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	Combined Insurance Company of America	301472	Agent - Health	12/22/2008	7/29/2009
Inactive	Combined Insurance Company of America	301472	Agent - Life	12/22/2008	7/29/2009
Denied	Madison National Life Insurance Company Inc.	301458	Agent - Health
Denied	Madison National Life Insurance Company Inc.	301458	Agent - Life
Inactive	Sterling Life Insurance Company	301947	Agent - Health	12/5/2008	6/26/2009
Inactive	Sterling Life Insurance Company	301947	Agent - Life	12/5/2008	6/26/2009
Inactive	United American Insurance Company	300910	Agent - Health	12/18/2008	12/11/2009
Inactive	United American Insurance Company	300910	Agent - Life	12/18/2008	12/11/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Progressive Casualty Insurance Company	300696	Adjuster - Independent	6/26/2006	4/8/2009

Sponsored By

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Parker, Kristi A	372152	Apprentice Adjuster - Not Applicable	4/11/2005	2/14/2006