DEPARTMENT OF INSURANCE

Affiliations

Name	Branch, Martin Keith	DOIID	624918	NAIC NPN	3771415

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Variable Life and Variable Annuities	2/18/2015	7/31/2024
Active	Non Resident	Agent	Life	2/4/2015	7/31/2024
Active	Non Resident	Agent	Health	2/4/2015	7/31/2024
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	05/15/2024	07/31/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	2/10/2015	12/27/2017
Active	Allianz Life Insurance Company of North America	301791	Agent - Life	4/7/2021
Active	Allianz Life Insurance Company of North America	301791	Agent - Variable Life and Variable Annuities	3/24/2021
Inactive	American Heritage Life Insurance Company	300272	Agent - Health	7/19/2006	6/23/2008
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	4/13/2006	6/23/2008
Inactive	Pacific Life Insurance Company	301848	Agent - Life	10/25/2007	7/31/2008
Inactive	Pacific Life Insurance Company	301848	Agent - Variable Life and Variable Annuities	11/5/2007	7/31/2008
Inactive	Union Security Insurance Company	301844	Agent - Life	5/19/2006	7/31/2008
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Life	11/12/2007	7/31/2008
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Variable Life and Variable Annuities	11/12/2007	7/31/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Concourse Financial Group Securities, Inc.	554596	Agent - Life
Denied	Concourse Financial Group Securities, Inc.	554596	Agent - Variable Life and Variable Annuities