DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Gray, Tabitha Dawn	DOIID	627082	NAIC NPN	8734192

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Limited Line Credit	2/27/2006	1/31/2011
Inactive	Non Resident	Agent	Life	6/5/2007	1/31/2011
* 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	2/27/2006	2/26/2008
Inactive	Empower Annuity Insurance Company of America	300259	Agent - Life	8/22/2007	1/31/2011
Inactive	Western National Life Insurance Company	300461	Agent - Life	6/13/2007	1/31/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Fort Campbell Federal Credit Union	630295	Agent - Limited Line Credit	4/18/2006	3/5/2007