DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Van Klaveren, Ross Michael	DOIID	660060	NAIC NPN	8605838

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	7/21/2007	7/31/2020
Inactive	Non Resident	Agent	Health	7/21/2007	7/31/2020
* 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	Allianz Life Insurance Company of North America	301791	Agent - Life	7/29/2020	7/31/2020
Inactive	Brighthouse Life Insurance Company	301829	Agent - Life	2/22/2019	7/31/2020
Inactive	Empower Annuity Insurance Company of America	300259	Agent - Life	2/21/2019	7/31/2020
Inactive	USAA Life Insurance Company	300734	Agent - Health	8/24/2007	2/19/2019
Inactive	USAA Life Insurance Company	300734	Agent - Life	8/24/2007	2/19/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Merrill Lynch Life Agency Inc.	400527	Agent - Life	2/21/2019	7/31/2020
Denied	Merrill Lynch Life Agency Inc.	400527	Agent - Health
Inactive	USAA Financial Planning Services Ins Agency Inc	579485	Agent - Life	12/8/2008	2/19/2019
Inactive	USAA Financial Planning Services Ins Agency Inc	579485	Agent - Health	12/8/2008	2/19/2019