DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Balcerzak, Evanna Leigh	DOIID	705959	NAIC NPN	13957706

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Limited Line Credit	5/14/2009		10/31/2026
Active	Resident	Agent	Life	9/14/2015		10/31/2026
* 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	Investors Heritage Life Insurance Company	300363	Agent - Limited Line Credit	5/14/2009	4/12/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	CBIA	527160	Agent - Life
Inactive	Central Bank & Trust Company	398350	Agent - Limited Line Credit	5/28/2009	3/23/2020