DEPARTMENT OF INSURANCE

Affiliations

Name	Peterson, Jeffrey Clark	DOIID	721338	NAIC NPN	6740637

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	1/19/2010	9/30/2014
Inactive	Non Resident	Agent	Variable Life and Variable Annuities	1/19/2010	9/30/2014
* 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.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Standard Insurance Company	300185	Agent - Life	1/19/2010	9/30/2014
Inactive	Standard Insurance Company	300185	Agent - Variable Life and Variable Annuities	1/19/2010	9/30/2014
Inactive	Western Reserve Life Assurance Company of Ohio	300760	Agent - Life	11/12/2010	1/28/2013
Inactive	Western Reserve Life Assurance Company of Ohio	300760	Agent - Variable Life and Variable Annuities	11/12/2010	1/28/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Concourse Financial Group Securities, Inc.	554596	Agent - Variable Life and Variable Annuities	1/19/2010	10/1/2014