DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Gass, Chad Alan	DOIID	746071	NAIC NPN	16131567

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	2/19/2013	11/1/2016
Inactive	Resident	Agent	Life	2/15/2011	11/1/2016
* 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	Modern Woodmen of America	301213	Agent - Life	5/6/2013	7/7/2016
Inactive	Woodmen of the World Life Insurance Society	301446	Agent - Health	2/20/2013	5/9/2013
Inactive	Woodmen of the World Life Insurance Society	301446	Agent - Life	2/18/2011	5/9/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Woodmen Insurance Agency, Inc.	579244	Agent - Life	3/19/2013	6/24/2013
Inactive	Woodmen Insurance Agency, Inc.	579244	Agent - Health	3/19/2013	5/9/2013