DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Velasquez, Kelley Eugene	DOIID	799660	NAIC NPN	16828425

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	3/26/2024		5/31/2026
Inactive	Non Resident	Agent	Health	12/15/2012	5/31/2018
* 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
Active	Allianz Life Insurance Company of North America	301791	Agent - Life	5/13/2024
Inactive	MassMutual Ascend Life Insurance Company	300320	Agent - Life	10/20/2016	2/15/2017
Active	Nassau Life and Annuity Company	513671	Agent - Life	6/4/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Joshua David Mellberg LLC	859326	Agent - Life