DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Burchett, Shawn C	DOIID	809506	NAIC NPN	16955133

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	5/21/2013	10/1/2016
Inactive	Resident	Agent	Life	5/21/2013	10/1/2016
* 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	Woodmen of the World Life Insurance Society	301446	Agent - Health	5/24/2013	11/13/2013
Inactive	Woodmen of the World Life Insurance Society	301446	Agent - Life	5/24/2013	11/13/2013

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	10/1/2013	11/13/2013
Inactive	Woodmen Insurance Agency, Inc.	579244	Agent - Health	10/1/2013	11/13/2013