DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Forrest, Tiffany L	DOIID	871909	NAIC NPN	10170424

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	3/12/2015	9/30/2023
Inactive	Non Resident	Agent	Life	3/12/2015	9/30/2023
* 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	Hartford Life and Accident Insurance Company	300878	Agent - Health	6/30/2015	10/30/2023
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	6/30/2015	10/30/2023
Inactive	Lincoln Life Assurance Company of Boston	301915	Agent - Health	6/17/2015	10/10/2019
Inactive	Lincoln Life Assurance Company of Boston	301915	Agent - Life	6/17/2015	10/10/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aon Insurance Agency LLC	516101	Agent - Life	5/12/2017	9/30/2023
Inactive	Aon Insurance Agency LLC	516101	Agent - Health	5/12/2017	9/30/2023