DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Burgess, Terry	DOIID	874118	NAIC NPN	17550719

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	9/27/2016	5/1/2018
* 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
Inactive	American-Amicable Life Insurance Co. of Texas	300257	Agent - Life	5/13/2015	4/27/2016
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Life	5/7/2015	5/1/2016
Inactive	Athene Annuity and Life Company	301893	Agent - Life	11/28/2016	3/21/2018
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	12/6/2016	5/1/2018
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	1/13/2017	5/1/2018
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	1/26/2017	12/22/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Legato Ins Group Inc	813891	Agent - Life	5/7/2015	5/1/2016