DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Crooks, Randy	DOIID	889193	NAIC NPN	17516160

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	8/31/2015		10/31/2024
Active	Non Resident	Agent	Health	8/31/2015		10/31/2024
Inactive	Non Resident	Agent	Property	8/25/2016	7/21/2023
Inactive	Non Resident	Agent	Casualty	8/25/2016	7/21/2023
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	08/15/2024	10/31/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Continental American Insurance Company	301700	Agent - Health	9/29/2015
Active	Continental American Insurance Company	301700	Agent - Life	9/29/2015
Inactive	National Casualty Company	301483	Agent - Casualty	9/16/2016	7/21/2023
Inactive	National Casualty Company	301483	Agent - Property	9/16/2016	7/21/2023
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	10/22/2015	9/23/2019
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	10/22/2015	9/23/2019
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	10/22/2015	9/23/2019
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	10/22/2015	9/23/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Aptia Insurance Services Group LLC	1283785	Agent - Health	3/22/2024
Active	Aptia Insurance Services Group LLC	1283785	Agent - Life	3/22/2024
Inactive	DVM Insurance Agency	636779	Agent - Property	12/5/2016	7/21/2023
Inactive	DVM Insurance Agency	636779	Agent - Casualty	12/5/2016	7/21/2023
Active	Mercer Health & Benefits Administration LLC	656414	Agent - Health	1/15/2019
Active	Mercer Health & Benefits Administration LLC	656414	Agent - Life	1/15/2019
Inactive	Mercer Health & Benefits Administration LLC	656414	Agent - Property	1/15/2019	7/21/2023
Inactive	Mercer Health & Benefits Administration LLC	656414	Agent - Casualty	1/15/2019	7/21/2023