DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Pitts, Tyson Michael	DOIID	925680	NAIC NPN	18074857

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	4/17/2018	7/31/2023
Inactive	Resident	Agent	Limited Line Credit	8/23/2016	7/31/2023
* 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	Forethought Life Insurance Company	301407	Agent - Life	9/12/2018	7/31/2023
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Limited Line Credit	9/13/2016	7/31/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	CBIA	527160	Agent - Life
Inactive	Central Bank & Trust Company	398350	Agent - Limited Line Credit	10/12/2016	3/23/2020