DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Petigny, Gerson	DOIID	975499	NAIC NPN	17672212

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	8/30/2021	2/28/2023
Inactive	Non Resident	Agent	Life	8/30/2021	2/28/2023
* 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	Allianz Life Insurance Company of North America	301791	Agent - Life	5/13/2022	2/28/2023
Inactive	American Financial Security Life Insurance Co.	301635	Agent - Health	11/27/2017	2/12/2019
Inactive	Federal Insurance Company	301144	Agent - Health	12/21/2017	2/28/2021
Inactive	Golden Rule Insurance Company	301943	Agent - Health	9/16/2021	3/14/2022
Inactive	Golden Rule Insurance Company	301943	Agent - Life	9/16/2021	3/14/2022
Inactive	LifeShield National Insurance Company	737111	Agent - Health	10/25/2018	2/28/2021
Inactive	S.USA Life Insurance Company, Inc.	301774	Agent - Life	8/21/2018	4/29/2020
Inactive	Unified Life Insurance Company	543169	Agent - Health	12/27/2018	7/7/2020
Inactive	Washington National Insurance Company	300587	Agent - Health	4/27/2020	2/28/2021
Inactive	Washington National Insurance Company	300587	Agent - Life	4/27/2020	2/28/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Life	8/21/2018	2/28/2021
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Health	5/11/2018	2/28/2021