DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Gould, Thomas	DOIID	979140	NAIC NPN	18225132

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	12/14/2017		11/30/2025
Active	Non Resident	Agent	Health	12/14/2017		11/30/2025
* 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	UNUM Life Insurance Company of America	300817	Agent - Health	3/1/2019	10/8/2021
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	3/1/2019	10/8/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Gallagher Affinity Insurance Services, Inc.	397758	Agent - Health
Denied	Gallagher Affinity Insurance Services, Inc.	397758	Agent - Life