DEPARTMENT OF INSURANCE

Name	Siepamann Borges Da Silva, Kim	DOIID	1214964	NAIC NPN	20375572

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Pending Replacement	Non Resident	Agent	Health	7/6/2022		6/30/2025
Pending Replacement	Non Resident	Agent	Life	7/6/2022		6/30/2025

*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	04/15/2025	06/30/2025

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date. Licensees subject to CE must complete CE requirements before Next Compliance Date in order to successfully complete the License Renewal Process.

Address Information

Type	Address
Business / Home Office	910 Houston St Apt 303 Fort Worth, TX 761026231
Residence	Not Public Information

Internet Information

Type	Address
Business Email	kimkim_kevin@hotmail.com

Phone Information

Type	Phone
Business / Home Office	(719) 406-5831