DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Insurer Details

NAME	American Fidelity Life Insurance Company
DOI ID	301282
FEIN #	590787372
ALIEN #
State of Domicile	FL
Domicile Country
Merged Into
NAIC #	60429
NAIC Group #	4877
Entity Type	Insurer
Admitted	6/20/1967
AM Best Rating
President	Jack B. Yancey
Process Agent	Carol B. Harrison Date Assigned : 12/4/2014 (See address table below for process agent address)
Authorized Insurer – these insurers are authorized to do the business of insurance by holding a Kentucky Certificate of Authority. Provides insurance coverage.

Line(s) of Authority

Life

Annuity

Type	Address
Agent Licensing Address	4060 Barrancas P.O. Box 4847 Pensacola, FL 32507
Annual Statement	500 South Palafox Street Suite 200 Pensacola, FL 32502
Catastrophe/Disaster Coordinator Address	500 South Palafox Street Suite 200 Pensacola, FL 32502
Company Licenses/Fee Contact Address	500 South Palafox Street Suite 200 Pensacola, FL 32502
Deposits Contact Address	500 South Palafox Street Suite 200 Pensacola, FL 32502
Local Domestic/Foreign State Contact Address	500 South Palafox Street Suite 200 Pensacola, FL 32502
Mailing	500 South Palafox Ste. 200 Pensacola, FL 32502
Premium Tax Address	500 South Palafox Street Suite 200 Pensacola, FL 32502
Process Agent	500 South Palafox Street Pensacola, FL 32502
Regulatory Compliance/Gvmt Relations Contact Address	500 South Palafox Street Suite 200 Pensacola, FL 32502
Statutory Home Office	500 South Palafox Street, Suite 200 Pensacola, FL 32502

Type	Number
Catastrophe/Disaster Coordination Contact - Business / Home Office	(850) 456-7401
Company Licenses/Fees Contact - Business / Home Office	(850) 456-7401
Deposits Contact - Business / Home Office	(850) 456-7401
Local Office in Domestic/Foreign State Contact - Business / Home Office	(850) 456-7401
Regulatory Compliance/Gvmt Relations Contact - Business / Home Office	(850) 456-7401
Business / Home Office	(850) 456-7401
Annual Statement - Fax	(850) 453-5440
Premium Tax Contact - Fax	(850) 453-5440
Catastrophe/Disaster Coordination Contact - Fax	(850) 453-5440
Company Licenses/Fees Contact - Fax	(850) 453-5440
Deposits Contact - Fax	(850) 453-5440
Local Office in Domestic/Foreign State Contact - Fax	(850) 453-5440
Regulatory Compliance/Gvmt Relations Contact - Fax	(850) 453-5440
Licensing - Fax	(850) 453-5440
Fax	(850) 453-5440
Licensing - Agent Licensing Phone	(850) 456-7401
Annual Statement - Annual Statement	(850) 456-7401
Premium Tax Contact - Premium Tax	(850) 456-7401

Type	Internet Information
Licensing - Business Email	shawnk@amfilife.com
Annual Statement - Business Email	bryanw@amfilife.com
Catastrophe/Disaster Coordination Contact - Business Email	rebeccah@amfilife.com
Company Licenses/Fees Contact - Business Email	carolynp@amfilife.com
Deposits Contact - Business Email	carolynp@amfilife.com
Local Office in Domestic/Foreign State Contact - Business Email	carolynp@amfilife.com
Premium Tax Contact - Business Email	carolynp@amfilife.com
Regulatory Compliance/Gvmt Relations Contact - Business Email	rebeccah@amfilife.com