DEPARTMENT OF INSURANCE
Affiliations
NameElliott, William ForstDOIID599440NAIC NPN1792887
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveNon ResidentAgentLife12/3/20049/30/2021 
InactiveNon ResidentAgentHealth12/3/20049/30/2021 
InactiveNon ResidentAgentVariable Life and Variable Annuities12/3/20049/30/2021 
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAllianz Life Insurance Company of North America301791Agent - Health9/27/201112/23/2013
InactiveAllianz Life Insurance Company of North America301791Agent - Life9/27/201112/23/2013
InactiveAllianz Life Insurance Company of North America301791Agent - Variable Life and Variable Annuities9/27/201112/23/2013
InactiveAmerican National Insurance Company301861Agent - Health8/22/20065/27/2021
InactiveAmerican National Insurance Company301861Agent - Life8/22/20069/30/2021
InactiveBrighthouse Life Insurance Company301829Agent - Health5/8/20199/30/2021
InactiveBrighthouse Life Insurance Company301829Agent - Life5/8/20199/30/2021
InactiveBrighthouse Life Insurance Company301829Agent - Variable Life and Variable Annuities5/8/20199/30/2021
InactiveCMFG Life Insurance Company300929Agent - Health9/19/20075/7/2019
InactiveCMFG Life Insurance Company300929Agent - Life9/19/20075/7/2019
InactiveCMFG Life Insurance Company300929Agent - Variable Life and Variable Annuities9/19/20075/7/2019
InactiveCUNA Mutual Life Insurance Company301467Agent - Health3/6/200612/31/2007
InactiveCUNA Mutual Life Insurance Company301467Agent - Life3/6/200612/31/2007
InactiveCUNA Mutual Life Insurance Company301467Agent - Variable Life and Variable Annuities3/6/200612/31/2007
InactiveDelaware Life Insurance Company301256Agent - Life9/22/200610/23/2008
InactiveDelaware Life Insurance Company301256Agent - Variable Life and Variable Annuities9/22/200610/23/2008
InactiveEquitable Financial Life Insurance Company300808Agent - Life12/2/20054/14/2006
InactiveEquitable Financial Life Insurance Company300808Agent - Variable Life and Variable Annuities12/2/20054/14/2006
InactiveFortitude Life Insurance & Annuity Company301503Agent - Life4/2/201012/23/2014
InactiveFortitude Life Insurance & Annuity Company301503Agent - Variable Life and Variable Annuities4/2/201012/23/2014
InactiveJackson National Life Insurance Company300486Agent - Life5/31/20199/30/2021
InactiveJackson National Life Insurance Company300486Agent - Variable Life and Variable Annuities5/31/20199/30/2021
InactiveLincoln National Life Insurance Company (The)301382Agent - Health4/23/201910/21/2021
InactiveLincoln National Life Insurance Company (The)301382Agent - Life4/23/201910/21/2021
InactiveLincoln National Life Insurance Company (The)301382Agent - Variable Life and Variable Annuities4/23/201910/21/2021
InactiveMEMBERS Life Insurance Company301289Agent - Health7/1/20135/7/2019
InactiveMEMBERS Life Insurance Company301289Agent - Life7/1/20135/7/2019
InactiveMEMBERS Life Insurance Company301289Agent - Variable Life and Variable Annuities7/1/20135/7/2019
InactiveMetLife Investors USA Insurance Company300845Agent - Health12/6/20052/27/2006
InactiveMetLife Investors USA Insurance Company300845Agent - Life12/6/20052/27/2006
InactiveMetLife Investors USA Insurance Company300845Agent - Variable Life and Variable Annuities12/6/20052/27/2006
InactiveMetropolitan Life Insurance Company301948Agent - Health12/6/20052/27/2006
InactiveMetropolitan Life Insurance Company301948Agent - Life12/6/20052/27/2006
InactiveMetropolitan Life Insurance Company301948Agent - Variable Life and Variable Annuities12/6/20052/27/2006
InactivePacific Life Insurance Company301848Agent - Life12/2/20059/15/2014
InactivePacific Life Insurance Company301848Agent - Variable Life and Variable Annuities12/2/20059/15/2014
InactiveProtective Life Insurance Company300638Agent - Health4/22/20199/30/2021
InactiveProtective Life Insurance Company300638Agent - Life4/22/20199/30/2021
InactiveProtective Life Insurance Company300638Agent - Variable Life and Variable Annuities4/22/20199/30/2021
InactivePruco Life Insurance Company300954Agent - Health4/2/201012/23/2014
InactivePruco Life Insurance Company300954Agent - Life4/2/201012/23/2014
InactivePruco Life Insurance Company300954Agent - Variable Life and Variable Annuities4/2/201012/23/2014
InactiveTalcott Resolution Life Insurance Company301759Agent - Health3/30/200612/29/2008
InactiveTalcott Resolution Life Insurance Company301759Agent - Life3/30/200612/29/2008
InactiveTalcott Resolution Life Insurance Company301759Agent - Variable Life and Variable Annuities3/30/200612/29/2008
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Health3/30/200612/29/2008
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Life3/30/200612/29/2008
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Variable Life and Variable Annuities3/30/200612/29/2008
InactiveTransamerica Life Insurance Company300571Agent - Life4/28/20119/30/2021
InactiveTransamerica Life Insurance Company300571Agent - Variable Life and Variable Annuities4/28/20119/30/2021
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveEdward D Jones & Co. Limited Partnership398146Agent - Health5/9/201910/20/2021
InactiveEdward D Jones & Co. Limited Partnership398146Agent - Life5/9/201910/20/2021
InactiveEdward D Jones & Co. Limited Partnership398146Agent - Variable Life and Variable Annuities5/9/201910/20/2021

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