Agency Information

BANKERS LIFE SECURITIES GENERAL AGENCY INC

11299 ILLINOIS ST, SUITE 200

CARMEL, IN 46032

312-396-7654

blsregistrations@banklife.com

17617083

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res. Producer Firm	3115366	10/19/2015	Active	10/19/2015	10/31/2027

Qualification Type	Original Issue Date	Status	Effective Date
Life	10/19/2015	Active	10/19/2015
Var. Annuities/Var. Life	10/19/2015	Active	10/19/2015

Company Name	Appointment Type	Status	Active Date
476
ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA	Life	Active	01/15/2016
	Var. Annuities/Var. Life	Active	01/15/2016
43
Company Name	Appointment Type	Status	Active Date
AMERICAN GENERAL LIFE INSURANCE COMPANY	Life	Active	05/13/2016
	Var. Annuities/Var. Life	Active	05/13/2016
653
Company Name	Appointment Type	Status	Active Date
BRIGHTHOUSE LIFE INSURANCE COMPANY	Life	Active	10/09/2017
	Var. Annuities/Var. Life	Active	10/09/2017
897
Company Name	Appointment Type	Status	Active Date
JACKSON NATIONAL LIFE INSURANCE COMPANY	Life	Active	02/08/2016
	Var. Annuities/Var. Life	Active	02/08/2016
512
Company Name	Appointment Type	Status	Active Date
PACIFIC LIFE INSURANCE COMPANY	Life	Active	11/04/2016
	Var. Annuities/Var. Life	Active	11/04/2016
817
Company Name	Appointment Type	Status	Active Date
PRUCO LIFE INSURANCE COMPANY	Life	Active	09/28/2016
	Var. Annuities/Var. Life	Active	09/28/2016
8
Company Name	Appointment Type	Status	Active Date
VOYA RETIREMENT INSURANCE AND ANNUITY COMPANY	Life	Active	03/24/2017

row(s) 1 - 13 of 13

Name	Association Type	Agent	Begin Date	End Date
ALBERTA S ROBERTS	Designated Resp Lic Prdcr	Yes	08/11/2020	-
STEVEN M JOSEPHSON	Designated Resp Lic Prdcr	Yes	08/11/2020	-

1 - 2