black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

JEFFREY F. VIVACQUA

PRODUCER NON-RESIDENT

License Number:
PRN356663
Status:
First Licensure:
07/16/2020
Cancel Date:
None

Mailing:
FAIRFIELD, IA 52556
Phone:
+1 (641) 472-5100
Fax:
+1 (641) 469-1696
Email:
insurancecenter@cir2.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 07/16/2020

Agency

Name Issue Date License Number Expiration Date Cancel Date
TBS AGENCY INC
07/16/2020 AGN50856

Employer

Name Issue Date License Number Expiration Date Cancel Date
AMERICAN NATIONAL INSURANCE COMPANY
03/19/2021 LHF11
CMFG LIFE INSURANCE COMPANY
06/08/2021 LHF155
FORETHOUGHT LIFE INSURANCE COMPANY
04/27/2021 LHF1013
INTEGRITY LIFE INSURANCE COMPANY
09/23/2021 LHF262166

Authority

Description Issue Date Termination Date Status
HEALTH 07/16/2020 Active
LIFE 07/16/2020 Active
VARIABLE CONTRACTS 07/16/2020 Active

Responsible For

Name License Number
TBS AGENCY INC AGN50856

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
19558116

Other Addresses

Address Type
FAIRFIELD, IA 52556
Office

An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.

Date: 06/25/2025 06:12:06 PM