DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Polzin, Michael	DOIID	314004	NAIC NPN	7162023

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Adjuster	Independent	11/21/1996	10/31/2007
Inactive	Non Resident	Apprentice Adjuster	Not Applicable	1/5/1996	11/21/1996
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	State Farm Mutual Automobile Insurance Company	301732	Adjuster - Independent	11/21/1996	10/31/2007

Sponsorships

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bowman, Marla Neika	520631	Apprentice Adjuster - Not Applicable	1/25/2001	7/24/2001
Inactive	Haney, Brian William	520629	Apprentice Adjuster - Not Applicable	1/25/2001	7/24/2001
Inactive	Watson, Terry Austin	520630	Apprentice Adjuster - Not Applicable	1/25/2001	7/24/2001

Sponsored By

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Smith, Mark Steeley	348927	Apprentice Adjuster - Not Applicable	1/5/1996	11/21/1996