DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Statts, Annette Marie	DOIID	321198	NAIC NPN	7168349

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Limited Line Credit	8/7/2000	12/31/2011
Inactive	Resident	Agent	Life	5/31/2001	1/1/2012
Inactive	Resident	Agent	Credit Life & Health	8/6/1999	8/7/2000
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Augustar Life Insurance Company	301816	Agent - Life	5/31/2001	4/12/2006
Inactive	Empower Annuity Insurance Company of America	300259	Agent - Life	11/26/2001	3/25/2011
Inactive	Everlake Life Insurance Company	300873	Agent - Life	9/22/2003	2/10/2011
Inactive	Glenbrook Life and Annuity Company	301384	Agent - Life	9/22/2003	1/1/2005
Inactive	Lincoln Life Assurance Company of Boston	301915	Agent - Life	10/26/2010	5/6/2011
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Life	10/17/2003	2/14/2011
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	9/22/2003	12/16/2004
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Life	12/16/2005	3/25/2011
Inactive	Pacific Life Insurance Company	301848	Agent - Life	9/21/2009	3/21/2011
Inactive	Southern Financial Life Insurance Company	300664	Agent - Credit Life & Health	8/6/1999	8/7/2000
Inactive	Southern Financial Life Insurance Company	300664	Agent - Limited Line Credit	8/7/2000	12/31/2011
Inactive	Symetra Life Insurance Company	301691	Agent - Life	4/11/2003	10/24/2006
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	5/31/2001	3/21/2011
Inactive	Western National Life Insurance Company	300461	Agent - Life	5/31/2001	3/21/2011
Inactive	Western-Southern Life Assurance Company	301590	Agent - Life	3/2/2010	1/1/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	U S Bancorp Ins Services L L C	400253	Agent - Life	3/10/2005	2/8/2011
Inactive	US Bancorp Investments, Inc.	572662	Agent - Life	12/18/2003	2/8/2011