DEPARTMENT OF INSURANCE

Affiliations

Name	Goetz, Jacinta Miller	DOIID	330238	NAIC NPN	7176701

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	General Lines	1/29/1987	8/15/2000
Inactive	Resident	Agent	Casualty	8/15/2000	6/22/2001
Inactive	Resident	Agent	Property	8/15/2000	6/22/2001
* 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	American Guarantee and Liability Insurance Company	301216	Agent - Casualty	8/15/2000	6/22/2001
Inactive	American Guarantee and Liability Insurance Company	301216	Agent - General Lines	3/17/1999	8/15/2000
Inactive	American Guarantee and Liability Insurance Company	301216	Agent - Property	8/15/2000	6/22/2001
Inactive	American Zurich Insurance Company	300592	Agent - Casualty	8/15/2000	6/17/2001
Inactive	American Zurich Insurance Company	300592	Agent - General Lines	3/17/1999	8/15/2000
Inactive	American Zurich Insurance Company	300592	Agent - Property	8/15/2000	6/17/2001
Inactive	Fairmont Insurance Company	301924	Agent - General Lines	4/13/1998	12/17/1999
Inactive	Fairmont Premier Insurance Company	300892	Agent - General Lines	4/13/1998	12/17/1999
Inactive	Fireman's Fund Insurance Company	301423	Agent - General Lines	1/29/1987	3/31/1996
Inactive	Frontier Insurance Company	300528	Agent - Casualty	8/15/2000	6/22/2001
Inactive	Frontier Insurance Company	300528	Agent - General Lines	1/21/2000	8/15/2000
Inactive	Frontier Insurance Company	300528	Agent - Property	8/15/2000	6/22/2001
Inactive	Hartford Accident and Indemnity Company	301917	Agent - General Lines	4/1/1996	12/22/1999
Inactive	Hartford Casualty Insurance Company	301332	Agent - General Lines	4/1/1996	12/22/1999
Inactive	Hartford Fire Insurance Company	300628	Agent - General Lines	4/1/1996	12/22/1999
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Casualty	8/15/2000	6/22/2001
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - General Lines	4/1/1996	8/15/2000
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Property	8/15/2000	6/22/2001
Inactive	Hartford Underwriters Insurance Company	301064	Agent - General Lines	4/1/1996	12/22/1999
Inactive	Markel Insurance Company	301475	Agent - Casualty	8/15/2000	6/22/2001
Inactive	Markel Insurance Company	301475	Agent - General Lines	10/8/1998	8/15/2000
Inactive	Markel Insurance Company	301475	Agent - Property	8/15/2000	6/22/2001
Inactive	StarStone National Insurance Company	300812	Agent - General Lines	4/13/1998	12/17/1999
Inactive	TIG Insurance Company	301750	Agent - General Lines	4/13/1998	12/17/1999
Inactive	Twin City Fire Insurance Company	300721	Agent - General Lines	4/1/1996	12/22/1999
Inactive	Zurich American Insurance Company	301121	Agent - Casualty	8/15/2000	6/22/2001
Inactive	Zurich American Insurance Company	301121	Agent - General Lines	3/17/1999	8/15/2000
Inactive	Zurich American Insurance Company	301121	Agent - Property	8/15/2000	6/22/2001
Inactive	Zurich American Insurance Company of Illinois	301805	Agent - Casualty	8/15/2000	6/22/2001
Inactive	Zurich American Insurance Company of Illinois	301805	Agent - General Lines	3/17/1999	8/15/2000
Inactive	Zurich American Insurance Company of Illinois	301805	Agent - Property	8/15/2000	6/22/2001

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Hyland Block & Hyland Inc.	398511	Agent - General Lines	3/4/1996	8/15/2000
Inactive	Hyland Block & Hyland Inc.	398511	Agent - Property	8/15/2000	6/22/2001
Inactive	Hyland Block & Hyland Inc.	398511	Agent - Casualty	8/15/2000	6/22/2001