DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Russell, Pat Tyra	DOIID	338788	NAIC NPN	7186541

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	General Lines	8/14/1995	4/18/2000
Inactive	Resident	Agent	Life	8/14/1995	4/18/2000
Inactive	Resident	Agent	Health	8/14/1995	4/18/2000
* 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	Mutual of Omaha Insurance Company	301012	Agent - Health	10/1/1998	11/7/1998
Inactive	Shelter General Insurance Company	301109	Agent - General Lines	8/14/1995	4/18/2000
Inactive	Shelter Life Insurance Company	300391	Agent - Health	8/14/1995	4/18/2000
Inactive	Shelter Life Insurance Company	300391	Agent - Life	8/14/1995	4/18/2000
Inactive	Shelter Mutual Insurance Company	301870	Agent - General Lines	8/14/1995	4/18/2000

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Healthplan Services, Inc.	401230	Agent - Health	8/31/1995	3/31/1997