DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Roth, Patsy J	DOIID	339296	NAIC NPN	252739

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Personal Lines	5/6/2005	1/31/2010
Inactive	Non Resident	Agent	Health	9/5/1996	1/31/2010
Inactive	Non Resident	Agent	Life	9/5/1996	1/31/2010
* 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	ACE American Insurance Company	300625	Agent - Personal Lines	9/11/2006	9/19/2008
Inactive	AMEX Assurance Company	301728	Agent - Personal Lines	5/31/2005	2/15/2010
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	4/18/2005	1/31/2010
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	4/18/2005	1/31/2010
Inactive	Minnesota Life Insurance Company	300488	Agent - Health	3/2/2009	5/4/2009
Inactive	Minnesota Life Insurance Company	300488	Agent - Life	3/2/2009	5/4/2009
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	5/11/2005	1/31/2010
Inactive	Stonebridge Life Insurance Company	301614	Agent - Health	9/5/1996	9/1/2004
Inactive	Stonebridge Life Insurance Company	301614	Agent - Life	9/5/1996	9/1/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Financial Insurance Services, Inc.	514710	Agent - Life	3/2/2006	5/15/2009
Inactive	Financial Insurance Services, Inc.	514710	Agent - Health	3/2/2006	5/15/2009