DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Pauly, Michael R	DOIID	350614	NAIC NPN	47140

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	11/17/1992	4/30/2005
Inactive	Non Resident	Agent	Health	11/17/1992	4/30/2005
* 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	Guardian Insurance & Annuity Company Inc. (The)	301920	Agent - Life	8/29/2002	2/9/2005
Inactive	Mutual Trust Life Insurance Company, A Pan-American Life Insurance Group Stock Company	300585	Agent - Health	11/17/1992	6/28/2005
Inactive	Mutual Trust Life Insurance Company, A Pan-American Life Insurance Group Stock Company	300585	Agent - Life	11/17/1992	6/28/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	MTL Agency Inc.	399962	Agent - Life	3/1/1993	1/5/2005
Inactive	MTL Agency Inc.	399962	Agent - Health	3/1/1993	1/5/2005