DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Pallay, Douglas Joseph	DOIID	360705	NAIC NPN	58872

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Administrator	Not Applicable	11/12/1987	3/31/1999
Inactive	Non Resident	Agent	Health	10/31/1978	3/2/1996
Inactive	Non Resident	Agent	Life	10/31/1978	3/2/1996
* 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	All American Life Insurance Company	300702	Agent - Health	10/31/1978	3/2/1996
Inactive	All American Life Insurance Company	300702	Agent - Life	10/31/1978	3/2/1996
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	5/24/1982	3/2/1996
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	5/24/1982	3/2/1996
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Health	11/12/1993	3/2/1996
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Life	11/12/1993	3/2/1996
Inactive	Connecticut General Life Insurance Company	301333	Agent - Health	7/7/1989	3/2/1996
Inactive	Connecticut General Life Insurance Company	301333	Agent - Life	7/7/1989	3/2/1996
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	2/15/1984	3/2/1996
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	2/15/1984	3/2/1996
Inactive	Time Insurance Company	300683	Agent - Health	11/9/1994	3/2/1996
Inactive	Time Insurance Company	300683	Agent - Life	11/9/1994	3/2/1996

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Sedgwick Claims Management Service Inc	401194	Administrator - Not Applicable	11/12/1987	3/31/1999