DEPARTMENT OF INSURANCE

Affiliations

Name	Jolly, Andrew Park	DOIID	363416	NAIC NPN	7197366

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Health	3/5/1996	5/1/1998
Inactive	Resident	Agent	Life	3/5/1996	5/1/1998
* 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	Allianz Life Insurance Company of North America	301791	Agent - Health	5/31/1996	5/1/1998
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	5/31/1996	5/1/1998
Inactive	Bankers United Life Assurance Company	300296	Agent - Health	8/29/1996	5/1/1998
Inactive	Bankers United Life Assurance Company	300296	Agent - Life	8/29/1996	5/1/1998
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Health	3/5/1996	5/1/1998
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	3/5/1996	5/1/1998
Inactive	Citizens Security Life Insurance Company	301257	Agent - Health	4/29/1996	5/1/1998
Inactive	Citizens Security Life Insurance Company	301257	Agent - Life	4/29/1996	5/1/1998
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Health	3/21/1996	11/4/1996
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Life	3/21/1996	11/4/1996
Inactive	Great Southern Life Insurance Company	301443	Agent - Health	4/8/1996	8/4/1997
Inactive	Great Southern Life Insurance Company	301443	Agent - Life	4/8/1996	8/4/1997
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Health	3/21/1996	5/1/1998
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Life	3/21/1996	5/1/1998
Inactive	Life Insurance Company of the Southwest	301867	Agent - Health	9/3/1996	5/1/1998
Inactive	Life Insurance Company of the Southwest	301867	Agent - Life	9/3/1996	5/1/1998
Inactive	Lincoln Heritage Life Insurance Company	500016	Agent - Life	3/6/1997	5/1/1998
Inactive	Midland Life Insurance Company (The)	300310	Agent - Health	10/24/1996	5/1/1998
Inactive	Midland Life Insurance Company (The)	300310	Agent - Life	10/24/1996	5/1/1998
Inactive	National Guardian Life Insurance Company	300596	Agent - Health	4/2/1996	5/1/1998
Inactive	National Guardian Life Insurance Company	300596	Agent - Life	4/2/1996	5/1/1998
Inactive	Professional Insurance Company	301281	Agent - Health	9/5/1996	3/31/1997
Inactive	Professional Insurance Company	301281	Agent - Life	9/5/1996	3/31/1997
Inactive	Security Life Insurance Company of America	300936	Agent - Health	4/23/1997	5/1/1998
Inactive	Security Life Insurance Company of America	300936	Agent - Life	4/23/1997	5/1/1998
Inactive	United Presidential Life Insurance Company	300422	Agent - Life	7/18/1996	5/1/1998

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Cowger & Miller Insurance Agency Inc.	399589	Agent - Health	8/9/1996	5/1/1998