DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Malott, Charles T	DOIID	367055	NAIC NPN	2439799

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	6/1/1999	4/30/2009
Inactive	Non Resident	Agent	Life	6/1/1999	4/30/2009
* 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	Globe Life and Accident Insurance Company	300639	Agent - Health	3/17/2003	1/3/2005
Inactive	Globe Life and Accident Insurance Company	300639	Agent - Life	3/17/2003	1/3/2005
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	12/2/2002	4/30/2009
Inactive	Humana Insurance Company	301104	Agent - Health	12/2/2002	4/30/2009
Inactive	Humana Insurance Company	301104	Agent - Life	12/2/2002	4/30/2009
Inactive	HumanaDental Insurance Company	301457	Agent - Health	1/28/2008	4/30/2009
Inactive	HumanaDental Insurance Company	301457	Agent - Life	1/28/2008	4/30/2009
Inactive	Prudential Insurance Company of America	300784	Agent - Health	6/1/1999	4/30/2009
Inactive	Prudential Insurance Company of America	300784	Agent - Life	6/1/1999	4/30/2009
Inactive	Wilton Reassurance Life Company of New York	300163	Agent - Life	3/12/2003	6/8/2006

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Automatic Data Processing Insurance Agency Inc.	512879	Agent - Health	12/7/2004	4/30/2009