DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Kelly, Patricia L	DOIID	384769	NAIC NPN	415593

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	12/15/2003	11/30/2015
Inactive	Non Resident	Agent	Health	12/15/2003	11/30/2015
* 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	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	9/22/2009	1/11/2016
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	9/22/2009	1/11/2016
Inactive	Boston Mutual Life Insurance Company	300143	Agent - Health	1/30/2004	11/30/2015
Inactive	Boston Mutual Life Insurance Company	300143	Agent - Life	1/30/2004	11/30/2015
Inactive	Combined Insurance Company of America	301472	Agent - Health	11/24/1997	9/30/1999
Inactive	Combined Insurance Company of America	301472	Agent - Life	11/24/1997	9/30/1999
Inactive	First Colony Life Insurance Company	301179	Agent - Life	6/2/1998	9/30/1999
Inactive	Kanawha Insurance Company	300127	Agent - Health	10/18/2004	11/30/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	10/18/2004	11/30/2015
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	1/8/2004	11/30/2015
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	1/8/2004	11/30/2015
Inactive	ReliaStar Life Insurance Company	301712	Agent - Health	1/16/2004	11/30/2015
Inactive	ReliaStar Life Insurance Company	301712	Agent - Life	1/16/2004	11/30/2015
Inactive	ReliaStar Life Insurance Company of New York	301018	Agent - Health	1/16/2004	6/25/2008
Inactive	ReliaStar Life Insurance Company of New York	301018	Agent - Life	1/16/2004	6/25/2008
Inactive	Trustmark Insurance Company	300317	Agent - Health	10/25/2005	2/11/2011
Inactive	Trustmark Insurance Company	300317	Agent - Life	10/25/2005	2/11/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	The Farmington Company	534046	Agent - Life	1/27/2004	11/30/2015
Inactive	The Farmington Company	534046	Agent - Health	1/27/2004	11/30/2015