DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Pickett, George Bailey	DOIID	391906	NAIC NPN	329921

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	7/21/1994	10/31/2003
Inactive	Non Resident	Agent	Life	1/13/2012	8/31/2013
* 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 Fidelity Assurance Company	301004	Agent - Health	7/21/1994	10/31/2003
Inactive	American Fidelity Assurance Company	301004	Agent - Life	7/21/1994	10/31/2003
Inactive	Augustar Life Assurance Corporation	301113	Agent - Life	1/20/2012	8/31/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Executive Ins Agency Inc	400244	Agent - Life	1/24/2012	8/31/2013