DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Matthiesen Jr, Karl Martin	DOIID	392793	NAIC NPN	1259590

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	5/31/2008	7/31/2018
Inactive	Non Resident	Agent	Health	5/31/2008	7/31/2018
* 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	National Teachers Associates Life Insurance Company	300107	Agent - Health	8/15/2008	7/30/2018
Inactive	National Teachers Associates Life Insurance Company	300107	Agent - Life	8/15/2008	7/30/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	National Teacher Associates of Kentucky Inc.	399320	Agent - Life	11/13/2008	3/31/2016
Inactive	National Teacher Associates of Kentucky Inc.	399320	Agent - Health	11/13/2008	3/31/2016