DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Patrick, Marietta F	DOIID	526221	NAIC NPN	7217728

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	8/21/2001	7/1/2004
Inactive	Resident	Agent	Health	8/14/2001	7/1/2004
* 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	10/4/2001	12/11/2002
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	10/4/2001	12/11/2002
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	2/25/2002	7/1/2004
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	2/25/2002	7/1/2004
Inactive	Augustar Life Assurance Corporation	301113	Agent - Health	1/24/2003	9/1/2003
Inactive	Augustar Life Assurance Corporation	301113	Agent - Life	1/24/2003	9/1/2003
Inactive	Augustar Life Insurance Company	301816	Agent - Health	1/24/2003	9/1/2003
Inactive	Augustar Life Insurance Company	301816	Agent - Life	1/24/2003	9/1/2003

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Medlink Inc	400721	Agent - Life	6/18/2002	7/1/2004
Inactive	Medlink Inc	400721	Agent - Health	6/18/2002	7/1/2004