DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Doughty, Carolyn Suzanne	DOIID	571299	NAIC NPN	360912

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	6/17/2003	9/30/2017
Inactive	Non Resident	Agent	Casualty	6/17/2003	9/30/2017
Inactive	Non Resident	Agent	Life	1/22/2008	9/30/2017
Inactive	Non Resident	Agent	Health	1/22/2008	9/30/2017
* 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 General Assurance Company	300586	Agent - Health	2/8/2008	12/31/2008
Inactive	American General Assurance Company	300586	Agent - Life	2/8/2008	12/31/2008
Inactive	Dairyland Insurance Company	301370	Agent - Casualty	2/11/2008	10/30/2008
Inactive	Dairyland Insurance Company	301370	Agent - Property	2/11/2008	10/30/2008
Inactive	Empire Fire and Marine Insurance Company	300666	Agent - Casualty	9/15/2003	3/4/2016
Inactive	Empire Fire and Marine Insurance Company	300666	Agent - Property	9/15/2003	3/4/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Harley-Davidson Ins Services Inc	545855	Agent - Casualty	1/24/2005	3/4/2016
Inactive	Harley-Davidson Ins Services Inc	545855	Agent - Property	1/24/2005	3/4/2016
Denied	Harley-Davidson Ins Services Inc	545855	Agent - Health
Denied	Harley-Davidson Ins Services Inc	545855	Agent - Life