DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Douglas, Mary Ann	DOIID	578064	NAIC NPN	7900976

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Limited Line Credit	10/29/2003	9/28/2007
* 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	CMFG Life Insurance Company	300929	Agent - Limited Line Credit	10/29/2003	9/28/2007

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Greater Kentucky Credit Union Inc	398095	Agent - Limited Line Credit	1/23/2004	9/28/2007