DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Chaplin, Mary Catherine	DOIID	580238	NAIC NPN	7925955

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	1/22/2004	8/31/2007
Inactive	Resident	Agent	Life	1/22/2004	8/31/2007
* 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	American Fidelity Assurance Company	301004	Agent - Health	2/15/2004	8/31/2007
Inactive	American Fidelity Assurance Company	301004	Agent - Life	2/15/2004	8/31/2007

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Chamber Services Division, Inc.	401091	Agent - Health	2/15/2004	2/28/2007
Inactive	Chamber Services Division, Inc.	401091	Agent - Life	2/15/2004	2/28/2007