DEPARTMENT OF INSURANCE

Affiliations

Name	Walczyk, Matthew Ryan	DOIID	587946	NAIC NPN	7926484

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	4/15/2004	11/30/2015
Inactive	Non Resident	Agent	Casualty	4/15/2004	11/30/2015
Inactive	Non Resident	Agent	Life	4/15/2004	11/30/2015
Inactive	Non Resident	Agent	Property	4/15/2004	11/30/2015
* 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	ACE American Insurance Company	300625	Agent - Casualty	5/14/2004	10/21/2011
Inactive	ACE American Insurance Company	300625	Agent - Property	5/14/2004	10/21/2011
Inactive	American Bankers Insurance Company of Florida	300360	Agent - Casualty	5/17/2004	9/30/2008
Inactive	American Bankers Insurance Company of Florida	300360	Agent - Property	5/17/2004	9/30/2008
Inactive	CSI Life Insurance Company	596032	Agent - Life	8/21/2009	4/27/2010
Inactive	Central States Health and Life Company of Omaha	301874	Agent - Health	9/29/2004	12/30/2011
Inactive	Central States Health and Life Company of Omaha	301874	Agent - Life	9/29/2004	12/30/2011
Inactive	Central States Indemnity Company of Omaha	300285	Agent - Casualty	9/29/2004	12/30/2011
Inactive	Central States Indemnity Company of Omaha	300285	Agent - Property	9/29/2004	12/30/2011
Inactive	Combined Insurance Company of America	301472	Agent - Health	8/24/2005	11/16/2007
Inactive	Combined Insurance Company of America	301472	Agent - Life	8/24/2005	11/16/2007
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	5/18/2004	3/5/2009
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	5/17/2004	11/30/2015
Inactive	Stonebridge Life Insurance Company	301614	Agent - Health	1/6/2012	4/4/2013
Inactive	Stonebridge Life Insurance Company	301614	Agent - Life	1/6/2012	4/4/2013
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	10/4/2011	4/4/2013
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	10/4/2011	4/4/2013
Inactive	Union Security Insurance Company	301844	Agent - Health	5/17/2004	8/1/2008
Inactive	Union Security Insurance Company	301844	Agent - Life	5/17/2004	8/1/2008
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	5/18/2004	3/5/2009
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	5/18/2004	3/5/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	PCCW Teleservices (US) , Inc.	533374	Agent - Casualty	2/15/2007	12/30/2011
Inactive	PCCW Teleservices (US) , Inc.	533374	Agent - Health	2/15/2007	11/30/2015
Inactive	PCCW Teleservices (US) , Inc.	533374	Agent - Life	2/15/2007	4/4/2013
Inactive	PCCW Teleservices (US) , Inc.	533374	Agent - Property	2/15/2007	12/30/2011