DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Mitchell, Marisa L	DOIID	589139	NAIC NPN	8069380

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Property	5/25/2004	3/11/2005
Inactive	Resident	Agent	Health	6/1/2004	2/7/2005
Inactive	Resident	Agent	Life	6/1/2004	2/7/2005
Inactive	Resident	Agent	Casualty	5/25/2004	3/11/2005
* 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	Dairyland Insurance Company	301370	Agent - Casualty	6/30/2004	1/11/2005
Inactive	Dairyland Insurance Company	301370	Agent - Property	6/30/2004	1/11/2005
Inactive	FB Insurance Company (The)	301763	Agent - Casualty	5/25/2004	12/28/2004
Inactive	FB Insurance Company (The)	301763	Agent - Health	6/1/2004	2/7/2005
Inactive	FB Insurance Company (The)	301763	Agent - Property	5/25/2004	12/28/2004
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	6/16/2004	3/11/2005
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	6/16/2004	3/11/2005
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	5/25/2004	12/28/2004
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Health	6/1/2004	2/7/2005
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	5/25/2004	12/28/2004
Inactive	Southern Farm Bureau Life Insurance Company	300909	Agent - Health	6/1/2004	12/28/2004
Inactive	Southern Farm Bureau Life Insurance Company	300909	Agent - Life	6/1/2004	12/28/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Casualty	6/7/2004	12/28/2004
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Health	6/7/2004	12/28/2004
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Life	6/7/2004	12/28/2004
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Property	6/7/2004	12/28/2004