DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Capuzzi, Nichole Kristine	DOIID	603134	NAIC NPN	8180794

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	7/28/2005	11/30/2021
Inactive	Non Resident	Agent	Casualty	7/28/2005	11/30/2021
Inactive	Non Resident	Agent	Health	4/3/2008	11/30/2021
* 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	AMEX Assurance Company	301728	Agent - Casualty	8/23/2005	8/20/2009
Inactive	AMEX Assurance Company	301728	Agent - Health	5/7/2008	8/20/2009
Inactive	AMEX Assurance Company	301728	Agent - Property	8/23/2005	8/20/2009
Inactive	American Family Connect Property and Casualty Insurance Company	622403	Agent - Casualty	8/18/2009	12/28/2011
Inactive	American Family Connect Property and Casualty Insurance Company	622403	Agent - Health	8/18/2009	12/28/2011
Inactive	American Family Connect Property and Casualty Insurance Company	622403	Agent - Property	8/18/2009	12/28/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	APAC Customer Services Inc	505425	Agent - Casualty	8/5/2009	8/20/2009
Inactive	APAC Customer Services Inc	505425	Agent - Property	8/5/2009	8/20/2009
Inactive	APAC Customer Services Inc	505425	Agent - Health	8/5/2009	8/20/2009