DEPARTMENT OF INSURANCE

Affiliations

Name	Goerlitz, David Edmund	DOIID	607764	NAIC NPN	8404648

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	4/26/2005	12/31/2018
Inactive	Non Resident	Agent	Casualty	10/17/2012	12/31/2018
Inactive	Non Resident	Agent	Life	4/26/2005	12/31/2018
Inactive	Non Resident	Agent	Property	10/17/2012	12/31/2018
* 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 Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	8/16/2006	8/31/2007
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	8/16/2006	8/31/2007
Inactive	American Heritage Life Insurance Company	300272	Agent - Health	8/19/2010	1/23/2013
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	8/19/2010	1/23/2013
Inactive	American United Life Insurance Company	300498	Agent - Health	9/11/2014	12/31/2018
Inactive	American United Life Insurance Company	300498	Agent - Life	9/11/2014	12/31/2018
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Health	12/23/2005	4/13/2007
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Life	12/23/2005	4/13/2007
Inactive	Bankers Life and Casualty Company	300701	Agent - Health	4/26/2005	11/14/2005
Inactive	Bankers Life and Casualty Company	300701	Agent - Life	4/26/2005	11/14/2005
Inactive	Boston Mutual Life Insurance Company	300143	Agent - Health	9/27/2007	12/31/2018
Inactive	Boston Mutual Life Insurance Company	300143	Agent - Life	9/27/2007	12/31/2018
Inactive	C.M. Life Insurance Company	301335	Agent - Health	9/12/2006	11/9/2012
Inactive	C.M. Life Insurance Company	301335	Agent - Life	9/12/2006	11/9/2012
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Health	3/24/2014	7/23/2015
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	3/24/2014	7/23/2015
Inactive	Combined Insurance Company of America	301472	Agent - Health	10/28/2014	12/31/2018
Inactive	Combined Insurance Company of America	301472	Agent - Life	10/28/2014	12/31/2018
Inactive	Genworth Life Insurance Company	300623	Agent - Health	4/7/2006	7/23/2007
Inactive	Genworth Life Insurance Company	300623	Agent - Life	4/7/2006	7/23/2007
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Life	7/30/2013	6/1/2016
Inactive	John Alden Life Insurance Company	300573	Agent - Health	4/2/2009	12/29/2010
Inactive	John Alden Life Insurance Company	300573	Agent - Life	4/2/2009	12/29/2010
Inactive	Kanawha Insurance Company	300127	Agent - Health	4/28/2009	3/9/2018
Inactive	Kanawha Insurance Company	300127	Agent - Life	4/28/2009	3/9/2018
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Health	9/12/2006	11/9/2012
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Life	9/12/2006	11/9/2012
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	7/1/2005	1/31/2008
Inactive	National Western Life Insurance Company	301515	Agent - Life	7/25/2013	12/31/2018
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	4/9/2014	3/9/2016
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	4/9/2014	3/9/2016
Inactive	Sagicor Life Insurance Company	300459	Agent - Life	8/22/2013	7/31/2017
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	4/4/2008	6/20/2011
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Life	4/4/2008	6/20/2011
Inactive	Sterling Investors Life Insurance Company	301785	Agent - Life	7/25/2013	6/16/2014
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	5/19/2011	12/31/2018
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	5/19/2011	12/31/2018
Inactive	Trustmark Insurance Company	300317	Agent - Health	10/5/2014	3/3/2018
Inactive	Trustmark Insurance Company	300317	Agent - Life	10/5/2014	3/3/2018
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	4/9/2014	3/9/2016
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	4/9/2014	3/9/2016
Inactive	United Home Life Insurance Company	300421	Agent - Life	8/29/2006	5/11/2009
Inactive	United World Life Insurance Company	300532	Agent - Health	7/1/2005	1/31/2008
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	7/1/2005	1/31/2008
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	7/1/2005	1/31/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Medlink Inc	400721	Agent - Health	11/17/2005	12/31/2018
Inactive	Medlink Inc	400721	Agent - Life	11/17/2005	12/31/2018