DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Pittman, Derek Zebulon	DOIID	608494	NAIC NPN	8466175

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Limited Line Credit	5/10/2005	7/31/2007
* 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	Universal Underwriters Life Insurance Company	301200	Agent - Limited Line Credit	6/2/2005	1/10/2006

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Cardinal Chrysler Jeep Dodge Inc	399200	Agent - Limited Line Credit	9/19/2005	1/10/2006