DEPARTMENT OF INSURANCE

Affiliations

Name	Carrillo, Maribel	DOIID	650810	NAIC NPN	7816872

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Casualty	3/7/2007	8/31/2017
Inactive	Non Resident	Agent	Property	3/7/2007	8/31/2017
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	PoliSeek AIS Insurance Solutions, Inc.	649167	Agent - Property
Denied	PoliSeek AIS Insurance Solutions, Inc.	649167	Agent - Casualty