DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Shotashvili, Roman M	DOIID	659866	NAIC NPN	9461813

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	7/18/2007	10/15/2013
Inactive	Non Resident	Agent	Health	7/18/2007	10/15/2013
* 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	USAA Life Insurance Company	300734	Agent - Health	8/24/2007	12/7/2011
Inactive	USAA Life Insurance Company	300734	Agent - Life	8/24/2007	12/7/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	USAA Financial Planning Services Ins Agency Inc	579485	Agent - Life	1/30/2009	12/7/2011
Inactive	USAA Financial Planning Services Ins Agency Inc	579485	Agent - Health	1/30/2009	12/7/2011