DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Makoutz, Patrick Michael	DOIID	694087	NAIC NPN	11136795

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	12/9/2010	8/31/2012
Inactive	Non Resident	Agent	Property	12/9/2010	8/31/2012
Inactive	Non Resident	Agent	Casualty	12/9/2010	8/31/2012
* 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 Connect Property and Casualty Insurance Company	622403	Agent - Casualty	12/15/2010	7/19/2012
Inactive	American Family Connect Property and Casualty Insurance Company	622403	Agent - Health	12/15/2010	7/19/2012
Inactive	American Family Connect Property and Casualty Insurance Company	622403	Agent - Property	12/15/2010	7/19/2012
Inactive	RLI Insurance Company	301217	Agent - Casualty	2/21/2011	6/26/2012
Inactive	RLI Insurance Company	301217	Agent - Property	2/21/2011	6/26/2012
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	12/2/2008	6/18/2009
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	12/2/2008	7/30/2009
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	12/2/2008	7/30/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Family Connect Insurance Agency, Inc.	619157	Agent - Property	12/22/2010	7/19/2012
Inactive	American Family Connect Insurance Agency, Inc.	619157	Agent - Casualty	12/22/2010	7/19/2012