DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Klepanchuk, Tatyana	DOIID	716925	NAIC NPN	15097614

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	10/29/2009	5/31/2012
Inactive	Non Resident	Agent	Life	10/29/2009	5/31/2012
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	12/24/2009	5/31/2012
Inactive	Aetna Life Insurance Company	301140	Agent - Health	12/24/2009	5/31/2012
Inactive	Aetna Life Insurance Company	301140	Agent - Life	12/24/2009	5/31/2012
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	11/30/2009	12/22/2011
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	11/30/2009	12/22/2011
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	11/30/2009	6/5/2012
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	11/30/2009	6/5/2012
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	11/30/2009	11/16/2011
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	11/30/2009	11/16/2011
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	11/19/2009	5/31/2012
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	11/19/2009	5/31/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Paychex Insurance Agency Inc	509469	Agent - Life	11/19/2009	5/22/2012
Inactive	Paychex Insurance Agency Inc	509469	Agent - Health	11/19/2009	5/22/2012