DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Samek, Peter	DOIID	757421	NAIC NPN	15277016

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	6/30/2011	3/31/2016
Inactive	Non Resident	Agent	Health	6/30/2011	3/31/2016
* 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	8/23/2011	4/21/2015
Inactive	Aetna Life Insurance Company	301140	Agent - Health	8/23/2011	4/21/2015
Inactive	Aetna Life Insurance Company	301140	Agent - Life	8/23/2011	4/21/2015
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	9/6/2011	4/20/2015
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	9/6/2011	4/20/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Manning & Napier Benefits LLC	758494	Agent - Life	7/15/2011	4/20/2015
Inactive	Manning & Napier Benefits LLC	758494	Agent - Health	7/15/2011	4/20/2015