DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Pallares, Marco Antonio	DOIID	759408	NAIC NPN	13959318

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	7/27/2011	5/31/2017
* 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 Equity Investment Life Insurance Company	300389	Agent - Life	12/18/2015	2/20/2017
Inactive	Athene Annuity and Life Company	301893	Agent - Life	6/3/2013	11/11/2015
Inactive	Security Benefit Life Insurance Company	300583	Agent - Life	6/15/2012	5/31/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Joshua David Mellberg LLC	859326	Agent - Life	7/21/2015	5/31/2017