DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Dela Cerna, Mario Pazmino	DOIID	775182	NAIC NPN	16475120

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	11/8/2023		6/30/2026
Active	Non Resident	Agent	Health	11/8/2023		6/30/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	04/15/2024	06/30/2024	04/08/2024	04/08/2024	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Allianz Life Insurance Company of North America	301791	Agent - Life	1/12/2024
Inactive	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	5/25/2023	8/4/2023
Inactive	Nassau Life and Annuity Company	513671	Agent - Life	6/15/2023	8/4/2023
Active	SILAC Insurance Company	300535	Agent - Life	1/2/2024
Inactive	Security Benefit Life Insurance Company	300583	Agent - Life	6/15/2012	6/30/2016

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	6/30/2016