DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Kauzlarich, David	DOIID	890501	NAIC NPN	263976

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	9/10/2015	8/31/2017
Inactive	Non Resident	Agent	Casualty	6/28/2016	8/31/2017
Inactive	Non Resident	Agent	Life	9/10/2015	8/31/2017
Inactive	Non Resident	Agent	Property	6/28/2016	8/31/2017
* 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	Continental American Insurance Company	301700	Agent - Health	9/23/2015	6/29/2016
Inactive	Continental American Insurance Company	301700	Agent - Life	9/23/2015	6/29/2016
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Casualty	7/12/2016	11/22/2016
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Property	7/12/2016	11/22/2016
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	10/2/2015	8/31/2017
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	10/2/2015	8/31/2017
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	10/2/2015	8/31/2017
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	10/2/2015	8/31/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Nationwide Sales Solutions Inc	631821	Agent - Property	7/12/2016	11/22/2016
Inactive	Nationwide Sales Solutions Inc	631821	Agent - Casualty	7/12/2016	11/22/2016