DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Martin, Michael T	DOIID	353910	NAIC NPN	1457958

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	11/17/2006	8/31/2013
Inactive	Non Resident	Agent	Property	11/17/2006	8/31/2013
Inactive	Non Resident	Agent	Casualty	11/17/2006	8/31/2013
Inactive	Non Resident	Agent	Health	11/17/2006	8/31/2013
* 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	Augustar Life Assurance Corporation	301113	Agent - Health	4/5/1999	10/31/2003
Inactive	Augustar Life Assurance Corporation	301113	Agent - Life	4/5/1999	10/31/2003
Inactive	Augustar Life Insurance Company	301816	Agent - Health	3/1/1999	10/31/2003
Inactive	Augustar Life Insurance Company	301816	Agent - Life	3/1/1999	10/31/2003
Inactive	Fireman's Fund Insurance Company	301423	Agent - Casualty	1/19/2012	10/28/2013
Inactive	Fireman's Fund Insurance Company	301423	Agent - Property	1/19/2012	10/28/2013
Inactive	Northwestern Mutual Life Insurance Company	300931	Agent - Health	2/19/2009	2/16/2011
Inactive	Northwestern Mutual Life Insurance Company	300931	Agent - Life	2/19/2009	2/16/2011
Inactive	Sun Life Assurance Company of Canada	301811	Agent - Health	6/2/2010	8/26/2011
Inactive	Sun Life Assurance Company of Canada	301811	Agent - Life	6/2/2010	8/26/2011
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	12/2/2009	10/30/2013
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	12/2/2009	10/30/2013
Inactive	Voya Retirement Insurance and Annuity Company	300643	Agent - Health	8/15/2009	12/7/2009
Inactive	Voya Retirement Insurance and Annuity Company	300643	Agent - Life	8/15/2009	12/7/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arthur J. Gallagher Risk Management Services, LLC	539806	Agent - Life	3/1/2011	5/10/2012
Inactive	Arthur J. Gallagher Risk Management Services, LLC	539806	Agent - Health	3/1/2011	5/10/2012
Inactive	Arthur J. Gallagher Risk Management Services, LLC	539806	Agent - Property	3/21/2012	5/10/2012
Inactive	Arthur J. Gallagher Risk Management Services, LLC	539806	Agent - Casualty	3/21/2012	5/10/2012