DEPARTMENT OF INSURANCE

Affiliations

Name	Self, Patricia Ann	DOIID	388723	NAIC NPN	2365825

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Casualty	2/5/2008	6/17/2014
Inactive	Non Resident	Agent	General Lines	5/10/1999	8/15/2000
Inactive	Non Resident	Agent	Property	2/5/2008	6/17/2014
* 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	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Casualty	10/10/2000	10/12/2005
Inactive	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Property	10/10/2000	10/12/2005
Inactive	First Liberty Insurance Corporation (The)	301060	Agent - Casualty	10/10/2013	6/17/2014
Inactive	First Liberty Insurance Corporation (The)	301060	Agent - Property	10/10/2013	6/17/2014
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	4/2/2008	6/17/2014
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	4/2/2008	6/17/2014
Inactive	GEICO Casualty Company	301178	Agent - Casualty	8/15/2000	2/23/2006
Inactive	GEICO Casualty Company	301178	Agent - General Lines	5/10/1999	8/15/2000
Inactive	GEICO General Insurance Company	301684	Agent - Casualty	8/15/2000	2/23/2006
Inactive	GEICO General Insurance Company	301684	Agent - General Lines	5/10/1999	8/15/2000
Inactive	GEICO General Insurance Company	301684	Agent - Property	8/15/2000	2/23/2006
Inactive	GEICO Indemnity Company	301720	Agent - Casualty	8/15/2000	2/23/2006
Inactive	GEICO Indemnity Company	301720	Agent - General Lines	5/10/1999	8/15/2000
Inactive	GEICO Indemnity Company	301720	Agent - Property	8/15/2000	2/23/2006
Inactive	Government Employees Insurance Company	300376	Agent - Casualty	2/26/2008	6/17/2014
Inactive	Government Employees Insurance Company	300376	Agent - General Lines	5/10/1999	8/15/2000
Inactive	Government Employees Insurance Company	300376	Agent - Property	2/26/2008	6/17/2014
Inactive	Homesite Insurance Company	301139	Agent - Casualty	11/19/2012	6/17/2014
Inactive	Homesite Insurance Company	301139	Agent - Property	11/19/2012	6/17/2014
Inactive	LM General Insurance Company	300133	Agent - Casualty	10/10/2013	6/17/2014
Inactive	LM General Insurance Company	300133	Agent - Property	10/10/2013	6/17/2014
Inactive	LM Insurance Corporation	301061	Agent - Casualty	10/10/2013	6/17/2014
Inactive	LM Insurance Corporation	301061	Agent - Property	10/10/2013	6/17/2014
Inactive	Liberty Insurance Corporation	300444	Agent - Casualty	10/10/2013	6/17/2014
Inactive	Liberty Insurance Corporation	300444	Agent - Property	10/10/2013	6/17/2014
Inactive	Liberty Mutual Fire Insurance Company	301913	Agent - Casualty	10/10/2013	6/17/2014
Inactive	Liberty Mutual Fire Insurance Company	301913	Agent - Property	10/10/2013	6/17/2014
Inactive	Liberty Mutual Insurance Company	301159	Agent - Casualty	10/10/2013	6/17/2014
Inactive	Liberty Mutual Insurance Company	301159	Agent - Property	10/10/2013	6/17/2014
Inactive	RLI Insurance Company	301217	Agent - Casualty	6/6/2008	12/30/2009
Inactive	RLI Insurance Company	301217	Agent - Property	6/6/2008	12/30/2009
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Casualty	10/10/2000	10/12/2005
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Property	10/10/2000	10/12/2005
Inactive	The Phoenix Insurance Company	301502	Agent - Casualty	7/30/2003	10/12/2005
Inactive	The Phoenix Insurance Company	301502	Agent - Property	7/30/2003	10/12/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Geico Insurance Agency, LLC	558517	Agent - Property	2/26/2008	6/17/2014
Inactive	Geico Insurance Agency, LLC	558517	Agent - Casualty	2/26/2008	6/17/2014