DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Michael Burris Agency Inc.	DOIID	398649	NAIC NPN	3148090

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	9/15/1998	6/20/2006
Inactive	Resident	Agent	Life	9/15/1998	6/20/2006
* 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 Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	9/15/1998	6/20/2006
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	9/15/1998	6/20/2006

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Burris, W Michael	374405	Agent - Health	9/15/1998	6/19/2006
Inactive	Burris, W Michael	374405	Agent - Life	9/15/1998	6/19/2006