DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Fidelity Assurance Inc.	DOIID	399978	NAIC NPN	1045245

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	8/23/1999	5/31/2003
Inactive	Non Resident	Agent	Health	8/23/1999	5/31/2003
* 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	Penn Treaty Network America Insurance Company	301297	Agent - Health	8/23/1999	1/13/2003
Inactive	Penn Treaty Network America Insurance Company	301297	Agent - Life	8/23/1999	1/13/2003

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Sarno, James	340682	Agent - Health	8/23/1999	1/13/2003
Inactive	Sarno, James	340682	Agent - Life	8/23/1999	1/13/2003