DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Chiavetta, Amanda L	DOIID	606875	NAIC NPN	7714128

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	4/13/2005	4/25/2013
Inactive	Non Resident	Agent	Life	4/13/2005	4/25/2013
* 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	Genworth Life Insurance Company	300623	Agent - Health	3/24/2008	10/4/2009
Inactive	Genworth Life Insurance Company	300623	Agent - Life	3/24/2008	10/4/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	USI Insurance Services National, Inc	509421	Agent - Life	5/1/2008	10/4/2009
Inactive	USI Insurance Services National, Inc	509421	Agent - Health	5/1/2008	10/4/2009