DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Fultz, Staci LeMaster	DOIID	553083	NAIC NPN	7341836

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Limited Line Credit	7/12/2002	10/20/2005
* 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	CICA Life Insurance Company of America	600487	Agent - Limited Line Credit	1/1/2005	10/20/2005
Inactive	First Alliance Insurance Company	301000	Agent - Limited Line Credit	10/10/2003	1/1/2005
Inactive	Southern Financial Life Insurance Company	300664	Agent - Limited Line Credit	7/12/2002	10/20/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Carrollton Federal Bank	399384	Agent - Limited Line Credit	1/27/2004	3/4/2005
Inactive	First National Bank Of Kentucky	399385	Agent - Limited Line Credit	2/18/2003	12/29/2003