DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Willie	DOIID	866743	NAIC NPN	16838287

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	1/23/2015	11/17/2015
Inactive	Non Resident	Agent	Casualty	1/23/2015	11/17/2015
* 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	Safe Auto Insurance Company	300419	Agent - Casualty	1/27/2015	8/11/2015
Inactive	Safe Auto Insurance Company	300419	Agent - Property	1/27/2015	8/11/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Safe Auto Group Agency Inc	557065	Agent - Casualty	5/29/2015	8/11/2015
Inactive	Safe Auto Group Agency Inc	557065	Agent - Property	5/29/2015	8/11/2015