DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Collett, Roy	DOIID	304950	NAIC NPN	7157848

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Limited Line Credit	8/7/2000	2/28/2011
Inactive	Resident	Agent	Credit Life & Health	10/26/1993	8/7/2000
* 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	Investors Heritage Life Insurance Company	300363	Agent - Limited Line Credit	7/12/2007	2/28/2011
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Credit Life & Health	11/24/1998	8/7/2000
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Limited Line Credit	8/31/2009	3/18/2011
Inactive	National Guardian Life Insurance Company	300596	Agent - Credit Life & Health	10/26/1993	12/1/1998

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bank of the Mountains	747565	Agent - Limited Line Credit	2/4/2011	2/28/2011
Inactive	Stacy Insurance Inc.	398813	Agent - Limited Line Credit	2/26/2004	2/28/2011