DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Caroway, Jack D	DOIID	309001	NAIC NPN	390911

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	7/26/2004	9/30/2007
Inactive	Non Resident	Agent	Health	7/26/2004	9/30/2007
* 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	Anthem Life Insurance Company	301209	Agent - Health	8/21/2006	9/30/2007
Inactive	Anthem Life Insurance Company	301209	Agent - Life	8/21/2006	9/30/2007
Inactive	New York Life Insurance Company	300431	Agent - Health	9/20/1999	2/9/2000
Inactive	New York Life Insurance Company	300431	Agent - Life	9/20/1999	2/9/2000

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CBISA Reaquisitian Corp	547026	Agent - Life	8/21/2006	9/30/2007
Inactive	CBISA Reaquisitian Corp	547026	Agent - Health	8/21/2006	9/30/2007