DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Hayes, Thomas Wayne	DOIID	310799	NAIC NPN	3098161

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	9/6/1996	7/1/1998
Inactive	Resident	Agent	Life	9/6/1996	7/1/1998
* 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	1/30/1997	7/1/1998
Inactive	Anthem Life Insurance Company	301209	Agent - Life	1/30/1997	7/1/1998
Inactive	Athene Annuity & Life Assurance Company	301798	Agent - Health	9/6/1996	12/26/1996
Inactive	Athene Annuity & Life Assurance Company	301798	Agent - Life	9/6/1996	12/26/1996
Inactive	Forethought Life Insurance Company	301407	Agent - Life	2/13/1997	8/4/1997

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Acordia of Louisville Inc.	401252	Agent - Life	2/24/1997	7/1/1998
Inactive	Acordia of Louisville Inc.	401252	Agent - Health	2/24/1997	7/1/1998