DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Jolly, Roger Wilson	DOIID	312256	NAIC NPN	7161264

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	8/5/1992	10/23/2002
Inactive	Resident	Agent	Life	10/8/1987	10/23/2002
* 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	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	9/6/1994	3/20/1998
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	9/6/1994	3/20/1998
Inactive	Investors Life Insurance Company of Indiana	301657	Agent - Life	10/8/1987	3/31/1997
Inactive	Modern Woodmen of America	301213	Agent - Life	12/6/1995	3/31/1996
Inactive	Pioneer Life Insurance Company	300110	Agent - Health	8/5/1992	10/23/2002
Inactive	Pioneer Life Insurance Company	300110	Agent - Life	8/5/1992	10/23/2002

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Kentucky Group Inc.	399177	Agent - Life	3/31/1994	10/23/2002
Inactive	Kentucky Group Inc.	399177	Agent - Health	3/31/1994	10/23/2002