DEPARTMENT OF INSURANCE

Affiliations

Name	Daugherty, Jack W	DOIID	316275	NAIC NPN	547811

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	8/28/2014	3/31/2016
Inactive	Resident	Agent	Health	9/14/1994	12/1/2000
* 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	Allianz Life Insurance Company of North America	301791	Agent - Health	8/26/1996	9/4/1997
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	8/26/1996	9/4/1997
Inactive	First Colony Life Insurance Company	301179	Agent - Health	4/14/1995	9/4/1997
Inactive	First Colony Life Insurance Company	301179	Agent - Life	8/21/1998	12/1/2000
Inactive	Golden Rule Insurance Company	301943	Agent - Health	11/15/1995	3/31/1997
Inactive	Golden Rule Insurance Company	301943	Agent - Life	11/15/1995	3/31/1997
Inactive	Humana Insurance Company	301104	Agent - Life	6/4/2015	12/8/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	6/4/2015	12/8/2015
Inactive	John Alden Life Insurance Company	300573	Agent - Health	6/6/1995	3/31/1997
Inactive	John Alden Life Insurance Company	300573	Agent - Life	6/6/1995	3/31/1997
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	5/1/1996	3/31/1997
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	5/1/1996	3/31/1997
Inactive	John Hancock Variable Life Insurance Company	301914	Agent - Health	5/22/1996	3/31/1997
Inactive	John Hancock Variable Life Insurance Company	301914	Agent - Life	5/22/1996	3/31/1997
Inactive	Kanawha Insurance Company	300127	Agent - Life	6/4/2015	10/22/2015
Inactive	Manhattan National Life Insurance Company	301011	Agent - Health	4/12/1996	9/4/1997
Inactive	Manhattan National Life Insurance Company	301011	Agent - Life	4/12/1996	9/4/1997
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Life	9/30/2014	3/31/2016
Inactive	New York Life Insurance Company	300431	Agent - Health	9/14/1994	1/27/1997
Inactive	New York Life Insurance Company	300431	Agent - Life	9/14/1994	1/27/1997
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Health	10/7/1994	1/27/1997
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Life	10/7/1994	1/27/1997
Inactive	Reassure America Life Insurance Company	301902	Agent - Life	9/24/1998	12/1/2000
Inactive	Time Insurance Company	300683	Agent - Health	10/21/1997	10/13/1998
Inactive	Time Insurance Company	300683	Agent - Life	10/21/1997	10/13/1998
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	9/24/2014	3/31/2016
Inactive	Union Security Insurance Company	301844	Agent - Health	2/17/1995	9/4/1997
Inactive	Union Security Insurance Company	301844	Agent - Life	2/17/1995	9/4/1997
Inactive	Woodmen of the World Life Insurance Society	301446	Agent - Life	6/24/1998	6/13/2000

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	6/25/1996	9/4/1997
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	6/25/1996	9/4/1997
Inactive	Daugherty Enterprizes Ltd	400155	Agent - Life	9/8/1998	12/1/2000
Inactive	Daugherty Enterprizes Ltd	400155	Agent - Health	9/8/1998	12/1/2000
Inactive	Healthplan Services, Inc.	401230	Agent - Health	8/31/1995	3/31/1997