DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Jay Douglas	DOIID	316304	NAIC NPN	7163178

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Limited Line Credit	7/21/2008	12/31/2011
Inactive	Resident	Agent	Credit Life & Health	10/21/1994	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	10/16/2008	12/31/2011
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	7/21/2008	12/31/2011
Inactive	National Guardian Life Insurance Company	300596	Agent - Credit Life & Health	6/9/1998	12/1/1998
Inactive	Protective Life Insurance Company of Kentucky	300663	Agent - Limited Line Credit	9/8/2000	5/31/2005
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Credit Life & Health	10/21/1994	6/9/1998

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Ohio County Motors LLC	514681	Agent - Limited Line Credit	8/12/2004	1/25/2007
Inactive	Thompson's Auto Parts & Service Center Inc.	399165	Agent - Credit Life & Health	9/22/1998	8/7/2000
Inactive	Thompson's Auto Parts & Service Center Inc.	399165	Agent - Limited Line Credit	8/7/2000	2/18/2003