DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Forker, Judy Ann	DOIID	319845	NAIC NPN	7167708

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Credit Life & Health	12/8/1994	2/26/1996
Inactive	Resident	Agent	Health	8/12/1993	7/1/1996
Inactive	Resident	Agent	General Lines	6/3/1992	7/1/1996
Inactive	Resident	Agent	Life	3/11/1993	7/1/1996
* 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	Cincinnati Life Insurance Company (The)	300601	Agent - Life	3/11/1993	7/1/1996
Inactive	Countryway Insurance Company	300809	Agent - General Lines	8/25/1992	7/1/1996
Inactive	Federal Home Life Insurance Company	301302	Agent - Credit Life & Health	12/8/1994	2/26/1996
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Health	3/7/1995	7/1/1996
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Life	3/7/1995	7/1/1996
Inactive	Kentucky National Insurance Company	301625	Agent - General Lines	6/3/1992	7/1/1996
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	8/12/1993	7/1/1996
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	8/12/1993	7/1/1996

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Latta Insurance Inc	399727	Agent - Life	5/23/1994	7/1/1996
Inactive	Latta Insurance Inc	399727	Agent - Health	5/23/1994	7/1/1996
Inactive	Latta Insurance Inc	399727	Agent - General Lines	5/23/1994	7/1/1996