DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Long, Mary Jo	DOIID	320334	NAIC NPN	7167949

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Credit Life & Health	6/7/1994	4/29/1996
Inactive	Resident	Agent	Limited Line Credit	11/21/2005	5/31/2009
* 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	Franklin Life Insurance Company (The)	300779	Agent - Credit Life & Health	11/18/1994	3/25/1996
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Credit Life & Health	6/7/1994	4/29/1996
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Limited Line Credit	11/21/2005	5/31/2009
Inactive	National Guardian Life Insurance Company	300596	Agent - Credit Life & Health	9/29/1995	4/29/1996

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Citizens Bank of Northern Kentucky, Inc.	398933	Agent - Credit Life & Health	12/5/1994	4/29/1996