DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Martin, Sam	DOIID	325900	NAIC NPN	7171689

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Credit Life & Health	5/8/1985	3/20/1996
Inactive	Resident	Agent	Mortgage Redemption	5/8/1985	3/20/1996
* 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	Banc One Kentucky Insurance Company	300824	Agent - Credit Life & Health	8/9/1990	3/20/1996
Inactive	Banc One Kentucky Insurance Company	300824	Agent - Mortgage Redemption	8/9/1990	3/20/1996

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Liberty National Bank of Owensboro	398750	Agent - Mortgage Redemption	5/8/1985	3/18/1996
Inactive	Liberty National Bank of Owensboro	398750	Agent - Credit Life & Health	5/8/1985	3/18/1996