DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Clayton, Charlotte W	DOIID	333464	NAIC NPN	3309144

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	7/9/1999	7/1/2002
Inactive	Resident	Agent	Health	7/9/1999	7/1/2002
* 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
Denied	AF&L Insurance Company	301582	Agent - Health
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	3/28/2001	7/1/2002
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	3/28/2001	7/1/2002
Inactive	Bankers Life and Casualty Company	300701	Agent - Health	7/9/1999	4/21/2000
Inactive	Bankers Life and Casualty Company	300701	Agent - Life	7/9/1999	4/21/2000
Denied	Penn Treaty Network America Insurance Company	301297	Agent - Health
Denied	Penn Treaty Network America Insurance Company	301297	Agent - Life
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	3/8/2000	9/24/2001
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Life	3/8/2000	9/24/2001

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Senior Healthcare Insurance Associates Inc.	399807	Agent - Life	12/31/1999	7/1/2002
Inactive	Senior Healthcare Insurance Associates Inc.	399807	Agent - Health	12/31/1999	7/1/2002