DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Henry William	DOIID	334139	NAIC NPN	7183031

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Limited Line Credit	8/7/2000	9/30/2003
Inactive	Resident	Agent	Credit Life & Health	4/30/1998	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	Omaha Health Insurance Company	301296	Agent - Limited Line Credit	7/9/2001	9/3/2002
Inactive	Parker Centennial Assurance Company	300134	Agent - Credit Life & Health	4/30/1998	8/7/2000
Inactive	Parker Centennial Assurance Company	300134	Agent - Limited Line Credit	8/7/2000	7/9/2001
Inactive	Protective Life Insurance Company of Kentucky	300663	Agent - Limited Line Credit	5/28/2002	9/30/2003

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Heritage Bank of Ashland Inc.	399900	Agent - Credit Life & Health	5/20/1998	8/7/2000
Inactive	Heritage Bank of Ashland Inc.	399900	Agent - Limited Line Credit	8/7/2000	7/9/2001