DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Black, Anita Marie	DOIID	338825	NAIC NPN	7186567

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Limited Line Credit	5/10/2018		9/30/2025
Inactive	Resident	Agent	Debtors Life	10/17/1997	8/7/2000
Inactive	Resident	Agent	Life	11/13/2001	10/1/2011
Inactive	Resident	Agent	Credit Life & Health	6/16/1995	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	American General Assurance Company	300586	Agent - Limited Line Credit	5/7/2001	3/28/2007
Inactive	Empower Annuity Insurance Company of America	300259	Agent - Life	11/28/2006	10/1/2011
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Credit Life & Health	10/17/1997	12/31/1998
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Debtors Life	10/17/1997	12/31/1998
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Limited Line Credit	5/10/2018	4/11/2024
Inactive	Jackson National Life Insurance Company	300486	Agent - Life	10/23/2008	10/1/2011
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Credit Life & Health	5/11/1999	8/7/2000
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Debtors Life	11/3/1999	8/7/2000
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Limited Line Credit	8/7/2000	8/6/2001
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	12/5/2001	1/7/2006
Inactive	Protective Life Insurance Company	300638	Agent - Life	3/17/2004	11/23/2009
Inactive	Symetra Life Insurance Company	301691	Agent - Life	4/5/2003	7/7/2004
Inactive	Union Fidelity Life Insurance Company	301136	Agent - Credit Life & Health	6/16/1995	8/7/2000
Inactive	Union Fidelity Life Insurance Company	301136	Agent - Limited Line Credit	8/7/2000	2/6/2001
Inactive	Western National Life Insurance Company	300461	Agent - Life	11/13/2001	11/21/2011
Inactive		300277	Agent - Life	3/16/2004	12/15/2006

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Integra Bank National Association	558914	Agent - Life	11/7/2006	10/1/2011
Inactive	Planters Bank Inc	399591	Agent - Limited Line Credit	2/25/2021	3/31/2023