DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Wortham, Michael David	DOIID	340546	NAIC NPN	7187313

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	6/30/2008
Inactive	Resident	Agent	Credit Life & Health	2/3/1995	8/7/2000
Inactive	Resident	Agent	Mortgage Redemption	8/25/1995	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	8/7/2000	6/30/2008
Inactive	American General Assurance Company	300586	Agent - Mortgage Redemption	8/25/1995	8/7/2000
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Credit Life & Health	11/24/1998	8/7/2000
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Limited Line Credit	8/7/2000	9/5/2006
Inactive	National Guardian Life Insurance Company	300596	Agent - Credit Life & Health	2/3/1995	12/1/1998
Inactive	Southern Financial Life Insurance Company	300664	Agent - Limited Line Credit	6/20/2003	6/30/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Community First Bank	400587	Agent - Mortgage Redemption	12/16/1996	8/7/2000
Inactive	Community First Bank	400587	Agent - Limited Line Credit	8/7/2000	6/30/2008