DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, David Paul	DOIID	340954	NAIC NPN	7187477

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	12/21/2001	12/1/2008
* 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	Forethought Life Insurance Company	301407	Agent - Life	2/1/2002	12/1/2008
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Life	12/21/2001	12/1/2008
Denied	Kentucky Funeral Directors Life Insurance Company	532905	Agent - Life
Inactive	Lincoln Memorial Life Insurance Company	300463	Agent - Life	3/30/2006	12/1/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CFH, Inc	695772	Agent - Life		12/17/2008
Inactive	Duell-Clark Funeral Chapel Inc.	399212	Agent - Life	5/19/1987	3/31/1997
Inactive	Landmark Group Ltd. [The]	398493	Agent - Life	2/1/1988	3/31/1997