DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Carl Richard	DOIID	344740	NAIC NPN	3024581

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	7/16/1969		4/30/2027
Active	Resident	Agent	Life	7/16/1969		4/30/2027
Active	Resident	Agent	Casualty	8/15/2000		4/30/2027
Active	Resident	Agent	Property	8/15/2000		4/30/2027
Inactive	Resident	Agent	General Lines	4/1/1971	8/15/2000
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	02/15/2025	04/30/2025	12/04/2024	12/04/2024	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	1st Choice Advantage Insurance Company, Inc.	750782	Agent - Casualty	8/15/2011	4/1/2016
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	3/18/2002	10/7/2011
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	3/18/2002	10/7/2011
Inactive	Allstate Indemnity Company	300778	Agent - Casualty	7/11/2003	10/18/2023
Inactive	Allstate Indemnity Company	300778	Agent - Property	7/11/2003	10/18/2023
Inactive	Allstate Insurance Company	300773	Agent - Casualty	7/11/2003	10/18/2023
Inactive	Allstate Insurance Company	300773	Agent - Property	7/11/2003	10/18/2023
Inactive	Allstate Property and Casualty Insurance Company	300593	Agent - Casualty	8/12/2005	10/18/2023
Inactive	Allstate Property and Casualty Insurance Company	300593	Agent - Property	8/12/2005	10/18/2023
Inactive	Allstate Vehicle & Property Insurance Company	301429	Agent - Casualty	2/18/2014	10/18/2023
Inactive	Allstate Vehicle & Property Insurance Company	301429	Agent - Property	2/18/2014	10/18/2023
Inactive	American Casualty Company of Reading, Pennsylvania	300956	Agent - Casualty	8/15/2000	12/2/2004
Inactive	American Casualty Company of Reading, Pennsylvania	300956	Agent - Property	8/15/2000	12/2/2004
Active	American Economy Insurance Company	300315	Agent - Casualty	10/24/2022
Active	American Economy Insurance Company	300315	Agent - Property	10/24/2022
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	1/15/2011
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	1/15/2011
Active	American Fire and Casualty Company	300567	Agent - Casualty	10/12/2004
Active	American Fire and Casualty Company	300567	Agent - Property	10/12/2004
Inactive	American Guarantee and Liability Insurance Company	301216	Agent - Casualty	10/18/2002	3/18/2010
Inactive	American Guarantee and Liability Insurance Company	301216	Agent - Property	10/18/2002	3/18/2010
Active	American Heritage Life Insurance Company	300272	Agent - Health	11/27/2000
Active	American Heritage Life Insurance Company	300272	Agent - Life	11/27/2000
Inactive	American Resources Insurance Company, Inc.	300454	Agent - Casualty	8/15/2000	4/23/2007
Inactive	American Resources Insurance Company, Inc.	300454	Agent - Property	8/15/2000	4/23/2007
Inactive	American Zurich Insurance Company	300592	Agent - Casualty	10/18/2002	3/18/2010
Inactive	American Zurich Insurance Company	300592	Agent - Property	10/18/2002	3/18/2010
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Health	8/8/2003	7/2/2004
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Life	8/8/2003	7/2/2004
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	1/31/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Health	8/11/1993	8/21/2000
Inactive	Anthem Life Insurance Company	301209	Agent - Life	8/11/1993	8/21/2000
Inactive	Assurance Company of America	300432	Agent - Casualty	2/5/2001	3/18/2010
Inactive	Assurance Company of America	300432	Agent - Property	2/5/2001	3/18/2010
Inactive	Brighthouse Life Insurance Company	301829	Agent - Health	6/28/1994	12/17/1998
Inactive	Brighthouse Life Insurance Company	301829	Agent - Life	6/28/1994	12/17/1998
Inactive	C.M. Life Insurance Company	301335	Agent - Health	10/26/2001	11/8/2012
Inactive	C.M. Life Insurance Company	301335	Agent - Life	10/26/2001	11/8/2012
Inactive	Colonial American Casualty & Surety Company	300769	Agent - Casualty	10/18/2002	3/18/2010
Inactive	Colonial American Casualty & Surety Company	300769	Agent - Property	10/18/2002	3/18/2010
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	9/8/2007	4/26/2024
Inactive	Consolidated Insurance Company	300943	Agent - Property	9/8/2007	4/26/2024
Inactive	Continental Casualty Company	301019	Agent - Casualty	5/8/2001	12/2/2004
Inactive	Continental Casualty Company	301019	Agent - Property	5/8/2001	12/2/2004
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	8/7/2014	4/16/2016
Inactive	Everett Cash Mutual Insurance Company	750768	Agent - Casualty	8/15/2011	4/1/2016
Inactive	Everett Cash Mutual Insurance Company	750768	Agent - Property	8/15/2011	4/1/2016
Inactive	Everlake Life Insurance Company	300873	Agent - Health	7/11/2003	10/18/2023
Inactive	Everlake Life Insurance Company	300873	Agent - Life	7/11/2003	10/18/2023
Inactive	Fidelity & Guaranty Life Insurance Company	301359	Agent - Health	7/16/1969	12/20/2012
Inactive	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	7/16/1969	3/24/2006
Inactive	Fidelity and Casualty Company of New York (The)	300160	Agent - Casualty	8/15/2000	12/27/2001
Inactive	Fidelity and Casualty Company of New York (The)	300160	Agent - Property	8/15/2000	12/27/2001
Inactive	Fidelity and Deposit Company of Maryland	300976	Agent - Casualty	10/18/2002	3/18/2010
Inactive	Fidelity and Deposit Company of Maryland	300976	Agent - Property	10/18/2002	3/18/2010
Inactive	Fidelity and Guaranty Insurance Company	301009	Agent - Casualty	10/3/2000	12/7/2006
Inactive	Fidelity and Guaranty Insurance Company	301009	Agent - Property	10/3/2000	12/7/2006
Inactive	Fidelity and Guaranty Insurance Underwriters Inc.	300559	Agent - Casualty	10/3/2000	12/7/2006
Inactive	Fidelity and Guaranty Insurance Underwriters Inc.	300559	Agent - Property	10/3/2000	12/7/2006
Inactive	Firemen's Insurance Company of Newark, New Jersey	300247	Agent - General Lines	2/4/1997	3/31/1998
Inactive	First National Insurance Company of America	301690	Agent - Casualty	10/7/2008	10/15/2021
Inactive	First National Insurance Company of America	301690	Agent - Property	10/7/2008	10/15/2021
Inactive	General Insurance Company of America	300261	Agent - Casualty	10/7/2008	10/15/2021
Inactive	General Insurance Company of America	300261	Agent - Property	10/7/2008	10/15/2021
Inactive	Glatfelter Insurance Company	301640	Agent - Casualty	2/5/2001	11/30/2007
Inactive	Glatfelter Insurance Company	301640	Agent - Property	2/5/2001	11/30/2007
Inactive	Glens Falls Insurance Company (The)	301922	Agent - General Lines	2/4/1997	3/31/1998
Inactive	Golden Rule Insurance Company	301943	Agent - Health	3/11/1986	3/31/1997
Inactive	Golden Rule Insurance Company	301943	Agent - Life	3/11/1986	3/31/1997
Active	Grange Indemnity Insurance Company	300793	Agent - Casualty	1/30/2018
Active	Grange Indemnity Insurance Company	300793	Agent - Property	1/30/2018
Active	Grange Insurance Company	300234	Agent - Casualty	1/30/2018
Active	Grange Insurance Company	300234	Agent - Property	1/30/2018
Inactive	Grange Life Insurance Company	300128	Agent - Health	1/30/2018	3/31/2021
Inactive	Grange Life Insurance Company	300128	Agent - Life	1/30/2018	12/28/2020
Active	Grange Property & Casualty Insurance Company	601680	Agent - Casualty	1/30/2018
Active	Grange Property & Casualty Insurance Company	601680	Agent - Property	1/30/2018
Inactive	Great American Alliance Insurance Company	301247	Agent - Casualty	10/4/2007	2/14/2014
Inactive	Great American Alliance Insurance Company	301247	Agent - Property	10/4/2007	2/14/2014
Inactive	Great American Insurance Company	301586	Agent - Casualty	10/4/2007	2/14/2014
Inactive	Great American Insurance Company	301586	Agent - Property	10/4/2007	2/14/2014
Inactive	Great American Insurance Company of New York	301897	Agent - Casualty	10/4/2007	2/14/2014
Inactive	Great American Insurance Company of New York	301897	Agent - Property	10/4/2007	2/14/2014
Inactive	GuideOne Elite Insurance Company	300490	Agent - Casualty	2/4/2004	1/16/2013
Inactive	GuideOne Elite Insurance Company	300490	Agent - Property	2/4/2004	1/16/2013
Inactive	GuideOne Insurance Company	301794	Agent - Casualty	2/4/2004	1/16/2013
Inactive	GuideOne Insurance Company	301794	Agent - Property	2/4/2004	1/16/2013
Inactive	GuideOne Specialty Insurance Company	300278	Agent - Casualty	2/4/2004	1/16/2013
Inactive	GuideOne Specialty Insurance Company	300278	Agent - Property	2/4/2004	1/16/2013
Inactive	Hartford Life Group Insurance Company	301708	Agent - Health	9/30/2004	12/31/2006
Inactive	Hartford Life Group Insurance Company	301708	Agent - Life	9/30/2004	12/31/2006
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	9/30/2004	12/7/2009
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	9/30/2004	12/7/2009
Inactive	Hartford Steam Boiler Inspection and Insurance Company	300799	Agent - Casualty	8/15/2000	5/14/2024
Inactive	Hartford Steam Boiler Inspection and Insurance Company	300799	Agent - Property	8/15/2000	5/14/2024
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	11/28/2005	4/16/2016
Inactive	Humana Insurance Company	301104	Agent - Health	11/28/2005	7/31/2014
Inactive	Humana Insurance Company	301104	Agent - Life	11/28/2005	7/31/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	11/28/2005	7/31/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	11/28/2005	7/31/2014
Inactive	Indiana Insurance Company	301909	Agent - Casualty	9/8/2007	2/3/2023
Inactive	Indiana Insurance Company	301909	Agent - Property	9/8/2007	2/3/2023
Inactive	Infinity Insurance Company	300416	Agent - Casualty	8/15/2000	3/31/2002
Inactive	Infinity Insurance Company	300416	Agent - General Lines	3/16/1994	8/15/2000
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Health	5/24/1999	7/2/2007
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Life	5/24/1999	7/2/2007
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Health	10/22/2001	4/2/2007
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Life	10/22/2001	4/2/2007
Inactive	Kansas City Fire and Marine Insurance Company	301936	Agent - General Lines	3/26/1979	3/31/1998
Active	Kansas City Life Insurance Company	301444	Agent - Life	5/1/2019
Active	Kentucky Home Life Insurance Company	300477	Agent - Health	10/14/2010
Active	Kentucky Home Life Insurance Company	300477	Agent - Life	10/14/2010
Active	Kentucky League of Cities Insurance Services Association	300026	Agent - Casualty	8/15/2000
Active	Kentucky League of Cities Insurance Services Association	300026	Agent - Property	8/15/2000
Active	Kentucky National Insurance Company	301625	Agent - Casualty	8/15/2000
Active	Kentucky National Insurance Company	301625	Agent - Property	8/15/2000
Inactive	Keystone National Insurance Company	745173	Agent - Casualty	4/4/2017	4/20/2023
Inactive	Keystone National Insurance Company	745173	Agent - Property	4/4/2017	4/20/2023
Inactive	Lincoln Benefit Life Company	301110	Agent - Health	7/7/2003	7/14/2014
Inactive	Lincoln Benefit Life Company	301110	Agent - Life	7/7/2003	7/14/2014
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	3/22/2007	7/7/2008
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	3/22/2007	7/7/2008
Inactive	Maryland Casualty Company	301719	Agent - Casualty	2/5/2001	3/18/2010
Inactive	Maryland Casualty Company	301719	Agent - Property	2/5/2001	3/18/2010
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Health	10/26/2001	11/8/2012
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Life	10/26/2001	11/8/2012
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	4/11/1995	11/17/2008
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	4/11/1995	11/17/2008
Inactive	National Fire Insurance Company of Hartford	301063	Agent - Casualty	8/15/2000	12/2/2004
Inactive	National Fire Insurance Company of Hartford	301063	Agent - General Lines	4/25/1997	8/15/2000
Inactive	National Fire Insurance Company of Hartford	301063	Agent - Property	8/15/2000	12/2/2004
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	9/8/2007	4/26/2024
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	9/8/2007	4/26/2024
Inactive	Northern Insurance Company of New York	301317	Agent - Casualty	2/5/2001	3/18/2010
Inactive	Northern Insurance Company of New York	301317	Agent - Property	2/5/2001	3/18/2010
Active	Ohio Casualty Insurance Company	301492	Agent - Casualty	10/12/2004
Active	Ohio Casualty Insurance Company	301492	Agent - Property	10/12/2004
Active	Ohio Security Insurance Company	300622	Agent - Casualty	10/12/2004
Active	Ohio Security Insurance Company	300622	Agent - Property	10/12/2004
Active	Peerless Indemnity Insurance Company	571682	Agent - Casualty	9/8/2007
Active	Peerless Indemnity Insurance Company	571682	Agent - Property	9/8/2007
Active	Peerless Insurance Company	301910	Agent - Casualty	9/8/2007
Active	Peerless Insurance Company	301910	Agent - Property	9/8/2007
Active	Principal Life Insurance Company	300129	Agent - Health	2/24/2010
Active	Principal Life Insurance Company	300129	Agent - Life	2/24/2010
Inactive	Redland Insurance Company	300687	Agent - Casualty	8/15/2000	12/13/2002
Inactive	Redland Insurance Company	300687	Agent - General Lines	8/8/1989	8/15/2000
Inactive	Redland Insurance Company	300687	Agent - Property	8/15/2000	12/13/2002
Active	SAFECO Insurance Company of America	300159	Agent - Casualty	8/15/2000
Inactive	SAFECO Insurance Company of America	300159	Agent - General Lines	6/21/1999	8/15/2000
Active	SAFECO Insurance Company of America	300159	Agent - Property	8/15/2000
Active	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	8/2/2022
Active	SAFECO Insurance Company of Illinois	301350	Agent - Property	8/2/2022
Inactive	Seaboard Surety Company	300510	Agent - Casualty	10/3/2000	12/7/2006
Inactive	Seaboard Surety Company	300510	Agent - Property	10/3/2000	12/7/2006
Inactive	Shenandoah Life Insurance Company	300130	Agent - Health	8/2/2006	3/31/2009
Inactive	Shenandoah Life Insurance Company	300130	Agent - Life	8/2/2006	10/24/2007
Inactive	St. Paul Fire and Marine Insurance Company	300782	Agent - Casualty	10/3/2000	12/7/2006
Inactive	St. Paul Fire and Marine Insurance Company	300782	Agent - Property	10/3/2000	12/7/2006
Inactive	St. Paul Guardian Insurance Company	301372	Agent - Casualty	10/3/2000	12/7/2006
Inactive	St. Paul Guardian Insurance Company	301372	Agent - Property	10/3/2000	12/7/2006
Inactive	St. Paul Mercury Insurance Company	300783	Agent - Casualty	10/3/2000	12/7/2006
Inactive	St. Paul Mercury Insurance Company	300783	Agent - Property	10/3/2000	12/7/2006
Inactive	St. Paul Protective Insurance Company	301215	Agent - Casualty	10/3/2000	4/21/2003
Inactive	St. Paul Protective Insurance Company	301215	Agent - Property	10/3/2000	4/21/2003
Inactive	Standard Insurance Company	300185	Agent - Health	3/6/2007	12/31/2013
Inactive	Standard Insurance Company	300185	Agent - Life	3/6/2007	12/31/2013
Inactive	State Auto Property & Casualty Insurance Company	301953	Agent - Casualty	3/11/2020	6/28/2022
Inactive	State Auto Property & Casualty Insurance Company	301953	Agent - Property	3/11/2020	6/28/2022
Inactive	Transcontinental Insurance Company	301731	Agent - Casualty	8/15/2000	12/2/2004
Inactive	Transcontinental Insurance Company	301731	Agent - General Lines	2/5/1997	8/15/2000
Inactive	Transcontinental Insurance Company	301731	Agent - Property	8/15/2000	12/2/2004
Inactive	Transportation Insurance Company	301575	Agent - Casualty	8/15/2000	12/2/2004
Inactive	Transportation Insurance Company	301575	Agent - General Lines	2/1/1997	8/15/2000
Inactive	Transportation Insurance Company	301575	Agent - Property	8/15/2000	12/2/2004
Inactive	Travelers Casualty and Surety Company of America	301334	Agent - Casualty	9/7/2004	9/7/2006
Inactive	Travelers Casualty and Surety Company of America	301334	Agent - Property	9/7/2004	9/7/2006
Active	Trustgard Insurance Company	300104	Agent - Casualty	1/30/2018
Active	Trustgard Insurance Company	300104	Agent - Property	1/30/2018
Inactive	United States Fidelity and Guaranty Company	301449	Agent - Casualty	10/3/2000	12/7/2006
Inactive	United States Fidelity and Guaranty Company	301449	Agent - Property	10/3/2000	12/7/2006
Inactive	Universal Underwriters Insurance Company	301558	Agent - General Lines	5/30/1997	4/28/1999
Inactive	Valley Forge Insurance Company	301052	Agent - Casualty	8/15/2000	12/2/2004
Inactive	Valley Forge Insurance Company	301052	Agent - General Lines	2/3/1997	8/15/2000
Inactive	Valley Forge Insurance Company	301052	Agent - Property	8/15/2000	12/2/2004
Active	West American Insurance Company	301112	Agent - Casualty	10/12/2004
Active	West American Insurance Company	301112	Agent - Property	10/12/2004
Inactive	West Bend Insurance Company	672974	Agent - Casualty	11/17/2011	12/28/2017
Inactive	West Bend Insurance Company	672974	Agent - Property	11/17/2011	12/28/2017
Active	Western Surety Company	300283	Agent - Casualty	8/15/2000
Inactive	Western Surety Company	300283	Agent - General Lines	9/23/1994	8/15/2000
Inactive	Zurich American Insurance Company	301121	Agent - Casualty	10/18/2002	3/18/2010
Inactive	Zurich American Insurance Company	301121	Agent - Property	10/18/2002	3/18/2010
Inactive	Zurich American Insurance Company of Illinois	301805	Agent - Casualty	10/18/2002	3/18/2010
Inactive	Zurich American Insurance Company of Illinois	301805	Agent - Property	10/18/2002	3/18/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	6/25/1996	6/21/2008
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	6/25/1996	6/21/2008
Inactive	Commonwealth Central Insurance, LLC	661011	Agent - Life	7/25/2007	1/6/2012
Inactive	Commonwealth Central Insurance, LLC	661011	Agent - Health	7/25/2007	1/6/2012
Inactive	Commonwealth Central Insurance, LLC	661011	Agent - Property	7/25/2007	1/6/2012
Inactive	Commonwealth Central Insurance, LLC	661011	Agent - Casualty	7/25/2007	1/6/2012
Inactive	Dental Choice Agency Inc.	398085	Agent - Health	3/3/2005	7/22/2014
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/3/2013	2/13/2025
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/3/2013	2/13/2025
Inactive	Gorman Clark Insurance LLC	636381	Agent - Life	7/27/2006	3/1/2007
Inactive	Gorman Clark Insurance LLC	636381	Agent - Health	7/27/2006	3/1/2007
Inactive	Gorman Clark Insurance LLC	636381	Agent - Property	7/27/2006	3/1/2007
Inactive	Gorman Clark Insurance LLC	636381	Agent - Casualty	7/27/2006	3/1/2007
Active	Hall & Clark Insurance Agency Inc.	399717	Agent - Life	3/31/1982
Active	Hall & Clark Insurance Agency Inc.	399717	Agent - Health	3/31/1982
Active	Hall & Clark Insurance Agency Inc.	399717	Agent - Property	8/15/2000
Active	Hall & Clark Insurance Agency Inc.	399717	Agent - Casualty	8/15/2000
Inactive	Healthplan Services, Inc.	401230	Agent - Health	8/31/1995	3/31/1997
Inactive	United Agency Of Kentucky Llc	401115	Agent - General Lines	4/6/1999	8/15/2000
Inactive	United Agency Of Kentucky Llc	401115	Agent - Property	8/15/2000	4/15/2016
Inactive	United Agency Of Kentucky Llc	401115	Agent - Casualty	8/15/2000	4/15/2016