DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, William R	DOIID	347138	NAIC NPN	7190150

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	2/28/2005
Inactive	Resident	Agent	Credit Life & Health	11/4/1994	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 Heritage Life Insurance Company	300272	Agent - Credit Life & Health	5/11/1995	1/9/1997
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Credit Life & Health	11/4/1994	8/7/2000
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Limited Line Credit	8/7/2000	2/28/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	First Southern National Bank	398361	Agent - Credit Life & Health	6/20/1995	8/7/2000
Inactive	First Southern National Bank	398361	Agent - Limited Line Credit	8/7/2000	5/6/2002