DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Blankenship, Charlotte A	DOIID	347205	NAIC NPN	7190205

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	1/26/1989	12/1/2000
Inactive	Resident	Agent	Life	1/26/1989	12/1/2000
* 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	Forethought Life Insurance Company	301407	Agent - Health	1/26/1989	12/1/2000
Inactive	Forethought Life Insurance Company	301407	Agent - Life	1/26/1989	12/1/2000

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Betts & West Funeral Home	398825	Agent - Life	2/3/1989	12/1/2000