DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Adams, Tom K	DOIID	351115	NAIC NPN	7191934

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Casualty	7/21/2011	8/1/2012
Inactive	Resident	Agent	Property	7/21/2011	8/1/2012
Inactive	Resident	Agent	Health	9/25/1995	7/1/1998
Inactive	Resident	Agent	Life	9/25/1995	7/1/1998
* 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	Anthem Life Insurance Company	301209	Agent - Health	11/13/1996	7/1/1998
Inactive	Anthem Life Insurance Company	301209	Agent - Life	11/13/1996	7/1/1998
Inactive	Augustar Life Assurance Corporation	301113	Agent - Health	10/31/1995	1/29/1996
Inactive	Augustar Life Assurance Corporation	301113	Agent - Life	10/31/1995	1/29/1996
Inactive	Augustar Life Insurance Company	301816	Agent - Health	10/31/1995	1/29/1996
Inactive	Augustar Life Insurance Company	301816	Agent - Life	10/31/1995	1/29/1996
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	12/2/2011	8/1/2012
Inactive	Bristol West Insurance Company	301655	Agent - Property	12/2/2011	8/1/2012
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	12/2/2011	8/1/2012
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	12/2/2011	8/1/2012
Inactive	Golden Rule Insurance Company	301943	Agent - Health	11/15/1995	9/30/1996
Inactive	Golden Rule Insurance Company	301943	Agent - Life	11/15/1995	9/30/1996
Inactive	National General Insurance Company	300152	Agent - Casualty	8/24/2011	8/1/2012
Inactive	National General Insurance Company	300152	Agent - Property	8/24/2011	8/1/2012
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	9/16/2011	8/1/2012
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	9/16/2011	8/1/2012
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	9/25/1995	9/30/1996
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	9/25/1995	9/30/1996

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Acordia of Lexington Inc.	401285	Agent - Life	4/18/1996	9/30/1996
Inactive	Acordia of Lexington Inc.	401285	Agent - Health	4/18/1996	9/30/1996
Inactive	Provident Insurance Agency, LLC	759825	Agent - Casualty	8/24/2011	8/1/2012
Inactive	Provident Insurance Agency, LLC	759825	Agent - Property	8/24/2011	8/1/2012