DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Guy D	DOIID	352527	NAIC NPN	7192586

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Life	12/31/1998	3/31/2007
Inactive	Resident	Agent	Health	12/31/1998	3/31/2007
Inactive	Resident	Agent	Casualty	10/2/2001	3/31/2007
Inactive	Resident	Agent	Property	6/6/2001	3/31/2007
Inactive	Resident	Temporary Agent	Ordinary Life (Temporary Life)	11/19/1996	12/3/1996
* 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	Allianz Life Insurance Company of North America	301791	Agent - Health	5/28/2002	3/31/2007
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	5/28/2002	3/31/2007
Inactive	American General Life and Accident Insurance Company	301362	Agent - Health	12/3/1996	3/6/2000
Inactive	American General Life and Accident Insurance Company	301362	Agent - Life	12/3/1996	3/6/2000
Inactive	American General Life and Accident Insurance Company	301362	Temporary Agent - Ordinary Life (Temporary Life)	11/19/1996	12/3/1996
Inactive	Assurity Life Insurance Company	301099	Agent - Health	7/1/2002	3/31/2007
Inactive	Assurity Life Insurance Company	301099	Agent - Life	7/1/2002	3/31/2007
Inactive	Bankers Life and Casualty Company	300701	Agent - Health	2/9/2000	7/9/2001
Inactive	Bankers Life and Casualty Company	300701	Agent - Life	2/9/2000	7/9/2001
Inactive	EMC National Life Company	300388	Agent - Health	9/30/2003	3/31/2007
Inactive	EMC National Life Company	300388	Agent - Life	9/30/2003	3/31/2007
Inactive	Everly Life Insurance Company	561641	Agent - Life	7/1/2006	3/31/2007
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Health	5/23/2003	3/31/2007
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Life	5/23/2003	3/31/2007
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Health	3/11/2002	3/31/2007
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Life	3/11/2002	3/31/2007
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	9/29/2003	3/31/2007
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	9/29/2003	3/31/2007
Inactive	Midland National Life Insurance Company	300923	Agent - Health	12/27/2000	3/31/2007
Inactive	Midland National Life Insurance Company	300923	Agent - Life	12/27/2000	3/31/2007
Inactive	National Travelers Life Company	300304	Agent - Health	7/6/2001	6/30/2003
Inactive	National Travelers Life Company	300304	Agent - Life	7/6/2001	6/30/2003
Inactive	Oakwood Insurance Company	300453	Agent - Property	7/18/1997	3/6/2000
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	3/24/2004	3/31/2007
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	3/24/2004	3/31/2007
Inactive	Progressive Northern Insurance Company	301378	Agent - Casualty	10/2/2001	3/31/2007
Inactive	Progressive Northern Insurance Company	301378	Agent - Property	6/6/2001	3/31/2007
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	12/31/1998	11/10/2004
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	12/31/1998	11/10/2004
Inactive	Settlers Life Insurance Company	300189	Agent - Life		7/1/2006
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	1/3/2001	11/6/2006
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Life	1/10/2001	11/6/2006
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Life	12/26/2002	3/31/2007
Inactive	Union Central Life Insurance Company	300307	Agent - Health	3/24/2003	3/31/2007
Inactive	Union Central Life Insurance Company	300307	Agent - Life	3/24/2003	3/31/2007
Inactive	Union Security Insurance Company	301844	Agent - Life	5/10/2001	1/20/2003
Inactive	United Financial Casualty Company	301886	Agent - Casualty	12/2/2005	3/31/2007
Inactive	United Financial Casualty Company	301886	Agent - Property	12/2/2005	3/31/2007
Inactive	West Coast Life Insurance Company	301607	Agent - Life	2/6/2003	3/31/2007
Inactive	Western National Life Insurance Company	300461	Agent - Life	10/1/1999	3/9/2000

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Branham Insurance Services Inc.	398580	Agent - Property	1/12/2005	3/31/2007
Inactive	Branham Insurance Services Inc.	398580	Agent - Casualty	1/12/2005	3/31/2007
Inactive	Select Insurance Agency, Inc.	503760	Agent - Property	3/17/2003	3/31/2007
Inactive	Select Insurance Agency, Inc.	503760	Agent - Life	12/8/2000	3/31/2007
Inactive	Select Insurance Agency, Inc.	503760	Agent - Health	12/8/2000	3/31/2007
Inactive	Select Insurance Agency, Inc.	503760	Agent - Casualty	3/17/2003	3/31/2007