DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Roberts, Charlotte Y	DOIID	359021	NAIC NPN	7195422

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	5/31/2004
Inactive	Non Resident	Agent	Life	9/29/2017	3/31/2020
Inactive	Resident	Agent	Credit Life & Health	4/1/1999	8/7/2000
Inactive	Non Resident	Agent	Health	9/29/2017	3/31/2020
* 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	Southern Financial Life Insurance Company	300664	Agent - Credit Life & Health	4/1/1999	8/7/2000
Inactive	Southern Financial Life Insurance Company	300664	Agent - Limited Line Credit	8/7/2000	12/26/2002
Inactive	Woodmen of the World Life Insurance Society	301446	Agent - Health	10/3/2017	10/31/2019
Inactive	Woodmen of the World Life Insurance Society	301446	Agent - Life	10/3/2017	10/31/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	National City Bank of Kentucky	400904	Agent - Credit Life & Health	12/8/1999	8/7/2000
Inactive	National City Bank of Kentucky	400904	Agent - Limited Line Credit	8/7/2000	12/26/2002