DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Carlson, Thomas Laird	DOIID	368780	NAIC NPN	889395

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	7/9/1990	10/25/1996
Inactive	Resident	Agent	General Lines	6/7/1990	9/23/1996
Inactive	Resident	Agent	Health	7/9/1990	10/25/1996
* 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	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	5/6/1996	10/4/1996
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	5/6/1996	10/4/1996
Inactive	Employers Insurance Company of Wausau	301813	Agent - General Lines	6/7/1990	9/23/1996
Inactive	Humana Insurance Company	301104	Agent - Health	1/27/1995	10/25/1996
Inactive	Humana Insurance Company	301104	Agent - Life	1/27/1995	10/25/1996
Inactive	Nationwide Life Insurance Company	300495	Agent - Health	7/9/1990	9/23/1996
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	7/9/1990	9/23/1996
Inactive	Wausau Business Insurance Company	301476	Agent - General Lines	11/10/1992	9/23/1996
Inactive	Wausau Underwriters Insurance Company	301105	Agent - General Lines	7/9/1990	9/23/1996

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Companies Agency of Kentucky Inc.	400449	Agent - Life	5/19/1993	9/23/1996
Inactive	Companies Agency of Kentucky Inc.	400449	Agent - Health	5/19/1993	9/23/1996
Inactive	Companies Agency of Kentucky Inc.	400449	Agent - General Lines	5/19/1993	9/23/1996