DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Ford Sr, Thomas A	DOIID	371478	NAIC NPN	7200822

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	12/26/2002
Inactive	Resident	Agent	Life	6/16/2009	3/1/2011
Inactive	Resident	Agent	Credit Life & Health	5/1/1986	8/7/2000
Inactive	Resident	Agent	Health	6/30/2009	3/1/2011
* 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	New York Life Insurance and Annuity Corporation	300726	Agent - Life	7/22/2009	3/1/2011
Inactive	Principal Life Insurance Company	300129	Agent - Health	7/21/2009	3/1/2011
Inactive	Principal Life Insurance Company	300129	Agent - Life	7/21/2009	3/1/2011
Inactive	Southern Financial Life Insurance Company	300664	Agent - Credit Life & Health	9/23/1998	8/7/2000
Inactive	Southern Financial Life Insurance Company	300664	Agent - Limited Line Credit	8/7/2000	12/26/2002
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Credit Life & Health	5/1/1986	9/23/1998

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Keycorp Ins Agency Usa Inc	602413	Agent - Health	7/21/2009	3/1/2011
Inactive	Keycorp Ins Agency Usa Inc	602413	Agent - Life	7/21/2009	3/1/2011
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