DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Ford, Sammy Lee	DOIID	373055	NAIC NPN	7201526

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	General Lines	10/6/1971	8/15/2000
Inactive	Resident	Agent	Life	12/30/1975	12/1/2000
Inactive	Resident	Agent	Health	12/30/1975	12/1/2000
* 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	Encova Life Insurance Company	301818	Agent - Health	12/30/1975	12/1/2000
Inactive	Encova Life Insurance Company	301818	Agent - Life	12/30/1975	12/1/2000
Inactive	MICO Insurance Company	301664	Agent - General Lines	8/22/1989	3/31/1996
Inactive	Motorists Mutual Insurance Company	300963	Agent - General Lines	10/6/1971	12/31/1999
Inactive	State Automobile Mutual Insurance Company	301824	Agent - General Lines	9/5/1974	8/15/2000

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Singleton & Associates Inc.	400346	Agent - General Lines	1/27/1976	8/15/2000
Inactive	Singleton & Associates Inc.	400346	Agent - Life	1/27/1976	12/1/2000
Inactive	Singleton & Associates Inc.	400346	Agent - Health	1/27/1976	12/1/2000