DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Blalock-Coleman Funeral Home Inc.	DOIID	398222	NAIC NPN	7220738

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	7/18/1988	5/31/2003
* 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	Forethought Life Insurance Company	301407	Agent - Life	7/18/1988	2/25/2003

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Coleman, Betty D	318048	Agent - Life	7/18/1988	6/19/1997
Inactive	Coleman, James M	325936	Agent - Life	7/18/1988	6/25/1997
Inactive	Imes, Richard Matthew	327695	Agent - Life	7/10/1997	2/25/2003