DEPARTMENT OF INSURANCE

Affiliations

Name	Middlefork Insurance Agency Inc	DOIID	398433	NAIC NPN	7220888

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Property	8/15/2000	5/2/2002
Inactive	Resident	Agent	Life	9/13/1983	5/2/2002
Inactive	Resident	Agent	Casualty	8/15/2000	5/2/2002
Inactive	Resident	Agent	Crop	3/31/1994	5/2/2002
Inactive	Resident	Agent	Health	2/11/1988	5/2/2002
Inactive	Resident	Agent	Assessment Chapter 299	12/22/1997	12/1/2000
Inactive	Resident	Agent	Credit Life & Health	9/12/1994	3/25/1996
Inactive	Resident	Agent	General Lines	6/1/1983	8/15/2000
* 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	American Fire and Casualty Company	300567	Agent - Casualty	8/15/2000	5/2/2002
Inactive	American Fire and Casualty Company	300567	Agent - General Lines	6/1/1983	8/15/2000
Inactive	American Fire and Casualty Company	300567	Agent - Property	8/15/2000	5/2/2002
Inactive	Chase Life and Annuity Company	300145	Agent - Life	9/13/1983	12/11/1996
Inactive	Continental Insurance Company (The)	301242	Agent - Crop	3/31/1994	5/2/2002
Inactive	First Mutual Insurance Company	301258	Agent - Assessment Chapter 299	12/22/1997	12/1/2000
Inactive	Franklin Life Insurance Company (The)	300779	Agent - Credit Life & Health	9/12/1994	3/25/1996
Inactive	Great Southern Life Insurance Company	301443	Agent - Health	4/23/1996	2/9/1998
Inactive	Great Southern Life Insurance Company	301443	Agent - Life	4/23/1996	2/9/1998
Inactive	Hartford Casualty Insurance Company	301332	Agent - Casualty	8/15/2000	5/2/2002
Inactive	Hartford Casualty Insurance Company	301332	Agent - General Lines	6/15/1995	8/15/2000
Inactive	Hartford Casualty Insurance Company	301332	Agent - Property	8/15/2000	5/2/2002
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Health	2/11/1988	5/2/2002
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Life	2/11/1988	5/2/2002
Inactive	Kentucky National Insurance Company	301625	Agent - General Lines	6/1/1983	12/31/1998
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	8/15/2000	5/2/2002
Inactive	Ohio Casualty Insurance Company	301492	Agent - General Lines	6/1/1983	8/15/2000
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	8/15/2000	5/2/2002
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	8/15/2000	5/2/2002
Inactive	Ohio Security Insurance Company	300622	Agent - General Lines	6/1/1983	8/15/2000
Inactive	Ohio Security Insurance Company	300622	Agent - Property	8/15/2000	5/2/2002
Inactive	South Carolina Insurance Company	300080	Agent - Casualty	8/15/2000	5/2/2002
Inactive	South Carolina Insurance Company	300080	Agent - General Lines	4/23/1998	8/15/2000
Inactive	South Carolina Insurance Company	300080	Agent - Property	8/15/2000	5/2/2002
Inactive	Trustmark Insurance Company	300317	Agent - Health	9/27/1999	7/12/2001
Inactive	Trustmark Insurance Company	300317	Agent - Life	9/27/1999	7/12/2001
Inactive	West American Insurance Company	301112	Agent - Casualty	8/15/2000	5/2/2002
Inactive	West American Insurance Company	301112	Agent - General Lines	6/1/1983	8/15/2000
Inactive	West American Insurance Company	301112	Agent - Property	8/15/2000	5/2/2002
Inactive	Western Surety Company	300283	Agent - General Lines	2/12/1987	8/15/2000

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Campbell, Harold Glenn	384965	Agent - Casualty	8/15/2000	5/2/2002
Inactive	Campbell, Harold Glenn	384965	Agent - General Lines	6/15/1982	8/15/2000
Inactive	Campbell, Harold Glenn	384965	Agent - Health	6/15/1982	5/2/2002
Inactive	Campbell, Harold Glenn	384965	Agent - Life	6/15/1982	5/2/2002
Inactive	Campbell, Harold Glenn	384965	Agent - Property	8/15/2000	5/2/2002
Inactive	Moore, Judy Lee	379759	Agent - Credit Life & Health	9/6/1994	3/25/1996
Inactive	Sebastian, Susan Pauline	333908	Agent - Casualty	8/15/2000	5/2/2002
Inactive	Sebastian, Susan Pauline	333908	Agent - General Lines	5/19/1988	8/15/2000
Inactive	Sebastian, Susan Pauline	333908	Agent - Property	8/15/2000	5/2/2002