DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Legacy Insurance Inc.	DOIID	398532	NAIC NPN	7220974

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	9/28/1993	5/24/2004
Inactive	Resident	Agent	Life	9/28/1993	5/24/2004
* 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	Chase Insurance Life and Annuity Company	300518	Agent - Health	6/21/2000	5/24/2004
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	6/21/2000	5/24/2004
Inactive	Jackson National Life Insurance Company	300486	Agent - Health	9/28/1993	12/17/1998
Inactive	Jackson National Life Insurance Company	300486	Agent - Life	9/28/1993	12/17/1998
Inactive	Midland Life Insurance Company (The)	300310	Agent - Health	12/13/1995	3/12/2002
Inactive	Midland Life Insurance Company (The)	300310	Agent - Life	12/13/1995	3/12/2002
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	10/22/1997	8/24/2000
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	10/22/1997	8/24/2000
Inactive	Reassure America Life Insurance Company	300678	Agent - Health	3/12/2002	4/28/2003
Inactive	Reassure America Life Insurance Company	300678	Agent - Life	3/12/2002	4/28/2003

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Acordia of Louisville Inc.	401252	Agent - Health	7/1/1993	12/31/2001
Inactive	Acordia of Louisville Inc.	401252	Agent - Life	7/1/1993	12/31/2001
Inactive	Crowl, Linda Lay	320629	Agent - Health	12/11/1991	2/17/2003
Inactive	Crowl, Linda Lay	320629	Agent - Life	12/11/1991	2/17/2003
Inactive	Early, Stephen Barry	316039	Agent - Health	12/11/1991	7/1/1998
Inactive	Early, Stephen Barry	316039	Agent - Life	12/11/1991	7/1/1998