DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Champion Preferred Automotive	DOIID	399530	NAIC NPN	7221732

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Denied	Resident	Agent	Limited Line Credit
Inactive	Resident	Agent	Credit Life & Health	7/28/1993	8/7/2000
* 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	Bankers Life Insurance Company	301784	Agent - Credit Life & Health	9/10/1996	3/31/1997
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Credit Life & Health	6/16/1997	8/7/2000
Denied	Investors Heritage Life Insurance Company	300363	Agent - Limited Line Credit
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Limited Line Credit	6/2/2004	12/1/2005
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Credit Life & Health	7/28/1993	2/29/1996

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bates, Don R	328200	Agent - Credit Life & Health	4/23/1998	11/23/1998
Inactive	Blankenship, Randall Blake	391008	Agent - Credit Life & Health	6/22/1998	11/23/1998
Inactive	Brown, Garland Dwayne	333085	Agent - Credit Life & Health	11/23/1998	8/7/2000
Inactive	Brown, Garland Dwayne	333085	Agent - Limited Line Credit	8/7/2000	5/31/2003
Inactive	Buford, Thomas H.	392022	Agent - Credit Life & Health	4/23/1998	8/7/2000
Inactive	Buford, Thomas H.	392022	Agent - Limited Line Credit	8/7/2000	5/31/2003
Inactive	Gifford, J Michael	326885	Agent - Credit Life & Health	4/23/1998	11/23/1998
Inactive	Madon, Edward C	323826	Agent - Credit Life & Health	6/16/1997	4/23/1998
Inactive	Mullins, David W	338683	Agent - Credit Life & Health	6/16/1997	4/23/1998
Inactive	Parker, David W	364529	Agent - Credit Life & Health	11/23/1998	8/7/2000
Inactive	Parker, David W	364529	Agent - Limited Line Credit	8/7/2000	5/31/2003
Inactive	Singleton, Neil Keith	349868	Agent - Credit Life & Health	11/23/1998	1/20/1999
Inactive	Slaughter, Edward Keith	334769	Agent - Credit Life & Health	4/23/1998	8/7/2000
Denied	Slaughter, Edward Keith	334769	Agent - Limited Line Credit