DEPARTMENT OF INSURANCE

Affiliations

Name	First State Bank Incorporated	DOIID	399998	NAIC NPN	7222080

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Mortgage Redemption	8/30/1995	8/7/2000
Inactive	Resident	Agent	Limited Line Credit	8/7/2000	3/31/2021
Inactive	Resident	Agent	Health	7/1/2010	3/31/2021
Inactive	Resident	Agent	Credit Life & Health	5/13/1994	8/7/2000
Inactive	Resident	Agent	Life	7/1/2010	3/31/2021
* 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	Fidelity Security Life Insurance Company	300466	Agent - Limited Line Credit	8/7/2000	3/10/2005
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Mortgage Redemption	8/30/1995	8/7/2000
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Health	7/27/2011	3/31/2021
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Life	7/27/2011	3/31/2021
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Credit Life & Health	11/24/1998	8/7/2000
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Health	7/1/2010	8/4/2016
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Life	7/1/2010	8/4/2016
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Limited Line Credit	8/7/2000	8/4/2016
Inactive	National Guardian Life Insurance Company	300596	Agent - Credit Life & Health	5/13/1994	12/1/1998

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Dant, Sandra Ann	743193	Agent - Limited Line Credit	12/16/2010	9/30/2019
Inactive	Dennis, Christopher M	386740	Agent - Health	7/1/2010	3/31/2021
Inactive	Dennis, Christopher M	386740	Agent - Life	7/1/2010	3/31/2021
Inactive	Free, Shelia M	343197	Agent - Limited Line Credit	3/27/2003	3/6/2009
Inactive	Johnson, Jerry Wayne	311455	Agent - Credit Life & Health	10/21/1992	8/7/2000
Inactive	Johnson, Jerry Wayne	311455	Agent - Limited Line Credit	8/7/2000	1/20/2005
Inactive	Mann, Charles	393142	Agent - Limited Line Credit	6/16/2010	6/30/2012
Inactive	Mercer, Michael H	382881	Agent - Health	7/26/2010	11/30/2020
Inactive	Mercer, Michael H	382881	Agent - Life	7/26/2010	11/30/2020
Inactive	Mercer, Michael H	382881	Agent - Limited Line Credit	7/26/2010	11/30/2020
Inactive	Richey, David L	349910	Agent - Health	6/15/2011	3/31/2021
Inactive	Richey, David L	349910	Agent - Life	6/15/2011	3/31/2021
Inactive	Richey, David L	349910	Agent - Limited Line Credit	6/15/2011	3/31/2021
Inactive	Riggs, Debra L	367269	Agent - Limited Line Credit	6/16/2010	7/31/2014
Inactive	Robertson, Lawrence Bruce	303606	Agent - Health	7/1/2010	5/31/2020
Inactive	Robertson, Lawrence Bruce	303606	Agent - Life	7/1/2010	8/4/2016
Inactive	Stratton, Sherry Robin	371605	Agent - Limited Line Credit	3/27/2003	6/16/2010
Inactive	Tucker, Jean J	377975	Agent - Credit Life & Health	10/21/1992	8/10/1999
Inactive	Wilkerson, Tiffany Kristen	515742	Agent - Limited Line Credit	6/16/2010	10/31/2018
Inactive	Williams, Tamara Kay	358170	Agent - Limited Line Credit	3/27/2003	2/4/2005