DEPARTMENT OF INSURANCE

Affiliations

Name	PBK Bank Inc.	DOIID	400000	NAIC NPN	7222082

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Limited Line Credit	8/7/2000		3/31/2025
Inactive	Resident	Agent	Credit Life & Health	12/21/1993	8/7/2000
Inactive	Resident	Agent	Mortgage Redemption	12/7/1995	8/7/2000
Pending Replacement	Resident	Agent	Life	2/20/2003		3/31/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	01/15/2025	03/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Franklin Life Insurance Company (The)	300779	Agent - Credit Life & Health	2/1/1994	4/8/1996
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Credit Life & Health	12/7/1995	8/7/2000
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Life	2/20/2003	2/26/2016
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Limited Line Credit	8/7/2000	2/17/2016
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Mortgage Redemption	12/7/1995	8/7/2000
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Credit Life & Health	11/24/1998	8/7/2000
Pending Replacement	Kentucky Home Life Insurance Company	300477	Agent - Life	5/7/2007
Active	Kentucky Home Life Insurance Company	300477	Agent - Limited Line Credit	8/7/2000
Inactive	National Guardian Life Insurance Company	300596	Agent - Credit Life & Health	12/21/1993	12/1/1998
Pending Replacement	Plateau Insurance Company	300368	Agent - Life	8/12/2016
Active	Plateau Insurance Company	300368	Agent - Limited Line Credit	8/12/2016
Active	Transamerica Life Insurance Company	300571	Agent - Limited Line Credit	10/1/2020
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Limited Line Credit	2/11/2008	10/1/2020

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Asher, Charles Anthony	376947	Agent - Limited Line Credit	3/29/2006	10/11/2010
Inactive	Bastin, Michael	335244	Agent - Life	2/20/2003	3/12/2003
Active	Bishop, Shannon David	839254	Agent - Limited Line Credit	6/3/2014
Inactive	Burris, Edgar Stanley	325487	Agent - Life	10/26/2006	5/1/2024
Inactive	Cooper, Jeffrey Scott	366854	Agent - Credit Life & Health	2/1/1994	3/31/1997
Inactive	Cooper, Jeffrey Scott	366854	Agent - Limited Line Credit	2/8/2021	9/30/2022
Inactive	Cooper, Michelle	383815	Agent - Limited Line Credit	2/6/2004	1/11/2005
Inactive	Deyo, Robert Charles	391051	Agent - Credit Life & Health	2/7/1997	8/7/2000
Inactive	Deyo, Robert Charles	391051	Agent - Limited Line Credit	8/7/2000	3/31/2003
Inactive	Douglas, Becky M	373898	Agent - Credit Life & Health	2/1/1994	8/7/2000
Inactive	Douglas, Becky M	373898	Agent - Limited Line Credit	8/7/2000	8/31/2003
Inactive	Duncan, William Brian	789043	Agent - Limited Line Credit	9/13/2012	9/23/2015
Inactive	Edgington, Bruce C.	344965	Agent - Limited Line Credit	2/6/2004	12/31/2005
Inactive	Elliott, John R	392424	Agent - Life	2/6/2004	6/30/2008
Inactive	Goforth, Jonathan David	584377	Agent - Limited Line Credit	1/11/2005	10/31/2006
Inactive	Hart, Robert Clayton	635152	Agent - Limited Line Credit	2/5/2007	1/20/2009
Inactive	Jackson, Jackie Allen	352443	Agent - Limited Line Credit	2/6/2004	3/29/2006
Inactive	Johnson, Janet Elmore	327314	Agent - Limited Line Credit	3/29/2006	1/31/2008
Inactive	Lanham, William Vance	339242	Agent - Life	2/20/2003	3/12/2003
Active	Marcum, Farris J	698536	Agent - Limited Line Credit	3/15/2011
Inactive	McGuffey, David Tyler	892680	Agent - Limited Line Credit	2/24/2016	8/29/2016
Active	Poynter, Justin Thomas	654934	Agent - Limited Line Credit	3/15/2011
Inactive	Ralston, Eric Jeffrey	609732	Agent - Limited Line Credit	2/5/2007	8/31/2014
Inactive	Reynolds, Judith G	382837	Agent - Credit Life & Health	2/1/1994	8/7/2000
Inactive	Reynolds, Judith G	382837	Agent - Limited Line Credit	8/7/2000	2/28/2005
Active	Southerland, Scotty Wayne	789054	Agent - Limited Line Credit	2/8/2021
Inactive	Whitaker, William Albert	646361	Agent - Limited Line Credit	2/5/2007	8/1/2008
Inactive	Williams, G Baker	315922	Agent - Limited Line Credit	2/6/2004	4/30/2010
Inactive	Woodall, David	368178	Agent - Limited Line Credit	1/11/2005	11/30/2005