DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Bosse Funeral Home Inc	DOIID	400021	NAIC NPN	7222102

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Life	12/11/2017		3/31/2027
* 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	01/15/2027	03/31/2027

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Cincinnati Equitable Life Insurance Company	641870	Agent - Life	12/15/2017
Inactive	Forethought Life Insurance Company	301407	Agent - Life	4/6/1998	6/17/2004
Inactive	Southland National Insurance Corporation	517954	Agent - Life	3/17/2009	12/28/2010

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Fahey, Martha J	386807	Agent - Life	4/6/1998	12/1/2000
Active	Moon, Paul Gary	1042618	Agent - Life	9/14/2021
Inactive	Reed, John Robert	373690	Agent - Life	10/10/2013	10/31/2017
Inactive	Wagner, James Miller	350251	Agent - Life	12/11/2017	6/30/2021