DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Charter House of Kentucky Inc.	DOIID	400512	NAIC NPN	7222480

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Property	8/15/2000	6/3/2002
Inactive	Resident	Agent	Casualty	8/15/2000	6/3/2002
Inactive	Resident	Agent	General Lines	8/24/1987	8/15/2000
* 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	Affiliated FM Insurance Company	300108	Agent - General Lines	12/7/1989	3/31/1996
Inactive	American Alternative Insurance Corporation	301697	Agent - General Lines	6/18/1996	8/28/1997
Inactive	Fidelity and Guaranty Insurance Company	301009	Agent - Casualty	8/15/2000	3/29/2002
Inactive	Fidelity and Guaranty Insurance Company	301009	Agent - General Lines	2/6/1995	8/15/2000
Inactive	Fidelity and Guaranty Insurance Company	301009	Agent - Property	8/15/2000	3/29/2002
Inactive	Fidelity and Guaranty Insurance Underwriters Inc.	300559	Agent - Casualty	8/15/2000	3/29/2002
Inactive	Fidelity and Guaranty Insurance Underwriters Inc.	300559	Agent - General Lines	2/6/1995	8/15/2000
Inactive	Fidelity and Guaranty Insurance Underwriters Inc.	300559	Agent - Property	8/15/2000	3/29/2002
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Casualty	8/15/2000	6/3/2002
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - General Lines	8/24/1987	8/15/2000
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Property	8/15/2000	6/3/2002
Inactive	United States Fidelity and Guaranty Company	301449	Agent - Casualty	8/15/2000	3/29/2002
Inactive	United States Fidelity and Guaranty Company	301449	Agent - General Lines	2/6/1995	8/15/2000
Inactive	United States Fidelity and Guaranty Company	301449	Agent - Property	8/15/2000	3/29/2002

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Butts, Delbert Leroy	308432	Agent - General Lines	8/24/1987	2/16/1996
Inactive	Stansbury, Jeanette B	326303	Agent - Casualty	8/15/2000	6/3/2002
Inactive	Stansbury, Jeanette B	326303	Agent - General Lines	2/16/1996	8/15/2000
Inactive	Stansbury, Jeanette B	326303	Agent - Property	8/15/2000	6/3/2002