DEPARTMENT OF INSURANCE

Affiliations

Name	Charles A Clark Inc. DBA : Charles A Clark Inc	DOIID	400796	NAIC NPN	7222690

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Casualty	8/15/2000	3/31/2020
Inactive	Resident	Agent	General Lines	6/16/1999	8/15/2000
Inactive	Resident	Agent	Property	8/15/2000	3/31/2020
Inactive	Resident	Agent	Health	6/16/1999	3/31/2020
Inactive	Resident	Agent	Life	6/16/1999	3/31/2020
* 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	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	9/1/2005	3/31/2020
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	9/1/2005	10/16/2012
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	12/29/2012	12/13/2017
Inactive	Bristol West Insurance Company	301655	Agent - Property	12/29/2012	12/13/2017
Inactive	Everly Life Insurance Company	561641	Agent - Life	9/19/2013	12/28/2016
Inactive	FB Insurance Company (The)	301763	Agent - Casualty	8/15/2000	11/5/2012
Inactive	FB Insurance Company (The)	301763	Agent - General Lines	6/16/1999	8/15/2000
Inactive	FB Insurance Company (The)	301763	Agent - Property	8/15/2000	11/5/2012
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	12/29/2012	12/13/2017
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	12/29/2012	12/13/2017
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	8/15/2000	11/5/2012
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - General Lines	6/16/1999	8/15/2000
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	8/15/2000	11/5/2012
Inactive	Lincoln Heritage Life Insurance Company	500016	Agent - Health	8/8/2013	12/14/2014
Inactive	Lincoln Heritage Life Insurance Company	500016	Agent - Life	8/8/2013	12/14/2014
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	3/20/2013	3/31/2020
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	3/20/2013	3/31/2020
Inactive	Southern Farm Bureau Life Insurance Company	300909	Agent - Health	6/16/1999	11/5/2012
Inactive	Southern Farm Bureau Life Insurance Company	300909	Agent - Life	6/16/1999	11/5/2012
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	6/28/2017	3/20/2019
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	6/28/2017	3/20/2019
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	6/28/2017	3/20/2019
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	6/28/2017	3/20/2019
Inactive	United Financial Casualty Company	301886	Agent - Casualty	3/20/2013	3/31/2020
Inactive	United Financial Casualty Company	301886	Agent - Property	3/20/2013	3/31/2020

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Clark, Charles A	321988	Agent - Casualty	8/15/2000	3/31/2020
Inactive	Clark, Charles A	321988	Agent - General Lines	6/16/1999	8/15/2000
Inactive	Clark, Charles A	321988	Agent - Health	6/16/1999	3/31/2020
Inactive	Clark, Charles A	321988	Agent - Life	6/16/1999	3/31/2020
Inactive	Clark, Charles A	321988	Agent - Property	8/15/2000	3/31/2020