DEPARTMENT OF INSURANCE

Affiliations

Name	Kywide Insurance Management Inc.	DOIID	400853	NAIC NPN	7222712

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Life	7/29/1999	2/27/2004
Inactive	Resident	Agent	Casualty	3/23/2001	1/16/2002
Inactive	Resident	Agent	Property	3/23/2001	1/16/2002
Inactive	Resident	Agent	Health	7/29/1999	2/27/2004
Inactive	Resident	Managing General Agent	Not Applicable	3/26/2001	3/31/2002
* 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	All American Life Insurance Company	300702	Agent - Health	7/29/1999	4/19/2001
Inactive	All American Life Insurance Company	300702	Agent - Life	7/29/1999	4/19/2001
Inactive	American General Life Insurance Company	301585	Agent - Health	9/3/2002	2/27/2004
Inactive	American General Life Insurance Company	301585	Agent - Life	12/19/2001	2/27/2004
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Life	1/14/2002	2/27/2004
Inactive	Baptist Health Plan, Inc.	300157	Agent - Health	5/17/2002	2/27/2004
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	4/2/2001	2/27/2004
Inactive	Continental Casualty Company	301019	Agent - Health	5/1/2000	2/27/2004
Inactive	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	7/1/2002	2/27/2004
Inactive	Fidelity Life Association, A Legal Reserve Life Insurance Company	300774	Agent - Life	4/2/2001	2/27/2004
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Health	5/3/2002	2/27/2004
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Life	5/3/2002	2/27/2004
Inactive	Inter-State Assurance Company	301556	Agent - Life	10/16/2000	2/15/2002
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Health	3/26/2001	3/26/2001
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Life	3/26/2001	2/27/2004
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Health	4/25/2002	2/27/2004
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Life	4/25/2002	2/27/2004
Inactive	Kentucky National Insurance Company	301625	Agent - Casualty	3/23/2001	1/16/2002
Inactive	Kentucky National Insurance Company	301625	Agent - Property	3/23/2001	1/16/2002
Inactive	Medical Life Insurance Company	300693	Agent - Health	4/2/2002	2/27/2004
Inactive	Medical Life Insurance Company	300693	Agent - Life	4/2/2002	2/27/2004
Inactive	North American Company for Life and Health Insurance	300291	Agent - Life	5/20/2002	2/27/2004
Inactive	Old Line Life Insurance Company of America (The)	301709	Agent - Health	9/24/2001	3/31/2003
Inactive	Old Line Life Insurance Company of America (The)	301709	Agent - Life	9/24/2001	3/31/2003
Inactive	Old Republic Life Insurance Company	301214	Agent - Health	1/2/2002	2/27/2004
Inactive	Old Republic Life Insurance Company	301214	Agent - Life	1/2/2002	2/27/2004
Inactive	Principal Life Insurance Company	300129	Agent - Health	7/16/2001	2/27/2004
Inactive	Principal Life Insurance Company	300129	Agent - Life	7/16/2001	2/27/2004
Inactive	Protective Life Insurance Company	300638	Agent - Health	5/12/2000	2/27/2004
Inactive	Protective Life Insurance Company	300638	Agent - Life	5/12/2000	2/27/2004
Inactive	Security-Connecticut Life Insurance Company	300316	Agent - Health	2/14/2000	2/27/2004
Inactive	Security-Connecticut Life Insurance Company	300316	Agent - Life	2/14/2000	2/27/2004
Inactive	Time Insurance Company	300683	Agent - Health	2/26/2001	2/20/2003
Inactive	Time Insurance Company	300683	Agent - Life	2/26/2001	2/20/2003
Inactive	Trustmark Insurance Company	300317	Agent - Health		5/19/2003
Inactive	Trustmark Insurance Company	300317	Agent - Life		5/19/2003
Inactive	West Coast Life Insurance Company	301607	Agent - Life	10/24/2002	2/3/2003
Inactive	Western National Life Insurance Company	300461	Agent - Life	9/10/2001	2/27/2004
Inactive	Wilco Life Insurance Company	300122	Agent - Life	8/27/1999	6/22/2001

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Booth, Thomas J	518980	Agent - Casualty	4/26/2002	4/26/2002
Inactive	Booth, Thomas J	518980	Agent - Health	8/15/2001	2/13/2003
Inactive	Booth, Thomas J	518980	Agent - Life	8/15/2001	2/13/2003
Inactive	Booth, Thomas J	518980	Agent - Property	3/23/2001	1/16/2002
Inactive	Booth, Thomas J	518980	Managing General Agent - Not Applicable	3/26/2001	8/31/2005
Inactive	Kane, Adam David	365497	Agent - Health	7/29/1999	12/1/2000
Inactive	Kane, Adam David	365497	Agent - Life	7/29/1999	12/1/2000
Inactive	Owen, David Abraham	357466	Agent - Health	2/1/2001	8/15/2001
Inactive	Owen, David Abraham	357466	Agent - Life	2/1/2001	8/15/2001