DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Lakeside Homes Inc.	DOIID	401075	NAIC NPN	7222897

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	9/26/1995	8/15/1997
Inactive	Resident	Agent	Limited Line Credit	8/7/2000	5/31/2004
Inactive	Resident	Agent	Credit Life & Health	3/24/2000	8/7/2000
Inactive	Resident	Agent	Life	9/26/1995	8/15/1997
* 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	American Heritage Life Insurance Company	300272	Agent - Health	9/26/1995	8/15/1997
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	9/26/1995	8/15/1997
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Credit Life & Health	3/24/2000	8/7/2000
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Limited Line Credit	8/7/2000	5/31/2004

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Epperson, Hargis	313654	Agent - Health	9/26/1995	7/1/1996
Inactive	Epperson, Hargis	313654	Agent - Life	9/26/1995	7/1/1996
Inactive	Tincher, Ellis J	503701	Agent - Credit Life & Health	3/24/2000	8/7/2000
Inactive	Tincher, Ellis J	503701	Agent - Limited Line Credit	8/7/2000	4/30/2004