DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Green, Jason A	DOIID	506500	NAIC NPN	6544410

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	7/20/2000	5/15/2004
Inactive	Resident	Agent	Health	7/20/2000	5/15/2004
* 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 General Life Insurance Company	301585	Agent - Health	9/3/2002	7/1/2004
Inactive	American General Life Insurance Company	301585	Agent - Life	9/3/2002	7/1/2004
Inactive	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	11/8/2000	3/24/2003
Inactive	Lafayette Life Insurance Company (The)	301039	Agent - Health	7/20/2000	1/27/2003
Inactive	Lafayette Life Insurance Company (The)	301039	Agent - Life	7/20/2000	1/27/2003
Inactive	Life Insurance Company of the Southwest	301867	Agent - Health	8/1/2001	5/13/2002
Inactive	Life Insurance Company of the Southwest	301867	Agent - Life	8/1/2001	5/13/2002
Inactive	National Life Insurance Company	301852	Agent - Health	8/1/2001	5/13/2002
Inactive	National Life Insurance Company	301852	Agent - Life	8/1/2001	5/13/2002
Inactive	Old Line Life Insurance Company of America (The)	301709	Agent - Health	7/27/2001	3/24/2003
Inactive	Old Line Life Insurance Company of America (The)	301709	Agent - Life	7/27/2001	3/24/2003

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	InsBanc, Inc.	520697	Agent - Life	5/24/2001	3/6/2003
Inactive	InsBanc, Inc.	520697	Agent - Health	5/24/2001	3/6/2003
Inactive	Republic Insurance Agency of Kentucky, LLC	541390	Agent - Life	11/19/2001	11/25/2002
Inactive	Republic Insurance Agency of Kentucky, LLC	541390	Agent - Health	11/19/2001	11/25/2002
Inactive	Senior Benefits Inc.	398077	Agent - Life	9/21/2000	2/12/2003
Inactive	Senior Benefits Inc.	398077	Agent - Health	9/21/2000	2/12/2003