DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Burton, Jerry Dale	DOIID	507109	NAIC NPN	7212560

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Credit Life & Health	6/9/2000	8/7/2000
Inactive	Resident	Agent	Limited Line Credit	8/7/2000	1/21/2003
* 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	Kentucky Home Life Insurance Company	300477	Agent - Credit Life & Health	6/9/2000	8/7/2000
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Limited Line Credit	8/7/2000	1/21/2003

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Fletcher Chevrolet-Buick	513864	Agent - Limited Line Credit	10/16/2000	1/21/2003