DEPARTMENT OF INSURANCE

Affiliations

Name	Booth, Thomas J	DOIID	518980	NAIC NPN	7215819

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Health	7/10/2001	9/1/2013
Inactive	Resident	Agent	Life	5/23/2001	9/1/2013
Inactive	Resident	Agent	Casualty	2/14/2001	9/1/2013
Inactive	Resident	Agent	Property	2/14/2001	9/1/2013
Inactive	Resident	Managing General Agent	Not Applicable	3/26/2001	8/31/2005
* 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	AIG Assurance Company	300897	Agent - Casualty	5/26/2005	9/29/2010
Inactive	AIG Assurance Company	300897	Agent - Property	5/26/2005	9/29/2010
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	1/27/2003	11/22/2007
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	1/27/2003	11/22/2007
Inactive	Allstate Indemnity Company	300778	Agent - Casualty	7/9/2003	3/8/2007
Inactive	Allstate Indemnity Company	300778	Agent - Property	7/9/2003	3/8/2007
Inactive	Allstate Insurance Company	300773	Agent - Casualty	7/9/2003	3/8/2007
Inactive	Allstate Insurance Company	300773	Agent - Property	7/9/2003	3/8/2007
Inactive	Allstate Property and Casualty Insurance Company	300593	Agent - Casualty	8/12/2005	3/8/2007
Inactive	Allstate Property and Casualty Insurance Company	300593	Agent - Property	8/12/2005	3/8/2007
Inactive	American Casualty Company of Reading, Pennsylvania	300956	Agent - Casualty	1/8/2003	12/2/2004
Inactive	American Casualty Company of Reading, Pennsylvania	300956	Agent - Property	1/8/2003	12/2/2004
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	10/7/2008	12/31/2012
Inactive	American Fire and Casualty Company	300567	Agent - Property	10/7/2008	12/31/2012
Inactive	American General Life Insurance Company	301585	Agent - Health	9/3/2002	4/15/2011
Inactive	American General Life Insurance Company	301585	Agent - Life	12/19/2001	4/15/2011
Inactive	American Growers Insurance Company	300841	Agent - Casualty	2/19/2002	4/14/2003
Inactive	American Growers Insurance Company	300841	Agent - Property	2/19/2002	4/14/2003
Inactive	American Heritage Life Insurance Company	300272	Agent - Health	6/25/2003	6/25/2008
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	6/25/2003	6/25/2008
Inactive	American United Life Insurance Company	300498	Agent - Health	1/3/2008	9/1/2013
Inactive	American United Life Insurance Company	300498	Agent - Life	1/3/2008	9/1/2013
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Health	12/3/2001	10/31/2006
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Life	12/3/2001	10/31/2006
Inactive	Assurance Company of America	300432	Agent - Casualty	12/6/2012	9/1/2013
Inactive	Assurance Company of America	300432	Agent - Property	12/6/2012	9/1/2013
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	2/16/2007	9/1/2013
Inactive	Bristol West Insurance Company	301655	Agent - Property	2/16/2007	9/1/2013
Inactive	CICA Life Insurance Company of America	600487	Agent - Health	1/1/2005	2/20/2007
Inactive	CICA Life Insurance Company of America	600487	Agent - Life	1/1/2005	2/20/2007
Inactive	Cincinnati Casualty Company (The)	300308	Agent - Casualty	3/9/2001	9/27/2001
Inactive	Cincinnati Casualty Company (The)	300308	Agent - Property	3/9/2001	9/27/2001
Inactive	Cincinnati Indemnity Company (The)	301566	Agent - Casualty	3/9/2001	9/27/2001
Inactive	Cincinnati Indemnity Company (The)	301566	Agent - Property	3/9/2001	9/27/2001
Inactive	Cincinnati Insurance Company	301298	Agent - Casualty	2/14/2001	9/27/2001
Inactive	Cincinnati Insurance Company	301298	Agent - Property	2/14/2001	9/27/2001
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	10/7/2008	10/20/2011
Inactive	Consolidated Insurance Company	300943	Agent - Property	10/7/2008	10/20/2011
Inactive	Continental Casualty Company	301019	Agent - Casualty	1/8/2003	12/2/2004
Inactive	Continental Casualty Company	301019	Agent - Property	1/8/2003	12/2/2004
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	7/24/2013	9/1/2013
Inactive	Everlake Life Insurance Company	300873	Agent - Health	7/9/2003	3/8/2007
Inactive	Everlake Life Insurance Company	300873	Agent - Life	7/9/2003	3/8/2007
Inactive	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	4/29/2002	3/24/2006
Inactive	First Alliance Insurance Company	301000	Agent - Health	7/10/2001	1/1/2005
Inactive	First Alliance Insurance Company	301000	Agent - Life	5/23/2001	1/1/2005
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Health	5/3/2002	12/18/2008
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Life	5/3/2002	12/18/2008
Inactive	Glatfelter Insurance Company	301640	Agent - Casualty	10/21/2002	11/30/2007
Inactive	Glatfelter Insurance Company	301640	Agent - Property	10/21/2002	11/30/2007
Inactive	Granite State Insurance Company	300818	Agent - Casualty	5/26/2005	9/29/2010
Inactive	Granite State Insurance Company	300818	Agent - Property	5/26/2005	9/29/2010
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	8/9/2013	9/1/2013
Inactive	Humana Insurance Company	301104	Agent - Health	8/9/2013	9/1/2013
Inactive	Humana Insurance Company	301104	Agent - Life	8/9/2013	9/1/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	11/15/2007	9/8/2010
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	11/15/2007	9/8/2010
Inactive	Illinois National Insurance Company	301367	Agent - Casualty	1/10/2007	9/29/2010
Inactive	Illinois National Insurance Company	301367	Agent - Property	1/10/2007	9/29/2010
Inactive	Indiana Insurance Company	301909	Agent - Casualty	10/7/2008	12/31/2012
Inactive	Indiana Insurance Company	301909	Agent - Property	10/7/2008	12/31/2012
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Health	8/30/2002	9/1/2013
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Life	8/30/2002	9/1/2013
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Health	4/25/2002	5/1/2004
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Life	4/25/2002	5/1/2004
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Health	4/25/2002	5/1/2004
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Life	4/25/2002	5/1/2004
Inactive	Kanawha Insurance Company	300127	Agent - Health	8/9/2013	9/1/2013
Inactive	Kanawha Insurance Company	300127	Agent - Life	8/9/2013	9/1/2013
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Health	2/12/2005	9/1/2013
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Life	2/12/2005	9/1/2013
Inactive	Kentucky National Insurance Company	301625	Agent - Casualty	3/17/2004	9/1/2013
Inactive	Kentucky National Insurance Company	301625	Agent - Property	3/17/2004	9/1/2013
Inactive	Lincoln Benefit Life Company	301110	Agent - Health	9/12/2003	3/8/2007
Inactive	Lincoln Benefit Life Company	301110	Agent - Life	9/12/2003	3/8/2007
Inactive	Maryland Casualty Company	301719	Agent - Casualty	12/6/2012	9/1/2013
Inactive	Maryland Casualty Company	301719	Agent - Property	12/6/2012	9/1/2013
Inactive	Millers Insurance Company (The)	300349	Agent - Casualty	9/21/2001	11/20/2001
Inactive	Millers Insurance Company (The)	300349	Agent - Property	9/21/2001	11/20/2001
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	10/7/2005	9/1/2013
Inactive	National Fire Insurance Company of Hartford	301063	Agent - Casualty	1/8/2003	12/2/2004
Inactive	National Fire Insurance Company of Hartford	301063	Agent - Property	1/8/2003	12/2/2004
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	10/7/2008	10/20/2011
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	10/7/2008	10/20/2011
Inactive	North American Company for Life and Health Insurance	300291	Agent - Life	5/20/2002	7/19/2010
Inactive	Northern Insurance Company of New York	301317	Agent - Casualty	12/6/2012	9/1/2013
Inactive	Northern Insurance Company of New York	301317	Agent - Property	12/6/2012	9/1/2013
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	10/7/2008	12/31/2012
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	10/7/2008	12/31/2012
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	10/7/2008	12/31/2012
Inactive	Ohio Security Insurance Company	300622	Agent - Property	10/7/2008	12/31/2012
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	PacifiCare Life and Health Insurance Company	301304	Agent - Health	12/13/2005	7/17/2012
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Life	12/13/2005	7/17/2012
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Casualty	10/7/2008	10/20/2011
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Property	10/7/2008	10/20/2011
Inactive	Peerless Insurance Company	301910	Agent - Casualty	10/7/2008	10/20/2011
Inactive	Peerless Insurance Company	301910	Agent - Property	10/7/2008	10/20/2011
Inactive	Plymouth Rock Assurance Preferred Corporation	301834	Agent - Casualty	9/10/2007	1/25/2011
Inactive	Plymouth Rock Assurance Preferred Corporation	301834	Agent - Property	9/10/2007	1/25/2011
Inactive	Principal Life Insurance Company	300129	Agent - Health	2/26/2003	11/30/2009
Inactive	Principal Life Insurance Company	300129	Agent - Life	2/26/2003	11/30/2009
Inactive	Protective Life Insurance Company	300638	Agent - Health	4/1/2002	11/23/2009
Inactive	Protective Life Insurance Company	300638	Agent - Life	2/25/2002	11/23/2009
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	4/9/2010	9/1/2013
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	4/9/2010	9/1/2013
Inactive	State Life Insurance Company	301497	Agent - Health	2/8/2002	7/2/2004
Inactive	State Life Insurance Company	301497	Agent - Life	2/8/2002	7/2/2004
Inactive	Symetra Life Insurance Company	301691	Agent - Health	2/7/2003	12/30/2010
Inactive	Symetra Life Insurance Company	301691	Agent - Life	2/7/2003	12/30/2010
Inactive	Transcontinental Insurance Company	301731	Agent - Casualty	1/8/2003	12/2/2004
Inactive	Transcontinental Insurance Company	301731	Agent - Property	1/8/2003	12/2/2004
Inactive	Transportation Insurance Company	301575	Agent - Casualty	1/8/2003	12/2/2004
Inactive	Transportation Insurance Company	301575	Agent - Property	1/8/2003	12/2/2004
Inactive	Trustmark Insurance Company	300317	Agent - Life	3/11/2002	9/16/2002
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	4/9/2010	9/1/2013
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	4/9/2010	9/1/2013
Inactive	United Concordia Life and Health Insurance Company	301220	Agent - Health	9/27/2005	9/1/2013
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	10/7/2005	9/1/2013
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	10/7/2005	9/1/2013
Inactive	Valley Forge Insurance Company	301052	Agent - Casualty	1/8/2003	12/2/2004
Inactive	Valley Forge Insurance Company	301052	Agent - Property	1/8/2003	12/2/2004
Inactive	West American Insurance Company	301112	Agent - Casualty	10/7/2008	12/31/2012
Inactive	West American Insurance Company	301112	Agent - Property	10/7/2008	12/31/2012
Inactive	West Coast Life Insurance Company	301607	Agent - Health	12/26/2001	1/30/2003
Inactive	West Coast Life Insurance Company	301607	Agent - Life	12/26/2001	1/30/2003
Inactive	Western National Life Insurance Company	300461	Agent - Life	9/10/2001	10/7/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Forcht Insurance Agency	398469	Agent - Property	10/31/2002	9/1/2013
Inactive	Forcht Insurance Agency	398469	Agent - Casualty	10/31/2002	9/1/2013
Inactive	Forcht Insurance Agency	398469	Agent - Life	11/20/2002	9/1/2013
Inactive	Forcht Insurance Agency	398469	Agent - Health	11/20/2002	9/1/2013
Denied	Kentucky National Insurance. Agency, Inc.	505857	Agent - Property
Denied	Kentucky National Insurance. Agency, Inc.	505857	Agent - Casualty
Inactive	Kywide Insurance Management Inc.	400853	Agent - Property	3/23/2001	1/16/2002
Inactive	Kywide Insurance Management Inc.	400853	Agent - Casualty	4/26/2002	4/26/2002
Inactive	Kywide Insurance Management Inc.	400853	Managing General Agent - Not Applicable	3/26/2001	8/31/2005
Inactive	Kywide Insurance Management Inc.	400853	Agent - Life	8/15/2001	2/13/2003
Inactive	Kywide Insurance Management Inc.	400853	Agent - Health	8/15/2001	2/13/2003
Inactive	Medlink Inc	400721	Agent - Life	2/19/2009	9/1/2013
Inactive	Medlink Inc	400721	Agent - Health	2/19/2009	9/1/2013
Inactive	United Agency Of Kentucky Llc	401115	Agent - Property	3/28/2003	2/25/2010
Inactive	United Agency Of Kentucky Llc	401115	Agent - Casualty	3/28/2003	2/25/2010