DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Jack R. Allen Insurance, Inc.	DOIID	520704	NAIC NPN	7223268

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Casualty	1/22/2001	3/31/2017
Inactive	Resident	Agent	Health	1/22/2001	3/31/2017
Inactive	Resident	Agent	Life	1/22/2001	2/1/2017
Inactive	Resident	Agent	Property	1/22/2001	3/31/2017
* 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	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	10/1/2005	12/1/2014
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	10/1/2005	10/16/2012
Inactive	Anthem Life Insurance Company	301209	Agent - Health	12/21/2009	12/1/2014
Inactive	Anthem Life Insurance Company	301209	Agent - Life	12/21/2009	12/1/2014
Inactive	FB Insurance Company (The)	301763	Agent - Casualty	1/22/2001	11/7/2014
Inactive	FB Insurance Company (The)	301763	Agent - Property	1/22/2001	11/7/2014
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	1/22/2001	11/7/2014
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	1/22/2001	11/7/2014
Inactive	Southern Farm Bureau Life Insurance Company	300909	Agent - Health	1/22/2001	11/7/2014
Inactive	Southern Farm Bureau Life Insurance Company	300909	Agent - Life	1/22/2001	11/7/2014

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Allen, Jack Reginald	375281	Agent - Casualty	8/15/2000	12/1/2016
Inactive	Allen, Jack Reginald	375281	Agent - Health	1/22/2001	11/7/2014
Inactive	Allen, Jack Reginald	375281	Agent - Life	1/22/2001	12/1/2016
Inactive	Allen, Jack Reginald	375281	Agent - Property	8/15/2000	12/1/2016
Inactive	Ball, Mary Anne	384991	Agent - Casualty	2/17/2004	3/31/2017
Inactive	Ball, Mary Anne	384991	Agent - Property	2/17/2004	3/31/2017
Inactive	Douglas, Ann C	302172	Agent - Casualty	2/17/2004	3/31/2017
Inactive	Douglas, Ann C	302172	Agent - Property	2/17/2004	3/31/2017
Inactive	Jones, Shirley W	335591	Agent - Casualty	2/17/2004	1/10/2006
Inactive	Jones, Shirley W	335591	Agent - Property	2/17/2004	1/10/2006
Inactive	Miller, Nancy I	366144	Agent - Casualty	2/17/2004	3/31/2017
Inactive	Miller, Nancy I	366144	Agent - Health	2/17/2004	3/31/2017
Inactive	Miller, Nancy I	366144	Agent - Property	2/17/2004	3/31/2017