DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Richard Nicholas	DOIID	537548	NAIC NPN	7219524

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	8/2/2011	8/1/2022
Inactive	Resident	Agent	Health	10/4/2001	7/1/2004
* 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 Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	10/4/2001	1/6/2004
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	10/4/2001	1/6/2004
Inactive	Homesteaders Life Company	300836	Agent - Life	8/29/2011	9/28/2022
Inactive	Modern Woodmen of America	301213	Agent - Life	9/6/2002	7/17/2003
Inactive	Southern Financial Life Insurance Company	300664	Agent - Life	3/18/2014	12/29/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Barnett-Strother Funeral Home LLC	748555	Agent - Life	12/5/2011	8/1/2022