DEPARTMENT OF INSURANCE

Affiliations

Name	Kelly, Jim D	DOIID	539049	NAIC NPN	7219763

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Denied	Resident	Agent	Life
* 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 Funeral Directors Life Insurance Company	532905	Agent - Life	1/17/2002	4/30/2006

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	York Funeral Home Inc.	539499	Agent - Life	2/4/2004	4/30/2006