DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Republic Insurance Agency of Kentucky, LLC	DOIID	541390	NAIC NPN	7223423

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	11/19/2001	7/1/2006
Inactive	Resident	Agent	Health	11/19/2001	7/1/2006
* 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	Lafayette Life Insurance Company (The)	301039	Agent - Health	11/19/2001	1/22/2004
Inactive	Lafayette Life Insurance Company (The)	301039	Agent - Life	11/19/2001	1/22/2004

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Green, Jason A	506500	Agent - Health	11/19/2001	11/25/2002
Inactive	Green, Jason A	506500	Agent - Life	11/19/2001	11/25/2002
Inactive	Howard, Jason	524081	Agent - Health	3/24/2004	4/30/2006
Inactive	Howard, Jason	524081	Agent - Life	3/24/2004	4/30/2006