DEPARTMENT OF INSURANCE

Affiliations

Name	Everly, Josiah Clark	DOIID	565322	NAIC NPN	2061942

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	4/9/2003	11/30/2004
* 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	Union Security Insurance Company	301844	Agent - Life	4/9/2003	11/30/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Everly PFP, Inc.	513945	Agent - Life	4/10/2003	11/30/2004