DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Butler Jr, Samuel Ansley	DOIID	575651	NAIC NPN	330611

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	9/5/2003	1/31/2010
Inactive	Non Resident	Agent	Health	9/5/2003	1/31/2010
* 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	Athene Annuity & Life Assurance Company	301798	Agent - Health	6/28/2006	8/21/2009
Inactive	Athene Annuity & Life Assurance Company	301798	Agent - Life	6/28/2006	8/21/2009
Inactive	Liberty Life Insurance Company	301542	Agent - Health	1/15/2004	6/30/2006
Inactive	Liberty Life Insurance Company	301542	Agent - Life	1/15/2004	6/30/2006

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Southwest Business Corporation	552783	Agent - Health	1/20/2004	8/21/2009
Inactive	Southwest Business Corporation	552783	Agent - Life	1/20/2004	8/21/2009