DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Muse Jr, Jerry David	DOIID	583564	NAIC NPN	7983921

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	2/11/2004	12/1/2017
* 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	Cincinnati Equitable Life Insurance Company	641870	Agent - Life	1/16/2007	11/30/2017
Inactive	Columbian Life Insurance Company	300810	Agent - Life	6/2/2008	10/20/2011
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Life	7/28/2004	11/30/2017
Inactive	National Guardian Life Insurance Company	300596	Agent - Life	3/7/2005	4/11/2005
Inactive	Southland National Insurance Corporation	517954	Agent - Life	3/5/2004	1/21/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	West Somerset Funeral Home Inc	516172	Agent - Life	1/28/2005	3/31/2014