DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Fields, Simon Paul	DOIID	584388	NAIC NPN	7996620

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Limited Line Credit	2/12/2004	9/30/2005
* 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	Investors Heritage Life Insurance Company	300363	Agent - Limited Line Credit	2/12/2004	9/30/2005
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Limited Line Credit	1/1/2005	9/30/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	B G Insurance Agency Inc.	400962	Agent - Limited Line Credit	3/3/2004	9/30/2005