DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Edward Gene	DOIID	587186	NAIC NPN	8018282

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Variable Life and Variable Annuities	3/31/2004	6/30/2005
Inactive	Non Resident	Agent	Life	3/31/2004	6/30/2005
Inactive	Non Resident	Agent	Health	3/31/2004	6/30/2005
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	4/14/2004	6/30/2005
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Variable Life and Variable Annuities	4/14/2004	6/30/2005
Inactive	Empower Annuity Insurance Company of America	300259	Agent - Life	4/13/2004	7/27/2005
Inactive	Everlake Life Insurance Company	300873	Agent - Life	4/14/2004	7/22/2005
Inactive	Everlake Life Insurance Company	300873	Agent - Variable Life and Variable Annuities	4/14/2004	7/22/2005
Inactive	Glenbrook Life and Annuity Company	301384	Agent - Life	4/14/2004	1/1/2005
Inactive	Glenbrook Life and Annuity Company	301384	Agent - Variable Life and Variable Annuities	4/14/2004	1/1/2005
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	5/18/2004	6/30/2005
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	5/18/2004	6/30/2005
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	3/4/2005	6/30/2005
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Variable Life and Variable Annuities	3/4/2005	6/30/2005
Inactive	John Hancock Variable Life Insurance Company	301914	Agent - Life	3/4/2005	6/30/2005
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Health	4/13/2004	7/15/2005
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Life	4/13/2004	7/15/2005
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Variable Life and Variable Annuities	4/13/2004	7/15/2005
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	3/11/2005	6/30/2005
Inactive	Nationwide Life Insurance Company	300495	Agent - Variable Life and Variable Annuities	3/11/2005	6/30/2005
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	4/13/2004	12/16/2004
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Variable Life and Variable Annuities	4/13/2004	12/16/2004
Inactive	Pacific Life Insurance Company	301848	Agent - Life	4/13/2004	6/30/2005
Inactive	Pacific Life Insurance Company	301848	Agent - Variable Life and Variable Annuities	4/13/2004	6/30/2005
Inactive	Protective Life Insurance Company	300638	Agent - Health	4/19/2004	7/7/2005
Inactive	Protective Life Insurance Company	300638	Agent - Life	4/19/2004	7/7/2005
Inactive	Protective Life Insurance Company	300638	Agent - Variable Life and Variable Annuities	4/19/2004	7/7/2005
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Health	4/19/2004	6/30/2005
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Life	4/19/2004	6/30/2005
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Variable Life and Variable Annuities	4/19/2004	6/30/2005
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Health	4/19/2004	6/30/2005
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Life	4/19/2004	6/30/2005
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Variable Life and Variable Annuities	4/19/2004	6/30/2005
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	4/12/2004	6/30/2005
Inactive	Transamerica Life Insurance Company	300571	Agent - Variable Life and Variable Annuities	4/12/2004	6/30/2005
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Life	4/22/2005	6/30/2005
Inactive	Western National Life Insurance Company	300461	Agent - Life	4/13/2004	7/25/2005
Inactive	Western-Southern Life Assurance Company	301590	Agent - Health	4/13/2004	7/1/2005
Inactive	Western-Southern Life Assurance Company	301590	Agent - Life	4/13/2004	7/1/2005
Inactive	Western-Southern Life Assurance Company	301590	Agent - Variable Life and Variable Annuities	4/13/2004	7/1/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	U S Bancorp Ins Services L L C	400253	Agent - Life	4/13/2004	6/30/2005
Inactive	U S Bancorp Ins Services L L C	400253	Agent - Variable Life and Variable Annuities	4/13/2004	6/30/2005
Inactive	U S Bancorp Ins Services L L C	400253	Agent - Health	4/13/2004	6/30/2005
Inactive	US Bancorp Investments, Inc.	572662	Agent - Life	4/13/2004	6/30/2005
Inactive	US Bancorp Investments, Inc.	572662	Agent - Variable Life and Variable Annuities	4/13/2004	6/30/2005
Inactive	US Bancorp Investments, Inc.	572662	Agent - Health	4/13/2004	6/30/2005