DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Stacy, Amy Denise	DOIID	588126	NAIC NPN	7951631

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	5/5/2004	7/1/2006
Inactive	Resident	Agent	Health	5/5/2004	8/3/2006
* 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	Augustar Life Insurance Company	301816	Agent - Life	5/18/2004	4/12/2006
Inactive	Empower Annuity Insurance Company of America	300259	Agent - Life	5/17/2004	3/28/2006
Inactive	Everlake Life Insurance Company	300873	Agent - Life	5/24/2004	2/27/2006
Inactive	Glenbrook Life and Annuity Company	301384	Agent - Life	5/24/2004	1/1/2005
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Health	5/24/2004	3/1/2006
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Life	5/24/2004	3/1/2006
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	5/19/2004	12/16/2004
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Life	12/16/2005	8/3/2006
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	5/18/2004	7/1/2006
Inactive	Western National Life Insurance Company	300461	Agent - Life	5/18/2004	4/18/2006

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 - Health	5/24/2004	3/1/2006
Inactive	U S Bancorp Ins Services L L C	400253	Agent - Life	5/18/2004	7/1/2006
Inactive	US Bancorp Investments, Inc.	572662	Agent - Health	5/24/2004	3/1/2006
Inactive	US Bancorp Investments, Inc.	572662	Agent - Life	5/18/2004	7/1/2006