DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Shane Marcum Ford, LLC	DOIID	599970	NAIC NPN	8332563

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Limited Line Credit	12/14/2004	3/31/2006
* 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	Kentucky Home Life Insurance Company	300477	Agent - Limited Line Credit	1/1/2005	5/8/2006

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bowen, Larry Eugene	521901	Agent - Limited Line Credit	12/14/2004	5/8/2006
Inactive	Marcum, Michael Shane	313563	Agent - Limited Line Credit	12/14/2004	3/31/2006