DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Slack, Timothy H	DOIID	634241	NAIC NPN	5444768

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	6/16/2006	3/31/2010
Inactive	Non Resident	Agent	Casualty	6/16/2006	3/31/2010
Inactive	Non Resident	Agent	Property	6/16/2006	3/31/2010
Inactive	Non Resident	Agent	Health	6/16/2006	3/31/2010
* 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	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	8/21/2006	3/31/2010
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	8/21/2006	3/31/2010
Inactive	American General Assurance Company	300586	Agent - Health	9/12/2006	3/31/2010
Inactive	American General Assurance Company	300586	Agent - Life	9/12/2006	3/31/2010
Inactive	Continental General Insurance Company	300691	Agent - Health	3/12/2007	12/3/2007
Inactive	Continental General Insurance Company	300691	Agent - Life	3/12/2007	12/3/2007
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009	3/31/2010
Inactive	Great American Assurance Company	300327	Agent - Casualty	7/27/2006	3/31/2010
Inactive	Great American Assurance Company	300327	Agent - Property	7/27/2006	3/31/2010
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/26/2009	3/31/2010
Inactive	Humana Insurance Company	301104	Agent - Health	11/14/2007	3/31/2010
Inactive	Humana Insurance Company	301104	Agent - Life	11/14/2007	3/31/2010
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	4/18/2007	3/31/2010
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	4/18/2007	3/31/2010
Inactive	HumanaDental Insurance Company	301457	Agent - Health	4/18/2007	3/31/2010
Inactive	HumanaDental Insurance Company	301457	Agent - Life	4/18/2007	3/31/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Flying J Ins Services Inc	541663	Agent - Life	8/21/2006	3/31/2010
Inactive	Flying J Ins Services Inc	541663	Agent - Health	8/21/2006	3/31/2010
Inactive	Flying J Ins Services Inc	541663	Agent - Property	8/21/2006	3/31/2010
Inactive	Flying J Ins Services Inc	541663	Agent - Casualty	8/21/2006	3/31/2010