DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Jason Brian	DOIID	635872	NAIC NPN	8855261

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Casualty	1/24/2008	1/23/2009
Inactive	Resident	Agent	Life	8/9/2006	2/28/2009
Inactive	Resident	Agent	Property	1/24/2008	1/23/2009
Inactive	Resident	Agent	Health	8/9/2006	2/28/2009
* 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	AIG Assurance Company	300897	Agent - Casualty	2/1/2008	3/19/2008
Inactive	AIG Assurance Company	300897	Agent - Property	2/1/2008	3/19/2008
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	7/18/2007	2/28/2009
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	7/18/2007	2/28/2009
Inactive	American General Life Insurance Company	301585	Agent - Health	7/8/2007	2/28/2009
Inactive	American General Life Insurance Company	301585	Agent - Life	7/8/2007	2/28/2009
Inactive	Banner Life Insurance Company	301696	Agent - Health	8/1/2007	1/23/2009
Inactive	Banner Life Insurance Company	301696	Agent - Life	8/1/2007	1/23/2009
Inactive	Celina Mutual Insurance Company (The)	301908	Agent - Casualty	2/27/2008	12/2/2008
Inactive	Celina Mutual Insurance Company (The)	301908	Agent - Property	2/27/2008	12/2/2008
Inactive	Grange Indemnity Insurance Company	300793	Agent - Casualty	1/31/2008	12/19/2008
Inactive	Grange Indemnity Insurance Company	300793	Agent - Property	1/31/2008	12/19/2008
Inactive	Grange Insurance Company	300234	Agent - Casualty	1/31/2008	12/19/2008
Inactive	Grange Insurance Company	300234	Agent - Property	1/31/2008	12/19/2008
Inactive	Grange Life Insurance Company	300128	Agent - Health	8/9/2007	12/19/2008
Inactive	Grange Life Insurance Company	300128	Agent - Life	8/9/2007	12/19/2008
Inactive	Illinois National Insurance Company	301367	Agent - Casualty	2/1/2008	3/19/2008
Inactive	Illinois National Insurance Company	301367	Agent - Property	2/1/2008	3/19/2008
Inactive	John Alden Life Insurance Company	300573	Agent - Health	7/18/2007	1/23/2009
Inactive	John Alden Life Insurance Company	300573	Agent - Life	7/18/2007	1/23/2009
Inactive	MassMutual Ascend Life Insurance Company	300320	Agent - Life	8/30/2007	12/22/2008
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	8/15/2007	1/23/2009
Inactive	Plymouth Rock Assurance Preferred Corporation	301834	Agent - Casualty	2/1/2008	3/19/2008
Inactive	Plymouth Rock Assurance Preferred Corporation	301834	Agent - Property	2/1/2008	3/19/2008
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	8/9/2006	6/14/2007
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	8/9/2006	6/14/2007
Inactive	Trustgard Insurance Company	300104	Agent - Casualty	1/31/2008	12/19/2008
Inactive	Trustgard Insurance Company	300104	Agent - Property	1/31/2008	12/19/2008
Inactive	United World Life Insurance Company	300532	Agent - Health	8/15/2007	1/23/2009
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	8/15/2007	1/23/2009
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	8/15/2007	1/23/2009
Inactive	West Coast Life Insurance Company	301607	Agent - Health	7/30/2007	1/23/2009
Inactive	West Coast Life Insurance Company	301607	Agent - Life	7/30/2007	1/23/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Kenneth L Beard Insurance Inc.	398090	Agent - Health	7/25/2007	10/20/2008
Inactive	Kenneth L Beard Insurance Inc.	398090	Agent - Life	7/25/2007	10/20/2008
Inactive	Kenneth L Beard Insurance Inc.	398090	Agent - Casualty	1/31/2008	10/20/2008
Inactive	Kenneth L Beard Insurance Inc.	398090	Agent - Property	1/31/2008	10/20/2008