DEPARTMENT OF INSURANCE

Affiliations

Name	Bouldin, Scott Alan	DOIID	684187	NAIC NPN	11066719

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Resident	Agent	Property	7/29/2008	3/31/2026
Active	Resident	Agent	Health	7/22/2008	3/31/2026
Active	Resident	Agent	Life	7/22/2008	3/31/2026
Active	Resident	Agent	Casualty	7/29/2008	3/31/2026
* 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 Home Insurance Company	301817	Agent - Casualty	9/22/2015	11/14/2021
Inactive	American Family Home Insurance Company	301817	Agent - Property	9/22/2015	11/14/2021
Active	American Modern Home Insurance Company	300791	Agent - Casualty	1/26/2023
Active	American Modern Home Insurance Company	300791	Agent - Property	1/26/2023
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	10/1/2018
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	10/1/2018
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	9/22/2015	11/14/2021
Inactive	American Modern Select Insurance Company	581481	Agent - Property	9/22/2015	11/14/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	9/22/2015	11/14/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Property	9/22/2015	11/14/2021
Active	Anthem Life Insurance Company	301209	Agent - Health	2/24/2010
Active	Anthem Life Insurance Company	301209	Agent - Life	2/24/2010
Active	Bristol West Insurance Company	301655	Agent - Casualty	10/16/2009
Active	Bristol West Insurance Company	301655	Agent - Property	10/16/2009
Active	Dairyland Insurance Company	301370	Agent - Casualty	9/3/2008
Active	Dairyland Insurance Company	301370	Agent - Property	9/3/2008
Active	FB Insurance Company (The)	301763	Agent - Casualty	7/29/2008
Active	FB Insurance Company (The)	301763	Agent - Health	7/22/2008
Active	FB Insurance Company (The)	301763	Agent - Property	7/29/2008
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	9/10/2009
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	9/10/2009
Active	Illinois Mutual Life Insurance Company	301479	Agent - Health	1/22/2023
Active	Illinois Mutual Life Insurance Company	301479	Agent - Life	1/22/2023
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	12/2/2008	12/30/2009
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	12/2/2008	12/30/2009
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	7/11/2014	1/21/2017
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	7/11/2014	1/21/2017
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	7/29/2008
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Health	7/22/2008
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	7/29/2008
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Health	7/22/2008
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Life	7/22/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	Designated Agent Company Inc.	681257	Agent - Life	12/16/2013
Active	Designated Agent Company Inc.	681257	Agent - Health	12/16/2013
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Casualty	8/1/2008
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Life	8/1/2008
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Health	8/1/2008
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Property	8/1/2008
Active	Scott Bouldin Insurance, Incorporated	796415	Agent - Casualty	10/31/2012
Active	Scott Bouldin Insurance, Incorporated	796415	Agent - Life	10/31/2012
Active	Scott Bouldin Insurance, Incorporated	796415	Agent - Health	10/31/2012
Active	Scott Bouldin Insurance, Incorporated	796415	Agent - Property	10/31/2012