DEPARTMENT OF INSURANCE

Affiliations

Name	Ray, Samuel Glenn	DOIID	735280	NAIC NPN	4596419

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Casualty	8/24/2010	7/31/2013
Inactive	Non Resident	Agent	Health	8/24/2010	7/31/2013
Inactive	Non Resident	Agent	Property	8/24/2010	7/31/2013
Inactive	Non Resident	Agent	Life	8/24/2010	7/31/2013
* 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 General Life Insurance Company	301585	Agent - Health	11/3/2010	3/19/2012
Inactive	American General Life Insurance Company	301585	Agent - Life	11/3/2010	3/19/2012
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	11/15/2010	9/25/2013
Inactive	American Modern Select Insurance Company	581481	Agent - Property	11/15/2010	9/25/2013
Inactive	Auto-Owners Insurance Company	301480	Agent - Casualty	1/14/2011	10/4/2012
Inactive	Auto-Owners Insurance Company	301480	Agent - Property	1/14/2011	10/4/2012
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	3/20/2013	7/31/2013
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/20/2013	7/31/2013
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	10/6/2010	3/21/2013
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Property	10/6/2010	3/21/2013
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	10/22/2010	9/13/2013
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	10/22/2010	9/13/2013
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	3/20/2013	7/31/2013
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/20/2013	7/31/2013
Inactive	Humana Insurance Company	301104	Agent - Health	3/20/2013	7/31/2013
Inactive	Humana Insurance Company	301104	Agent - Life	3/20/2013	7/31/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	3/20/2013	7/31/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	3/20/2013	7/31/2013
Inactive	Kanawha Insurance Company	300127	Agent - Health	3/20/2013	7/31/2013
Inactive	Kanawha Insurance Company	300127	Agent - Life	3/20/2013	7/31/2013
Inactive	Owners Insurance Company	300796	Agent - Casualty	1/14/2011	10/4/2012
Inactive	Owners Insurance Company	300796	Agent - Property	1/14/2011	10/4/2012
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	10/22/2010	5/28/2013
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	10/22/2010	5/28/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Wells Fargo Insurance Inc.	518950	Agent - Life	1/7/2011	3/19/2012
Inactive	Wells Fargo Insurance Inc.	518950	Agent - Health	1/7/2011	3/19/2012
Inactive	Wells Fargo Insurance Inc.	518950	Agent - Property	10/14/2010	2/6/2013
Inactive	Wells Fargo Insurance Inc.	518950	Agent - Casualty	10/14/2010	2/6/2013