DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Fst Assoc Inc	DOIID	769820	NAIC NPN	1439085

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Denied	Non Resident	Agent	Casualty
Denied	Non Resident	Agent	Property
Inactive	Non Resident	Agent	Life	11/30/2011	3/31/2015
Inactive	Non Resident	Agent	Health	11/30/2011	3/31/2015
* 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	Berkshire Life Insurance Company of America	300983	Agent - Health	1/15/2014	3/31/2015
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	1/15/2014	3/31/2015
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	1/15/2014	3/31/2015
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	1/15/2014	3/31/2015
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	10/28/2013	3/31/2015
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	10/28/2013	3/31/2015
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	10/18/2013	4/23/2015
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	10/18/2013	4/23/2015
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	10/18/2013	4/23/2015
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	10/18/2013	4/23/2015

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Kendall, Mark C	501371	Agent - Health	11/30/2011	3/31/2015
Inactive	Kendall, Mark C	501371	Agent - Life	11/30/2011	3/31/2015