DEPARTMENT OF INSURANCE

Affiliations

Name	Green, Sean William	DOIID	860194	NAIC NPN	17421493

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Life	11/18/2014	4/30/2017
Inactive	Resident	Agent	Health	11/18/2014	4/30/2017
Inactive	Resident	Agent	Property	11/14/2014	4/30/2017
Inactive	Resident	Agent	Casualty	11/14/2014	4/30/2017
* 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	5/25/2016	4/30/2017
Inactive	American General Life Insurance Company	301585	Agent - Life	5/25/2016	4/30/2017
Inactive	American Modern Home Insurance Company	300791	Agent - Casualty	1/23/2015	10/21/2015
Inactive	American Modern Home Insurance Company	300791	Agent - Property	1/23/2015	10/21/2015
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	1/23/2015	10/21/2015
Inactive	American Modern Select Insurance Company	581481	Agent - Property	1/23/2015	10/21/2015
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	1/23/2015	10/21/2015
Inactive	American Southern Home Insurance Company	626276	Agent - Property	1/23/2015	10/21/2015
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	1/15/2015	4/30/2017
Inactive	Bristol West Insurance Company	301655	Agent - Property	1/15/2015	4/30/2017
Inactive	Dairyland Insurance Company	301370	Agent - Casualty	1/20/2015	11/10/2015
Inactive	Dairyland Insurance Company	301370	Agent - Property	1/20/2015	11/10/2015
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	1/15/2015	4/30/2017
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	1/15/2015	4/30/2017
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	12/8/2014	10/15/2015
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Health	12/8/2014	10/15/2015
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	12/8/2014	10/15/2015
Inactive	Pruco Life Insurance Company	300954	Agent - Life	6/21/2016	4/30/2017
Inactive	Southern Farm Bureau Life Insurance Company	300909	Agent - Health	12/8/2014	10/15/2015
Inactive	Southern Farm Bureau Life Insurance Company	300909	Agent - Life	12/8/2014	10/15/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/8/2014	10/15/2015
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/8/2014	10/15/2015
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Life	12/8/2014	10/13/2015
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Health	12/8/2014	10/13/2015
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Property	12/8/2014	10/13/2015
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Casualty	12/8/2014	10/13/2015