DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Timothy Alan	DOIID	878493	NAIC NPN	17586044

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Limited Line Credit	5/20/2015	5/31/2018
* 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	Southern Financial Life Insurance Company	300664	Agent - Limited Line Credit	7/13/2016	5/31/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Jeff Wyler Florence Inc	400502	Agent - Limited Line Credit	7/13/2016	1/25/2018