DEPARTMENT OF INSURANCE

Name	Middlefork Insurance Agency Inc	DOIID	398433	NAIC NPN	7220888

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Property	8/15/2000	5/2/2002
Inactive	Resident	Agent	General Lines	6/1/1983	8/15/2000
Inactive	Resident	Agent	Life	9/13/1983	5/2/2002
Inactive	Resident	Agent	Casualty	8/15/2000	5/2/2002
Inactive	Resident	Agent	Credit Life & Health	9/12/1994	3/25/1996
Inactive	Resident	Agent	Assessment Chapter 299	12/22/1997	12/1/2000
Inactive	Resident	Agent	Crop	3/31/1994	5/2/2002
Inactive	Resident	Agent	Health	2/11/1988	5/2/2002

*If a status is Pending, Pending Replacement,or the record displays Affidavit on File, click on them for more details.

No License Renewal Information

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date.

Address Information

Type	Address
Business / Home Office	R. R. 3, Box 67 Booneville, KY 41314

Phone Information

Type	Phone
Business / Home Office	(606) 593-6268