DEPARTMENT OF INSURANCE

Name	Shane Marcum Ford, LLC	DOIID	599970	NAIC NPN	8332563

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Inactive	Resident	Agent	Limited Line Credit	12/14/2004	3/31/2006

*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	101 S Main St Inez, KY 41224
Mailing	PO Box 313 Inez, KY 41224

Phone Information

Type	Phone
Business / Home Office	(606) 298-3535