DEPARTMENT OF INSURANCE

Affiliations

Name	Clemens, Carolyn Noreen	DOIID	364335	NAIC NPN	3239851

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Property	8/15/2000		4/30/2027
Active	Resident	Agent	Life	8/11/1986		4/30/2027
Active	Resident	Agent	Health	8/11/1986		4/30/2027
Active	Resident	Agent	Casualty	8/15/2000		4/30/2027
Inactive	Resident	Agent	General Lines	7/12/2000	8/15/2000
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	02/15/2025	04/30/2025	02/03/2025	02/03/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Benefit Life Insurance Company	301002	Agent - Life	6/23/2015	11/30/2022
Active	Atlantic Coast Life Insurance Company	642114	Agent - Health	8/23/2017
Active	Atlantic Coast Life Insurance Company	642114	Agent - Life	8/23/2017
Inactive	Everly Life Insurance Company	561641	Agent - Life	1/6/2017	11/14/2018
Inactive	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	10/9/2013	2/12/2018
Inactive	Forethought Life Insurance Company	301407	Agent - Life	3/25/2014	12/29/2016
Inactive	Golden Rule Insurance Company	301943	Agent - Health	1/3/2006	6/9/2008
Inactive	Golden Rule Insurance Company	301943	Agent - Life	1/3/2006	6/9/2008
Inactive	Great Western Insurance Company	501693	Agent - Life	10/9/2017	4/21/2025
Inactive	Homesteaders Life Company	300836	Agent - Life	12/27/2017	4/29/2019
Inactive	Independent Mutual Fire Insurance Company	300851	Agent - Casualty	10/24/2011	2/25/2013
Inactive	Independent Mutual Fire Insurance Company	300851	Agent - General Lines	7/12/2000	7/12/2000
Inactive	Independent Mutual Fire Insurance Company	300851	Agent - Property	10/24/2011	2/25/2013
Inactive	Liberty Bankers Life Insurance Company	542461	Agent - Life	4/16/2015	12/20/2022
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	11/10/2021	8/27/2024
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	11/10/2021	8/27/2024
Inactive	Midland National Life Insurance Company	300923	Agent - Life	9/28/2014	10/25/2017
Active	National Guardian Life Insurance Company	300596	Agent - Life	12/30/2016
Active	National Western Life Insurance Company	301515	Agent - Life	6/3/2013
Inactive	Pacific Life Insurance Company	301848	Agent - Health	5/26/2013	7/8/2015
Inactive	Pacific Life Insurance Company	301848	Agent - Life	5/13/2013	7/8/2015
Inactive	Southern Financial Life Insurance Company	300664	Agent - Life	10/26/2017	4/21/2025
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	11/2/2010	10/29/2015
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	11/2/2010	10/29/2015
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	8/12/2010	9/18/2018
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	8/12/2010	9/18/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	Legacy Planning And Solutions LLC	809055	Agent - Life	5/3/2013
Active	Legacy Planning And Solutions LLC	809055	Agent - Health	5/3/2013
Active	Secure Horizon Group	1355639	Agent - Life	1/21/2025
Active	Secure Horizon Group	1355639	Agent - Health	1/21/2025