DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Bosse Funeral Home Inc	DOIID	400021	NAIC NPN	7222102

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Life	12/11/2017		3/31/2027
* 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
Active	Cincinnati Equitable Life Insurance Company	641870	Agent - Life	12/15/2017
Inactive	Forethought Life Insurance Company	301407	Agent - Life	4/6/1998	6/17/2004
Inactive	Southland National Insurance Corporation	517954	Agent - Life	3/17/2009	12/28/2010

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Fahey, Martha J	386807	Agent - Life	4/6/1998	12/1/2000
Active	Moon, Paul Gary	1042618	Agent - Life	9/14/2021
Inactive	Reed, John Robert	373690	Agent - Life	10/10/2013	10/31/2017
Inactive	Wagner, James Miller	350251	Agent - Life	12/11/2017	6/30/2021