DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Berea Funeral Service Inc.	DOIID	401024	NAIC NPN	7222849

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	6/6/1996	5/8/2006
* 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	Columbian Life Insurance Company	300810	Agent - Life	6/4/1998	1/27/2003
Inactive	Forethought Life Insurance Company	301407	Agent - Life	6/6/1996	5/8/2006
Inactive	Reassure America Life Insurance Company	301902	Agent - Life	12/6/1999	1/3/2003

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Davenport, Janel Lakes	384152	Agent - Life	1/20/2004	5/8/2006
Inactive	Lakes, Manuel	331124	Agent - Life	6/6/1996	5/8/2006
Inactive	Powell, Gregory Glenn	321059	Agent - Life	6/6/1996	1/20/2004