DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Kristin Clark Insurance Inc.	DOIID	509495	NAIC NPN	7223123

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		3/31/2026
Active	Resident	Agent	Life	6/2/2000		3/31/2026
Active	Resident	Agent	Casualty	8/15/2000		3/31/2026
Active	Resident	Agent	Health	6/2/2000		3/31/2026
Inactive	Resident	Agent	General Lines	6/2/2000	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	01/15/2026	03/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	9/1/2005
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	6/12/2021
Active	FB Insurance Company (The)	301763	Agent - Casualty	8/15/2000
Inactive	FB Insurance Company (The)	301763	Agent - General Lines	6/2/2000	8/15/2000
Active	FB Insurance Company (The)	301763	Agent - Property	8/15/2000
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	8/15/2000
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - General Lines	6/2/2000	8/15/2000
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	8/15/2000
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Health	6/2/2000
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Life	6/2/2000

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Clark, Kristin Conley	324567	Agent - Casualty	3/31/2003
Inactive	Clark, Kristin Conley	324567	Agent - General Lines	6/2/2000	8/15/2000
Active	Clark, Kristin Conley	324567	Agent - Health	3/31/2003
Active	Clark, Kristin Conley	324567	Agent - Life	3/31/2003
Active	Clark, Kristin Conley	324567	Agent - Property	3/31/2003