DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, David Allen	DOIID	573506	NAIC NPN	7810365

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Life	6/29/2009	5/1/2013
Inactive	Resident	Agent	Health	6/29/2009	5/1/2013
* 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	Allianz Life Insurance Company of North America	301791	Agent - Health	3/26/2004	11/22/2007
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	3/26/2004	11/22/2007
Inactive	American Continental Insurance Company	643130	Agent - Health	3/28/2011	5/1/2013
Inactive	American Continental Insurance Company	643130	Agent - Life	3/28/2011	5/1/2013
Inactive	American Equity Investment Life Insurance Company	300389	Agent - Life	9/14/2006	5/1/2009
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	8/6/2009	1/19/2010
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	8/6/2009	1/19/2010
Inactive	Augustar Life Assurance Corporation	301113	Agent - Life	1/20/2004	3/1/2006
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	3/28/2011	5/1/2013
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	3/28/2011	5/1/2013
Inactive	Forethought Life Insurance Company	301407	Agent - Health	3/8/2011	5/1/2013
Inactive	Forethought Life Insurance Company	301407	Agent - Life	3/8/2011	5/1/2013
Inactive	Gerber Life Insurance Company	300529	Agent - Health	2/25/2011	12/26/2012
Inactive	Gerber Life Insurance Company	300529	Agent - Life	2/25/2011	12/26/2012
Inactive	Independent Order of Foresters	300743	Agent - Life	6/13/2011	11/16/2011
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	2/25/2011	12/17/2012
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	9/20/2012	5/1/2013
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	9/20/2012	5/1/2013
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	7/1/2011	5/1/2013
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	7/1/2011	5/1/2013
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	2/25/2011	12/17/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	2/25/2011	12/17/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Seniors Financial Group, Inc.	544154	Agent - Health	5/17/2011	11/10/2011
Inactive	American Seniors Financial Group, Inc.	544154	Agent - Life	5/17/2011	11/10/2011
Inactive	Continental Health Alliance LLC	667000	Agent - Health	6/13/2011	5/1/2013
Inactive	Continental Health Alliance LLC	667000	Agent - Life	6/13/2011	5/1/2013
Inactive	Walker Financial Services Inc.	399255	Agent - Health	1/18/2005	1/24/2007
Inactive	Walker Financial Services Inc.	399255	Agent - Life	1/18/2005	1/24/2007