DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Guy Steven	DOIID	712426	NAIC NPN	14798239

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Preneed Funeral	7/31/2026		1/31/2028
Inactive	Resident	Agent	Life	5/8/2014	2/1/2018
* 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	Kentucky Funeral Directors Life Insurance Company	532905	Agent - Life	8/27/2015	2/1/2018
Active	Kentucky Funeral Directors Life Insurance Company	532905	Agent - Preneed Funeral	8/25/2026

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CFH, Inc	695772	Agent - Life	8/28/2015	2/1/2018
Active	Gs Clark Holdings LLC	1478751	Agent - Preneed Funeral	8/25/2026