DEPARTMENT OF INSURANCE

Affiliations

Name	Haynes, Chasidy S	DOIID	1068105	NAIC NPN	19372086

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Resident	Agent	Life	1/21/2020	9/30/2026
Active	Resident	Agent	Property	2/2/2021	9/30/2026
Active	Resident	Agent	Health	9/7/2021	9/30/2026
Active	Resident	Agent	Casualty	2/2/2021	9/30/2026
* 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	07/15/2026	09/30/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	7/8/2021	6/28/2022
Inactive	American Modern Property and Casualty Insurance Company	301954	Agent - Property	7/8/2021	6/28/2022
Inactive	American Pet Insurance Company, Inc.	301240	Agent - Casualty	1/8/2024	4/7/2025
Inactive	American Pet Insurance Company, Inc.	301240	Agent - Property	1/8/2024	4/7/2025
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	7/28/2021	6/22/2022
Inactive	Bristol West Insurance Company	301655	Agent - Property	7/28/2021	6/22/2022
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	7/28/2021	6/22/2022
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	7/28/2021	6/22/2022
Inactive	Grange Indemnity Insurance Company	300793	Agent - Casualty	10/29/2021	6/23/2022
Inactive	Grange Indemnity Insurance Company	300793	Agent - Property	10/29/2021	6/23/2022
Inactive	Grange Insurance Company	300234	Agent - Casualty	10/29/2021	6/23/2022
Inactive	Grange Insurance Company	300234	Agent - Property	10/29/2021	6/23/2022
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Casualty	10/29/2021	6/23/2022
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Property	10/29/2021	6/23/2022
Inactive	Kansas City Life Insurance Company	301444	Agent - Life	11/1/2021	6/23/2022
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Life	10/6/2020	6/22/2022
Inactive	Milbank Insurance Company	925185	Agent - Casualty	6/7/2021	6/22/2022
Inactive	Milbank Insurance Company	925185	Agent - Property	6/7/2021	6/22/2022
Inactive	State Farm Fire and Casualty Company	301809	Agent - Casualty	7/1/2022	4/7/2025
Inactive	State Farm Fire and Casualty Company	301809	Agent - Property	7/1/2022	4/7/2025
Inactive	State Farm Life Insurance Company	301810	Agent - Life	7/1/2022	4/7/2025
Inactive	State Farm Mutual Automobile Insurance Company	301732	Agent - Casualty	7/1/2022	4/7/2025
Inactive	State Farm Mutual Automobile Insurance Company	301732	Agent - Health	7/1/2022	4/7/2025
Inactive	Trustgard Insurance Company	300104	Agent - Casualty	10/29/2021	6/23/2022
Inactive	Trustgard Insurance Company	300104	Agent - Property	10/29/2021	6/23/2022
Inactive	Woodmen of the World Life Insurance Society	301446	Agent - Life	8/26/2020	6/22/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Pending	Hub International Midwest Limited	398717	Agent - Life
Pending	Hub International Midwest Limited	398717	Agent - Casualty
Pending	Hub International Midwest Limited	398717	Agent - Property
Pending	Hub International Midwest Limited	398717	Agent - Health
Inactive	Insurance Partners of Kentucky LLC	806972	Agent - Life	4/12/2021	6/23/2022
Inactive	Insurance Partners of Kentucky LLC	806972	Agent - Casualty	6/7/2021	6/28/2022
Inactive	Insurance Partners of Kentucky LLC	806972	Agent - Property	6/7/2021	6/28/2022