DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Jackson, Jeremy Allen	DOIID	1046834	NAIC NPN	19224354

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	8/12/2019		10/31/2024
Active	Resident	Agent	Life	7/24/2019		10/31/2024
Active	Resident	Agent	Casualty	8/5/2019		10/31/2024
Active	Resident	Agent	Property	7/31/2019		10/31/2024
* 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	08/15/2024	10/31/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Modern Home Insurance Company	300791	Agent - Casualty	1/26/2023
Active	American Modern Home Insurance Company	300791	Agent - Property	1/26/2023
Active	Bristol West Insurance Company	301655	Agent - Casualty	9/12/2019
Active	Bristol West Insurance Company	301655	Agent - Property	9/12/2019
Active	Dairyland Insurance Company	301370	Agent - Casualty	9/23/2019
Active	Dairyland Insurance Company	301370	Agent - Property	9/23/2019
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	9/12/2019	12/20/2023
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	9/12/2019	12/20/2023
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	9/3/2019
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Health	9/3/2019
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	9/3/2019
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Health	9/3/2019
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Life	9/3/2019
Active	Trexis Insurance Corporation	599902	Agent - Casualty	9/12/2019
Active	Trexis One Insurance Corporation	684197	Agent - Casualty	9/12/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Designated Agent Company Inc.	681257	Agent - Health	10/12/2019
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Casualty	9/3/2019
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Life	9/3/2019
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Health	9/3/2019
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Property	9/12/2019