DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Amburgey, Crystal	DOIID	1057763	NAIC NPN	19298860

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	10/18/2019		3/31/2027
Active	Resident	Agent	Casualty	10/29/2019		3/31/2027
Active	Resident	Agent	Life	10/18/2019		3/31/2027
Active	Resident	Agent	Property	10/28/2019		3/31/2027
* 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	01/15/2025	03/31/2025	02/04/2025	02/04/2025	Yes

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	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	4/13/2023
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	12/9/2019	12/20/2024
Inactive	Bristol West Insurance Company	301655	Agent - Property	12/9/2019	12/20/2024
Active	Dairyland Insurance Company	301370	Agent - Casualty	1/6/2020
Active	Dairyland Insurance Company	301370	Agent - Property	1/6/2020
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	12/9/2019	12/20/2023
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	12/9/2019	12/20/2023
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	11/8/2019
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Health	11/8/2019
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	11/8/2019
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Health	11/8/2019
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Life	11/8/2019
Active	Trexis Insurance Corporation	599902	Agent - Casualty	12/6/2019
Active	Trexis One Insurance Corporation	684197	Agent - Casualty	12/6/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Crystal S. Amburgey Insurance, LLC	1074868	Agent - Casualty	2/19/2020
Active	Crystal S. Amburgey Insurance, LLC	1074868	Agent - Life	2/19/2020
Active	Crystal S. Amburgey Insurance, LLC	1074868	Agent - Health	2/19/2020
Active	Crystal S. Amburgey Insurance, LLC	1074868	Agent - Property	2/19/2020
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Casualty	11/8/2019
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Life	11/8/2019
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Health	11/8/2019
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Property	12/9/2019