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	07/15/2024	09/30/2024	09/30/2024	09/30/2024	Yes

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
Active	American Pet Insurance Company, Inc.	301240	Agent - Casualty	1/8/2024
Active	American Pet Insurance Company, Inc.	301240	Agent - Property	1/8/2024
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
Active	State Farm Fire and Casualty Company	301809	Agent - Casualty	7/1/2022
Active	State Farm Fire and Casualty Company	301809	Agent - Property	7/1/2022
Active	State Farm Life Insurance Company	301810	Agent - Life	7/1/2022
Active	State Farm Mutual Automobile Insurance Company	301732	Agent - Casualty	7/1/2022
Active	State Farm Mutual Automobile Insurance Company	301732	Agent - Health	7/1/2022
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
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