DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Kusiak, Sherry Lynn	DOIID	1072373	NAIC NPN	8083028

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Independent Adjuster	Workers' Compensation	1/28/2020		3/31/2027
Active	Non Resident	Independent Adjuster	Property & Casualty	1/28/2020		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
Independent Adjuster	01/15/2025	03/31/2025	02/05/2025	02/05/2025	Yes

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Athens Program Ins Services LLC	948440	Independent Adjuster - Workers' Compensation	7/5/2023
Active	Athens Program Ins Services LLC	948440	Independent Adjuster - Property & Casualty	7/5/2023