DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Haynes, Rebecca Jean	DOIID	1172532	NAIC NPN	19744945

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	11/15/2021	11/30/2024
Inactive	Non Resident	Agent	Property	11/15/2021	11/30/2024
Active	Non Resident	Staff Adjuster	Property & Casualty	1/8/2024		11/30/2026
* 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
Staff Adjuster	09/15/2026	11/30/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Independence American Insurance Company	524747	Agent - Casualty	9/10/2023	11/30/2024
Inactive	Independence American Insurance Company	524747	Agent - Property	9/10/2023	11/30/2024
Inactive	United States Fire Insurance Company	582240	Agent - Casualty	11/18/2021	1/10/2024
Inactive	United States Fire Insurance Company	582240	Agent - Property	11/18/2021	1/10/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	PTZ Insurance Agency LTD	695420	Agent - Casualty	12/6/2022	11/30/2024
Inactive	PTZ Insurance Agency LTD	695420	Agent - Property	12/6/2022	11/30/2024